TITLE: Increasing Laboratory Capacity to Support HIV/AIDS Care and Treatment

NEED and COMPARATIVE ADVANTAGE: The ASCP has been working with MOHSW in the strengthening

of in-service training since 2005. In 2007 ASCP started working with the schools of laboratory pre-service

training to review the curriculum and incorporate HIV standard of care tests, new technology, quality

assurance and laboratory management in order to ensure that trainees from the schools were well equipped

to work in the national laboratory network upon graduation. In FY 2008 ASCP will provide mentorship and

technical assistance to the school trainers for the reviewed curriculum by pairing faculty from US

Universities with each of the five zonal schools. As a national center for quality assurance, the National HIV

Quality Assurance Laboratory and Training Center (NHLQATC) will need to be accredited. In FY 2008

ASCP will work with the MOHSW to prepare the NHLQATC for international accreditation. ASCP will draw

expertise and resources from its partners in the Joint Commission International (JCI) and the ASCP Institute

Pre-Service Training Work Group. ASCP will complement the work with USG laboratory partners Clinical

and Laboratory Standards Institute (CLSI), the Association of Public Health Laboratories, and the American

Association of Microbiology (ASM) who will be assisting the NHLQATC with standards and document

preparation (CLSI), Laboratory information systems and strategic planning (APHL) and quality assurance

for opportunistic infections (ASM)

ACCOMPLISHMENTS: ASCP's accomplishments include: Training of Trainers for Chemistry, Hematology

and CD4; technical assistance for regional roll-out trainings; simplification of Chemistry, hematology and

CD4 modules to facilitate continued lower level trainings; curriculum gap analysis and workshop with

laboratory school faculty; development of supplemental materials to be presented to school tutors through

partnerships with US based Universities; Review and modification of facility-level Laboratory Management

modules and training of trainers for facility level management training.

ACTIVITIES: An ASCP consultant will provide two separate Technical Assistance trips (one month each

trip), focused on assisting with preparing National HIV Laboratory and Quality Assurance Training Centre

laboratory for accreditation. JCI will make an assessment of the NHLQATC to identify gaps. Based on this

assessment ASCP will make recommendations to MOHSW. ASCP will then develop a plan with MOHSW

for the accreditation of the NHLQATC

ASCP will collaborate with CLSI, ASM and APHL in mentoring and training laboratory personnel on the

implementation of minimum quality standards following which a re assessment of laboratories will be done

to assess accreditation readiness. JCI accreditation can help international health care organizations, public

health agencies, health ministries and laboratory users (clinicians and the public) to evaluate, improve and

demonstrate the quality of patient care in Tanzania. JCI accreditation standards are based on international

consensus standards and set to uniform, achievable expectations for structures, processes and outcomes

for laboratories.

ASCP will develop and institute continuing education and training programs for management, CD4,

Chemistry and Haematology targeting the NHLQATC managers and technical staff in preparing the training

center for national training programs to be conducted out of the NHLQATC

as part of its quality assurance activities.

Two ASCP consultants will provide six month Technical assistance (TA) to the schools for Laboratory

training (TBD). The consultants will be educators and each will work in a different school providing

mentorship to the tutors as well as teaching in subjects of their specialty. The purpose of the long-term TA

is to build human-resource capacity within zonal schools, give ASCP an opportunity to gain first-hand

knowledge regarding the implementation of standardized curriculum developed in collaboration with the

ASCP Institute Pre-Service Work Group, and Build sustainable relationships with in country faculty for future

twinning projects with US based universities. The technical assistance will also allow ASCP to assist with

developing a work plan to address faculty shortages in Tanzania Laboratory training Schools

LINKAGES: ASCP activities are closely linked with MOHSW, AMREF and other USG laboratory consortium

partners (CLSI, APHL,ASM) in implementing laboratory strengthening for HIV/AIDS. ASCP will work with

the Joint Commission International (JCI) for activities involving accreditation. ASCP will link with the Care

and Treatment partners through the coordination of MOHSW and CDC for insight into the needs of the care

and treatment partners in CD4, Chemistry and Hematology training.

CHECK BOXES: Human Capacity Development in Pre-Service training: This area is addressed by the Pre-

Service Technical Assistance within the Laboratory Schools and the Pre-Service Monitoring and Evaluation

activity, The Chemistry, Hematology, and CD4 training that will be conducted to Quality Managers and

NALQATC staff addresses this area.

Local Organization Capacity Building: Through the accreditation activities outlined above, ASCP will

strengthen the NHLQATC's capacity for quality testing, training and QA/QC.

M&E: With assistance from MOHSW, ASCP will develop specific tools that will assist with monitoring and

evaluating the implementation of the curriculum deliverables within the five zonal Laboratory Schools. The

M&E tools will include comprehensive surveys of faculty and students, face-to-face interviews with faculty

and principals, checklists reflecting new materials and equipment. ASCP will also develop a specific M&E

tool with indicators sufficiently specific to evaluate the effect of in-service trainings at point of service.

Approximately 12% of the budget is dedicated to monitoring and evaluating the effectiveness of this

program and its activities. Four consultants from the ASCP Pre-Service Work Group will monitor and

evaluate the pilot curriculum programs, visiting all 5 schools of Laboratory Sciences. This will be a 2-week

activity, complete formative assessment using checklists that address the use of previously developed

curriculum and survey in-country faculty regarding the effectiveness and practicality of the new curriculum

ASCP will Review 24-month goals set by Pre-Service Work Group and discuss with faculty if additional

materials, lectures, etc. are needed.

SUSTAINABILITY: The use of the Training of Trainers model for training builds training capacity within

Tanzania. The TOT model has been used for Hematology, Chemistry, CD4, and Laboratory Management

training. Additionally, the long-term Technical Assistance provided at the pre-service level will allow ASCP

to make realistic suggestions regarding strengthening the human resources within the schools. NHQALTC

accreditation will also contribute to sustainability by providing a national quality assurance laboratory

capacity to carry out quality assurance activities in the country which will serve to assure the Ministry of

Health, the Government, and licensing bodies and clinicians that laboratories are performing at a

recognized and required level of performance.

Activity Narrative: TITLE: Increasing Laboratory Capacity to Support HIV/AIDS Care and Treatment