Training and certification for POC sites and testers

1. ADVANCING THE LABORATORY PROFESSION AND NETWORKS IN AFRICA Training and certification for POC sites and testers Anafi Mataka ASLM IAS 2019 Satellite Session, Mexico City, 22 July 2019

2. Outline Introduction The Objectives Implementation

3. Introduction to Rapid Testing Competency • Priority area in laboratory quality improvement efforts for 90-90-90 goals • Major program component to effective screening, diagnosis, and viral load monitoring • The First 90 and Rapid Test Performance: False positives a problem?

4. Personnel and site certification  • ISO requirement – POCT - 22870 Clause 5.1.3 c: Only personnel who have completed the training and demonstrated competence shall carry out POCT. Records of training/attestation (or certification) and of retraining and re-attestation (or recertification) shall be retained. Review the RT site records Observe the RT site operations practical competence (100%) and written assessment (80%). Ask open ended questions Follow client specimen or result through the testing process

5. Introduction to Rapid Testing Competency • ASLM and Pan African Consortium offering TA finalization of certification frameworks and implementation of selected training programs • RTCQI best practices in PEPFAR-supported countries: Uganda, Ghana, Zambia, Malawi, Cameroon, and Tanzania. 20

6. The Objectives • To establish a national certification framework for HIV testers and testing sites • To improve the accuracy and reliability of HIV rapid testing through implementation of RTCQI best practices • To enhance the competency of HIV testers and testing sites towards national certification

7. Implementation

8. 1. National certification framework for HIV testers and testing sites

9. 1. National certification framework contents – Example

10. 1. National certification framework – Example

12. Maintenance of site and tester certification. Monitoring and Evaluation

13. 2. Improving the accuracy and reliability of HIV rapid testing through implementation of RTCQI best practices • Refresher training sessions in preparation for national certification activities have been conducted in all countries - Tanzania, Malawi, Ghana, Cameroon, Zambia and Uganda.. • 852 SITES enrolled

14. 3. Enhance the competency of HIV testers and testing sites towards national certification • Regional baseline assessments conducted to assess number of available testing facilities, testing points, testers, and establish targets for Year 1

15. 3. Auditors and Competence Evaluators Trained Trained site auditors and competency evaluators to support implementation of national certification activities

16. 3. – Cont - Conducted audits of HIV testing sites towards national certification Coverage of audited sites over 90% in all the 6 countries

17. Ongoing and planned activities • Tester Certification has started • Tanzania (139/166 non-laboratory testers were evaluated, of which 93 certified) • Other countries - not yet fully implemented • Site assessment – ongoing • EQA • Ongoing • Performance of EQA in a few countries

18. Key take home messages • Rapid HIV testing has been essential in meeting 90-90-90 goals • Competency – of testers is a requirement by international standards • Countries need to put in place systems and institutionalize continuous improvement of rapid testing and POC. • ASLM and the PAC has worked to develop national certification frameworks in 6 countries and hope to scale up to about 20 in the near future.

19. Thank You Become and ASLM member!