This Component provides targeted support to create and render functional the regional laboratory network . Uganda, working in close collaboration with ECSA-HC, will lead the establishment of the network. It includes three sub-components:
- Diagnostic Services for Vulnerable Populations in Cross Border Areas
The first sub-component supports five satellite laboratories in each country (and six in Tanzania) to expand access to diagnostic services for vulnerable groups in cross border areas and to serve as sentinel surveillance sites to monitor hot spots for disease transmission. Bank financing will promote a systems approach to laboratory development based on quality management principles and include:
(i) Support for rehabilitation, expansion, and/or construction of laboratories at existing hospitals;
(ii) Provision of laboratory equipment and materials, including waste management equipment and protective gear to ensure the safety of lab personnel;
(iii) Acquisition of computer equipment, software, and technical support for integrated laboratory information systems to improve the quality of data generated and videoconferencing capacity to allow personnel across sites to consult each other and to have access to timely information about disease outbreaks; and
(iv) Provision of operating funds to render the laboratories functional, including strengthening human resources which are the backbone of quality diagnostics.
- Reference and Specialized Services and Drug Resistance Monitoring
The project will bolster the capacities of the Central Public Health Laboratories in the participating countries and network them to share information, conduct joint training and research, and collaborate in harmonizing policies and strategies.
This process will focus on the TB laboratory functions (which have been relatively neglected), supporting one of the labs to be upgraded to a Supranational Regional Laboratory (SRL).
- Disease Surveillance and Preparedness
The proposed project will complement ongoing regional and global initiatives to improve Integrated Disease Surveillance
and Response (IDSR) country systems. It will support the IDSR strategic goals to improve availability of quality information by:
(i) strengthening competence of lab and facility personnel to collect, analyze, and use surveillance data;
(ii) reinforcing lab networking and district capacity (particularly those in border areas) to report, investigate, and adequately respond to disease outbreaks; and
(iii) strengthening communications and data sharing to respond rapidly to
outbreaks. Kenya will take a lead in this area and work closely with the EAC health desk to harmonize tools, offer training and technical support, and serve as a center of excellence, documenting and sharing good practices in disease surveillance.
The project will support training in a range of institutions in Tanzania and in the other three countries and across the region. The recently constructed National Health Laboratory Quality Assurance and Training Centre in Tanzania will be established as a regional training center for the East Africa Community, providing up to date in-service training and post-graduate mentorships.
The Muhimbili University of Health and Allied Sciences will provide diploma and degree programs. Other regional training programs (such as the Arusha training organized by the International Union Against Tuberculosis and Lung Disease in collaboration with the Tanzanian National Tuberculosis/Leprosy Program) and other training centers like the African Center for Integrated Laboratory Training in Johannesburg will be supported, particularly for training trainers.
Each country has prepared and finalized a training plan which provides details of short and long term programs, including regional and longer term training in identified areas of laboratory sciences and field epidemiology.
It was agreed that the scope of all critical training programs supported under the project such as laboratory management, infection control and bio-safety, and disease outbreak investigation would be nation-wide, ensuring synergies with activities provided by other partners, while training programs linked to specific inputs provided under the project, such as rapid TB diagnosis and cultures, will be limited to staff working at the laboratories supported by the project.
In addition, a three-month certificate program with credits on leadership will be developed and introduced for laboratory managers to enhance career prospects. Trainees will include staff from private laboratories. In addition, the project will support fellowships in field epidemiology through the flagship FELTP program.
By project completion over 2000 laboratory specialists will have received training and a professional cadre of laboratory managers will be established in the sub-region. The training plans were reviewed and finalized during the appraisal mission.
Joint Operational Research & Knowledge Sharing and Regional Coordination and Program Management
The project finances relevant operational research which is related to activities supported under the project. The three main research priorities identified by countries relate to the need to:
(i) evaluate the effectiveness of the new TB related diagnostic technologies at the programmatic level,
(ii) assess drug resistance patterns for endemic diseases, and
(iii) ascertain the feasibility of using mobile phone technologies for weekly surveillance reporting of selected priority diseases. The evidence generated through this joint operational research will help inform public policy and the scale up of these interventions in the participating countries and in the region. As agreed during project preparation, Kenya would set up an operational research working group, and work closely with ECSA-HC. The project will fund:
(a) TA to support operational research;
(b) operating costs to organize workshops to share results; and
(c) training to boost capacities to conduct research.
A tentative list of criteria have been identified and include:
(i) relevance of proposal to activities supported under the project;
(ii) rigor of the methodology;
(iii) involvement of research groups from more than one participating country as a way to build regional capacity;
(iv) cost of proposal; and
(v)potential of research to inform public policy and practice.
- Sharing & Regional Coordination:
ECSA-HC will play a coordinating and convening role and be responsible for the following activities at the regional level:
Convene Technical Experts and Policymakers:
The organization will support the country-led working groups by providing a forum for discussions and deliberations. The ECSA-HC Secretariat will facilitate the work of technical partners (e.g. CDC, WHO) which will assist in harmonizing laboratory operating procedures and quality assurance systems. ECSA-HC will use its existing mechanisms (e.g. conference of health ministers; advisory committee of permanent secretaries) to share results from the regional project, and advocate for policy change at both the technical and policy levels.
- Facilitate Capacity Building and Training:
The ECSA-HC Secretariat will support countries to implement a regional study on human resources for laboratory services and one on public/private partnerships with a view to identifying options for enhancing the quality and efficiency of laboratory services, as described below; prepare policy briefs on HR issues; take stock of training institutions offering higher level training in laboratory services; and facilitate networking of laboratory managers by organizing bi-annual professional meetings.
- Establish a Forum for Learning and Knowledge Sharing:
The organization will facilitate exchanges of experiences; document best practices in laboratory networking in the region; work with their health journalist network to report on achievements and lessons; establish a peer review mechanism for reviewing research findings; and drawing policy conclusions to be brought to the attention of policy makers; maintain a repository of information on activities supported under the project which can be shared regionally; and prepare a regional communications strategy for disseminating main findings from the project, documenting the state of laboratories (before/after), and informing the public on related public health issues.