Improving The Quality Of Laboratory Systems Through Strengthening Laboratory Management Towards Accreditation (Slmta) In Rwanda, 2010-2013

Background: Efficient and reliable laboratory services and networking are essential components of effective, well functioning health systems in disease surveillance. Therefore, improving the performance of clinical and public health laboratories is one of the main goals of strengthening health system. In July 2009, in Kigali, Rwanda saw the concurrent launch of World Health Organization Regional Office for Africa (WHO AFRO) stepwise framework for preparing laboratories to achieve ISO 15189 Standards and accreditation, and the Strengthening Laboratory Management Toward Accreditation (SLMTA) program. This study describes the achievements of Rwanda laboratories in the implementation of the SLMTA Program after 4 years of program implementation. Methods & Materials: The SLMTA programme in Rwanda was implemented since 2010, with three cohorts, each composed of 5 laboratories. A baseline laboratory audit, and exit audit was conducted in January 2010 and May 2011 where by a follow up audit took place in May 2012 for cohort 1 laboratories. In Nov 2011, a second cohort of district hospital laboratories (satellite) were enrolled with a baseline audit in November 2011, exit audit done in December 2012 and a recent follow up was in November 2013. In March 2013, a third cohort comprising another five district hospital laboratories has been enrolled with a baseline audit. Results: Audit results showed that one of the 15 enrolled laboratories had one star rating at baseline audit out of a maximum of 5 stars. However, after three sessions of SLMTA workshops and interspersing improvement projects, ten laboratories with exit audit, two achieved 1 star, two achieved 2 stars, five laboratories reach 3 stars and 1 laboratory reached 4 stars rating. At follow up audit in 2 cohorts, five laboratories reached four stars, five laboratories had three stars and one laboratory had two stars Conclusion: Rwanda laboratories enrolled in the accreditation process, achieved significant improvement in quality performance and disease surveillance. The SLMTA workshops, mentorship and quarterly performance based financing (PBF) audit played a big role in the accelerating improvements of Rwanda laboratories