ART and Science: ASCP at the Center of the Laboratory Capacity Building in Resource-Limited Countries

1. ART and Science:ASCP at the Center of the Laboratory Capacity Buildingin Resource-Limited Countries Ian R Lemieux, RN, MPH, MLS(ASCP)CM ASCP Consultant Clinical Project Manager, Fenway Institute

2. Founded in 1922 • Leader in pathology and laboratory medicine in the United States • Inclusive membership unites pathologists and laboratory professionals to advance the profession • 130,000 members include: • Pathologists • Doctoral-level laboratory scientists • Laboratory professionals, including: • Pathologists’ assistants • Medical technologists • Cytotechnologists • Histotechnologists • Histologic technicians • Phlebotomists • Medical laboratory technicians

3. ASCP • Sponsors hundreds of workshops, symposia, teleconferences, e-courses, and self-study programs annually • Publishes of medical textbooks, reference manuals, slide atlases, audiovisual materials, and computer software, Critical Values, a quarterly newsmagazine, and two prestigious journals, the American Journal of Clinical Pathology and LABMEDICINE

4. Global Outreach • Cooperative Agreement with the CDC since 2005 • Scope of work: build laboratory capacity and support laboratory training and quality improvement • In-service • Laboratory Accreditation • Pre-service curriculum development

5. In-Service Training • Fill an immediate knowledge gap for practicing lab professionals • Provide material resources for on-going education in-country • Subject specific trainings in • Basic laboratory operations • CD4 • Clinical chemistry • Hematology • Laboratory management • Phlebotomy

6. ASCP Pre-Service Programs • Provide teaching tools serve to strengthen the institutions of learning and increase the knowledge and core competencies of the next generation of lab professionals • Goal is accomplished through the following activities • Revise or develop new curriculum • Improve faculty teaching and training skills • Develop new course content • ASCP Pre-Service program by the numbers • 11 countries • 38 MLS programs engaged • 28 MLS programs teaching finalized curricula • 2 countries graduating students educated entirely by new curricula

7. Laboratory Accreditation • One of two laboratory indicators for PEPFAR • Proves quality of laboratory results • Strengthening Laboratory Management Towards Accreditation (SLMTA) • Strengthen laboratory management • Achieve immediate laboratory improvement • Accelerate the process of accreditation

8. Thank you

9. Laboratory Work Force Development In Africa: ASLM-ASCP collaboration

10. ASLM MISSION To advance professional laboratory medicine practice, science, systems and networks in Africa needed to support preventive medicine, quality care of patients and disease control through partnership with governments and relevant organizations. ADVANCING THE LABORATORY PROFESSION & NETWORK IN AFRICA

11. 8 Strategic objectives Laboratory-Clinic Interface Laboratory Networks & Strategies Technical Assistance Laboratory Standards and Accreditation ASLM Research Capacity and Publication Laboratory Workforce Development Laboratory Policy Development Advocacy and Communication ADVANCING THE LABORATORY PROFESSION & NETWORK IN AFRICA

12. Human resource challenges in Africa High turnover Absence of standards Absence of rewarding system Absence of career structure Job dissatisfaction The shortage of qualified staff is a critical bottleneck to service provision, Shortage of qualified laboratory workforce Absence of recognition

13. Laboratory workforce development is one of the important pillars of ASLM • Develop the laboratory workforce in a comprehensive manner, • Laboratory workforce standards & norms, • Assessment of labs workforce gaps • Database development • Policy framework & country guidance, • Work with ASLM collaborating centers to build partnerships with universities to integrate internships and fellowships for continuing education for laboratory trainees and professionals.

14. Laboratory standard and accreditation All ASLM strategic objectives contribute to lab workforce development Laboratory policy development Laboratory and network and strategy Laboratory workforce development Research capacity and publication Career Development Advocacy and communication Technical assistance Laboratory-clinic interface

15. ASLM co organized the first Lab work force consultation with WHO-Afro and CDC (March 2012 • . Recommendations from the meeting: • Promote the establishment of national Laboratory Professional Regulatory Councils, which will: • -Define the code of conduct • - Minimum standards for training (pre- and in-service) • -Approving curriculum • -Accreditation of training institutes • -Licensing of lab professionals • -Define standard cadres and minimal qualifications for lab track • ASLM in collaboration with ASCP • To conduct systematic needs assessment for lab HRH in African countries • To develop laboratory HRH development strategy including the establishment of Lab professional levels (CLA, MLT, MLS, etc), Minimum competencies • Eligibility routes, Exams .. etc

16. Thank youwww.aslm.org Career Development

17. ART and Science:ASCP at the Center of the Laboratory Capacity Buildingin Resource-Limited Countries The Tanzania experience Dr Charles G MassambuAssistant Director, Diagnostic Services, MOHSW, Tanzania Project Director, Laboratory Services Strengthening Program

18. Geographic location of Tanzania

19. Lab Services in Tanzania National Health Labs (2) Zonal Hosp Labs (8) Regional Hosp Labs (30) District Hosp Labs (>100) Health Centre Labs (>500) Dispensary Labs (>5000)

20. Organizational framework Dept of Curative Services Diagnostic Services Section HLPC Lab Services PHLB Public sector Lab Support Program (CDC, WHO, GF, WB) Private sector NHLQATC LIS LQS Training HCTS

21. Challenges • In-service • Inadequate lab personnel • Brain Drain • Lack of career path for lab personnel to advanced degree • Inadequate competence in QMS, biosafety/biosecurity and modern diagnostic technologies • Varying level of knowledge, competences and confidences from one lab professional to another • Inadequate field exposure to lab QMS implementation and biorisk management and biosurveillance • Lack of accredited clinical laboratory

22. Challenges… 2 • Pre service • Questionable quality of lab school training • Inadequate number and capacity of lab schools • Critical shortage of faculty • Inadequate and non-standardized lab school curricula • Inadequate training materials and equipment • Inadequate infrastructure (Library, laboratory, computer lab) • Rapid changes in technologies and new emerging technologies

23. Strategic objectives • In-service • Improve lab personnel competences in QMS, biosurveillance, and biorisk management and modern diagnostic technologies through hands-on training, teach back, lab mentorship • Introduce mentorship and couching programs to regional and District hosp labs • Improve and strengthen field exposure and practical training • Introduce regional and district labs to WHO Afro Stepwise Accreditation using SLMTA/SLIPTA approach

24. Strategic objectives… 2 • Pre service • Improve quality of lab school training through supportive supervision, mentorship and sensitizing regulatory bodies on QMS and Quality Standards • Expand the number and capacity of lab schools • Increase the number of qualified lab school tutors • Review/develop and standardize lab school curricula • Improve the number and quality of lab school training materials and equipment • Improve lab school infrastructure (Library, laboratory, computer lab) • Review/update training curricula and SOPs

25. Strategic objectives… 2 • Capacity building • Laboratory Management • Lab School Assessment • Lab School Curricular Development • Lab Training Programs M&E • SLMTA ToT Training • Material support • Lab Equipment and TrainingMaterials • Technical support • Lab School Mentorship • SLMTA Implementation

26. Thank you