Detailed Mechanism Funding and Narrative

Years of mechanism: 2011 2012 2013 2014

Details for Mechanism ID: 13270
Country/Region: Ghana
Year: 2011
Main Partner: Global Health Systems Solutions Inc.
Main Partner Program: Ghana
Organizational Type: Private Contractor
Funding Agency: HHS/CDC
Total Funding: $350,000

The clinical laboratory system, part of the Ghana Health Service (GHS), is responsible for hospital laboratories in ten regional and 170 district hospitals. It is comprised of 406 private, quasi-government and government laboratories. The public health laboratory system, also part of GHS, is comprised of one National Public Health Reference Laboratory (NPHRL) and three zonal public health laboratories. A national health insurance bill has been passed into law by the parliament of Ghana which seeks to set up a National Health Insurance Scheme (NHIS), which would enable residents in Ghana to obtain, at least, basic healthcare services without paying money at the point of delivery of the service. NHIS has recently launched a new scheme, making it mandatory for laboratories to obtain accreditation/certification or risk losing the privileges provided by NHIS. Thus, MOH has shown strong commitment towards laboratory accreditation.

The Global Fund is a key donor in the area of laboratory services for screening, treatment, and monitoring HIV/AIDS patients including drug resistance. Though these services exist, the provision of quality laboratory services and the conduct of reliable diagnostic testing are still challenges in Ghana. The quality management systems (QMS) in the pre-analytical, analytical and post analytical process for laboratories has not been addressed as a whole. In order to leverage and coordinate donor laboratory efforts, USG support will be targeted to reinforce the basic scale-up assistance coming from the Global Fund and from PMI. USG support will build national capacity for QMS, trainings and the monitoring of laboratory quality through accreditation using the tools of external quality assessment (EQA), including Proficiency Testing (PT) programs.

USG Ghana's PF will support cost-effective, quality laboratory practices to promote reliable and accurate results, thus contributing to effective patient care. This will in turn build a positive attitude by patients towards testing. USG Ghana will work closely with the GOG to support zonal and regional laboratories identified by GHS in preparation for the accreditation process. This will include evaluating, developing, improving, and maintaining the laboratories QMS (managerial and technical) in compliance with the College of American Pathologists (CAP) and ISO 15189 requirements with the goal of accreditation. This will be a two to three year process.

**Please note that this mechanism represents the second of two grantees who are receiving money from the same cooperative agreement. It's part of the mechanism ID new013.*

Funding for Laboratory Infrastructure (HLAB): $350,000

**Please note that this mechanism represents the second of two grantees who are receiving money from the same cooperative agreement. It's part of the mechanism ID new013.*

Global Health Systems Solutions (GHSS) will receive funds to support the implementation of quality management systems. It will ensure that the NPHRL is accredited and will prepare zonal and regional hospital laboratories selected in consultation with the Ghana Health Service (GHS) for accreditation.

As each laboratory is unique, GHSS will continue to support the customization of the Quality System Essentials (QSEs) activities for each of the selected laboratories. GHSS will continue to mentor laboratory managers and support the implementation of the QSEs as the primary focal areas. Laboratories will continue to focus on QSEs identified by initial gap assessment and address them in a stepwise manner. The work plan will be carried out in phases: 1)implementation of milestones through mentoring program ; 2) continuing self-assessment of progress by the laboratory management; 3) quality improvement activities and on-going assistance based on needs. GHSS will continue to support training of laboratory managers trained to improve the quality of laboratory management within the network and provide mentorship.

As part of the quality management systems, the external quality assessment (EQA) is a critical component that includes on-site supervision and proficiency testing (PT) programs. GHSS will work closely with the NPHRL to reinforce existing quality assurance/quality control programs and to supervise the decentralization of EQA programs at the regional level and ensure national coveage.

GHSS will support the NPHRL to enroll in the digital program for proficiency testing for rapid testing. GHSS will implement a proficiency testing program for HIV at 200 HIV testing sites and organize training workshops on quality assurance for HIV testing for the Dried Tube Specimen (DTS) technology for EQA in serology, and printing and dissemination of standardized logbooks for use at all HIV testing sites. GHSS, in collaboration with NPHRL, will support the implementation of an EQA program for CD4, chemistry and hematology and enroll 20 testing facilities and laboratories in the program. GHSS will support the distribution of proficiency testing panels, collection of results, and supervisory activities.

GHSS will train a pool of 20 mentors to provide on-site mentoring for the 5 laboratories engaged in the accreditation process through 2011.

Cross Cutting Budget Categories and Known Amounts Total: $125,000
Human Resources for Health $125,000