Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 12184
Country/Region: eSwatini
Year: 2010
Main Partner: University Research Corporation, LLC
Main Partner Program: NA
Organizational Type: Private Contractor
Funding Agency: HHS/CDC
Total Funding: $500,000

URC is an implementing partner for PEPFAR Swaziland in three separate but complementary areas, HVTB, HLAB and HVCT. The HVTB component supports Partnership Framework efforts to improve the management of TB/HIV co-infection and facilitate the roll out of a comprehensive HIV-related care package. The HVCT component focuses on expanding provider-initiated HTC as part of the effort to ensure a greater percentage of the population knows their HIV status. The HLAB component undertakes broad based efforts to build laboratory capacity in support of health systems strengthening and decentralization and is described more fully below.

The overall goal of this project is to strengthen laboratory quality assurance, quality management systems and to expand both HIV/AIDS and TB diagnostic services at all levels within the Swaziland health system through:

Provision of technical expertise in improving existing procedures and practices involving HIV/AIDS/TB diagnosis at the National Reference Laboratory (NRL) and peripheral laboratories and introduction of new technologies

Strengthening national capacity to lead and manage roll-out of adequate HIV & TB diagnostic services

Institutionalization of modern quality improvement approaches as an integral part of health care.

The URC/CDC laboratory project will contribute to the key intervention area, "Decentralized and improved quality of care and treatment services for adults and children, including HIV testing and TB/HIV" in the Partnership Framework (PF) and the care and treatment thematic area of the National Strategic Framework on HIV/AIDS 2009-2014 (NSF).

The University Research Corporation (URC)/ CDC Laboratory project works in all four regions of the country and covers all seven public hospital laboratories, seven health center laboratories as well as the 12 mini laboratories currently being established in the rural clinics. URC's strategy for strengthening laboratory services will build on the following principles:

ensuring strong country ownership;

integrating project activities within Swaziland's health systems to ensure long-term program sustainability;

capacity building through training/mentoring lab staff in quality assurance/quality management on both general lab-related and TB diagnostic services;

linking project activities with other PEPFAR and donor funded initiatives to increase returns on USG investments in the country; and

working with GKOS and other partners to ensure that laboratory services are strengthened as an important component to TB/HIV services.

The three URC projects will share costs of offices, procurement and financial management systems making the program to be more cost efficient.

URC has a full time M&E Officer to provide TA to the National Clinical Laboratory Services (NCLS). The Officer works closely with national systems to collect, collate, generate, analysis and disseminate data and information from facilities to national and international partners. The M&E Unit provides direct TA to facilities and national M&E staff to assure quality of data reported.

Currently, there is no electronic Laboratory Information System (LIS) to assist in data collection and utilization, which hinders evidence-based programming. Without electronic management of data, little research, monitoring of disease trends and detection of emerging diseases can be achieved. The three PEPFAR partners will support the introduction of a comprehensive LIS. The system will customized to a resource limited environment and local staff will be trained in its operation and maintenance.

Funding for Laboratory Infrastructure (HLAB): $500,000

HLABURC will provide direct TA and support to Laboratory organizational leadership in implementation of the 5 year laboratory strategic development plan (2008-2013) and policy, and enhance capacity development for laboratory supervisors. A rapid situational assessment will be conducted at the beginning of the project to inform detailed interventions and at each level and the report of the situational analysis disseminated to the MOH and relevant stakeholders. Quarterly review meetings will be supported to facilitate data reviews and quality improvement. Support will also be given to attend regional and international trainings.

In order to scale up existing interventions and initiate new interventions, the project will recruit two laboratory experts, one based at URC and working closely with the Director, National Clinical Laboratory Services and the other based at the National Referral Laboratory in Mbabane and working closely with the Quality Assurance Manager. The project will also support a limited number of laboratory staff to conduct lab test as well as those to facilitate a functional national laboratory sample transportation system and will assist in developing a comprehensive LIMS.

Strengthening laboratory management towards accreditation training (SLMTA) consists of three one-week trainings over a 9 month period targeted towards level II and level III laboratory technicians. The final training would be completed during COP10. Two 1 month long technical assistance and mentorship trips using various consultants will work with laboratories in Swaziland to create sustainability and work towards accreditation. URC will also sponsor two stakeholders from Swaziland to attend a Leadership Exchange Seminar in the United States, as well as visit the CDC lab in Atlanta. The meeting will offer the stakeholder an opportunity to learn about laboratory practices in the United States; it will also offer an opportunity to strengthen the relationship and partnership between Swaziland, CDC and URC.

Subpartners Total: $0
South African Medical Research Council: NA
National Institute for Communicable Diseases - South Africa: NA
Swaziland Standards Authority: NA
Cross Cutting Budget Categories and Known Amounts Total: $41,500
Construction/Renovation $1,500
Human Resources for Health $40,000
Key Issues Identified in Mechanism
Increasing gender equity in HIV/AIDS activities and services
Military Populations
Tuberculosis
Workplace Programs