ministry of health & child care · 1.1.2 the national blood services zimbabwe (nbsz) the nbsz...

Ministry of Health & Child Care

National Health Laboratory Strategic Plan

Government of Zimbabwe

2017 - 2021

ii

National Health Laboratory Strategic Plan 2017-2021

FOREWORD

Accurate and reliable diagnosis is the cornerstone of disease management and prevention. As such, medical laboratories are indispensable as they provide the diagnostic services that are critical to individual case management but also to disease surveillance, control and education. This Strategic Plan (2017 - 2021) is a major milestone in the journey towards quality, accessible and reliable laboratory services.

The value of laboratory services is often overlooked despite its vital contribution to the provision of cost effective quality health care. Laboratory results provide the only scientific approach to patient management allowing the clinician to make accurate diagnosis and rationalize drug use. It is estimated that 70% of all diagnosis depend on the laboratory.

In addition, laboratories play a vital role in epidemiological surveillance, control of infectious diseases such as cholera, TB, diarrheal diseases and other communicable diseases. With the launch of the 90-90-90 UNAIDS HIV Global targets, the role of the laboratory has even been more heightened for diagnosis of people with HIV and monitoring viral suppression for people receiving antiretroviral therapy. In addition, other emerging public health threats such as MDR and XDR TB, Ebola virus have demonstrated the weaknesses and the need to revitalise the Laboratory services.

The Ministry of Health and Child Care is committed to strengthening the coordination and quality of laboratory services to support the implementation of the National Health Strategy. Furthermore, maintaining a functional and effective national health laboratory services requires guidance, support and regulation through well laid down policies and strategies. The overall objective of this strategic plan is to provide a shared vision, goals and targets for the laboratory services for the period 2017 – 2021.

I wish to thank all who contributed to the development of this strategic plan and call upon all the stakeholders and partners to align their present and future activities with the guidelines laid out in this strategic plan. The successful implementation of this strategic plan will contribute significantly to improved health service delivery in general.

Bregadier General Dr G. GwinjiPermanent SecretaryMinistry of Health and Child Care


iii

The development of the Zimbabwe Health Laboratory Strategic Plan (NHLSP) involved the participation of stakeholders at different stages of the consultative process. In particular, the consultative process included planning meetings and review of key documents.The contributions of the following institutions and organizations are acknowledged for the development of this strategic plan

• Ministry of Health and Child Care for the leadership and guidance provided through the Laboratory Directorate

• UNICEF and CHAI for the financial and technical support throughout the development, drafting, finalization and printing of the plan

• The members of the Laboratory Community for their commitment and dedication in developing the strategic plan

• Partners such as EGPAF, JSI, MSF, and others for the dedicated participation and contributions to the creation of this strategic plans

I would like to acknowledge the consultants and all participants from the National Reference laboratories, Central and District hospital laboratories, other organizations and individuals for their significant contributions in revising the Zimbabwe Health Laboratory Strategic Plan.

ACKNOWLEDGEMENTS

Mr D. Mangwana Director Laboratory ServicesMinistry of Health and Child Care

iv


TABLE OF CONTENTS

FOREWORD...............................................................................................................................................ii

ACKNOWLEDGEMENTS..........................................................................................................................iii

TABLE OF CONTENTS.............................................................................................................................iv

ABBREVIATIONS AND ACRONYMS........................................................................................................vi

INTRODUCTION.........................................................................................................................................1

1. EXISTING LABORATORY SERVICES...................................................................................................2

1.1 Public facilities.......................................................................................................................................2

1.1.1 National Reference laboratories/Central/Province/District/Rural health centres................................2

1.1.2 The National Blood Services Zimbabwe (NBSZ)...........................................................................2

1.1.3 Government Analyst’s Laboratory...................................................................................................3

1.1.4 National Institute of Health Research.............................................................................................3

1.1.5 Central Veterinary Laboratory.........................................................................................................3

1.1.6 Zimbabwe National Quality Assurance Programme (ZINQAP)......................................................3

1.2 Private sector and other research institutions ..................................................................................4

2. SITUATION ANALYSIS...........................................................................................................................5

2.1 Laboratory organization and structure...............................................................................................5

2.2 Laboratory tiered network and referral..............................................................................................5

2.3 Legal and Regulatory Frameworks...................................................................................................6

2.4 Human Resources............................................................................................................................6

2.5 Laboratory Equipment and Commodities..........................................................................................6

2.6 Infrastructure.....................................................................................................................................7

2.7 Quality Management System (including Biosafety)............................................................................7

2.8 Laboratory Information System.........................................................................................................7

2.9 Research, development and Collaboration.......................................................................................8

2.10 Monitoring and Evaluation...............................................................................................................8

2.11 Financing Laboratory Services........................................................................................................8

2.12 SWOT ANALYSIS...........................................................................................................................9

3. THE STRATEGIC PLAN.................................................................................................................... 9

3.1 STRATEGIES..................................................................................................................................11

3.1.1 Laboratory organization and structure..........................................................................................11


v

3.1.2 Laboratory tiered network and referral.........................................................................................12

3.1.3 Legal and Regulatory Frameworks...............................................................................................13

3.1.4 Human Resources........................................................................................................................13

3.1.5 Laboratory Equipment and Commodities.....................................................................................14

3.1.6 Infrastructure ................................................................................................................................15

3.1.7 Quality Management System.......................................................................................................16

3.1.8 Biosafety......................................................................................................................................17

3.1.9 Monitoring and Evaluation............................................................................................................17

3.1.10 Laboratory Information System..................................................................................................18

3.1.11 Research, development and Collaboration.................................................................................18

3.1.12 Financing Laboratory Services...................................................................................................19

4.STRATEGIC PLAN MATRIX (2017 – 2021)......................................................................................20

4.1 LABORATORY ORGANIZATION AND STRUCTURE.....................................................................20

4.2 LABORATORY TIERED NETWORK AND REFERRAL..................................................................21

4.3 LEGAL AND REGULATORY FRAMEWORKS................................................................................23

4.4 HUMAN RESOURCES....................................................................................................................24

4.5 LABORATORY EQUIPMENT..........................................................................................................25

4.6 COMMODITIES..............................................................................................................................27

4.7 QUALITY MANAGEMENT SYSTEM...............................................................................................30

4.8 BIOSAFETY.....................................................................................................................................32

4.9 LABORATORY INFORMATION SYSTEM......................................................................................33

4.10. RESEARCH, DEVELOPMENT AND COLLABORATION.............................................................35

4.11 MONITORING and Evaluation......................................................................................................36

4.11 FINANCING Laboratory Services..................................................................................................37

5.PRIORITY STRATEGIC ACTIVITIES................................................................................................38

vi


BRTI Biomedical Research and Training Institute

DLS Department of Laboratory Services

GOZ Government of Zimbabwe

HIV Human Immunodeficiency virus

M&E Monitoring and Evaluation

MLCSCZ Medical Laboratory and Clinical Scientists Council of Zimbabwe

MOHCC Ministry of Health and Child Care

NBSZ National Blood Services Zimbabwe

NMRL National Microbiology Reference Laboratory

NTRL National TB Reference Laboratory

PT Proficiency Testing

EQA External Quality Assessment

QC/IQC Quality Control/ Internal Quality Control

UZ University of Zimbabwe

WHO World Health Organisation

ZINQAP Zimbabwe National Quality Assurance Program

ABBREVIATIONS AND ACRONYMS


1

Zimbabwe is a landlocked country situated in the southern part of Africa, with a total land area of 390,757 square kilometres. It shares borders with Zambia, Mozambique, South Africa, Botswana, and Namibia. The country has a population estimated at 12 million. It is divided into 10 administrative provinces, two of which are urban (i.e. Harare and Bulawayo). The provinces are in turn divided into 62 districts.

Zimbabwe is one of the countries within the Sub-Saharan region that are seriously affected by the HIV and AIDS pandemic. The HIV and AIDS in Zimbabwe is generalised and mature. The adult HIV prevalence is estimated at 15% and about 1.4 million are people living with HIV. Other priority diseases and conditions to be addressed are malaria and TB.

The Government of Zimbabwe desires to have the highest possible level of health and quality of life for all its citizens, attained through the combined efforts of individuals, communities, organizations and the government, which will allow them to participate fully in the socioeconomic development of the country. This vision will be attained through guaranteeing every Zimbabwean access to comprehensive and effective health services.

The country’s health care delivery is guided by the National Health Strategy. One of the National Health Strategy’ main objectives is to seek equity in health by targeting resources and programs to the most vulnerable and needy in the population. The public health system is built on primary health care services which are provided through rural health centres and rural hospitals in each of the rural districts.

The laboratory services in Zimbabwe has the responsibility to fulfil the needs of all patients and clients, and promote the health and well-

being of the public in the following service areas; public health and epidemiological needs, clinical health and the provision of safe blood and blood products, national reference laboratory function, quality assurance, teaching and research. These laboratories operate with minimum standard requirements for equipment, reagents and supplies, staffing levels and qualifications, repertoire of available tests at each level of the tiered system from Rural Health Centre right up to the National Reference Laboratories.

In Zimbabwe, the role of health laboratory services, as integral and important to both clinical and public health functions, is increasingly recognized. For years, public sector laboratory services and systems have been severely neglected. Despite this central role, strengthening laboratory services has, until recently received inadequate attention in the country. Unfortunately, these recent efforts have gone into improving disease specific control programs such as HIV/AIDS, TB, and malaria, where the funding has been available through global health initiatives.

There has been significant effort to improve and strengthen the quality of health laboratory services in Zimbabwe. However, there are still many challenges to be addressed such as operating with a limited budget, inadequately staffed laboratory facilities, inadequately maintained equipment, and inadequate supplies. This National Health Laboratory Strategic Plan aims at improving and strengthening the quality and management of health laboratory services at all levels of the healthcare delivery system. This will be achieved through complemented efforts involving the Ministry of Health and its partners.

INTRODUCTION

2


EXISTING LABORATORY SERVICES

Health laboratories refer to government institutions, private institutions, research and teaching institutions. The MOHCC laboratories are organized under the Laboratory Services Directorate covering the disciplines of Medical Microbiology, Chemical Pathology, Haematology, Histopathology and Blood Bank/ Blood Transfusion.

The Health Laboratory System has two major arms; first the public health laboratories that serve the department of epidemiology and disease control in the Ministry of Health and Child Care (MOHCC). These include institutions such as the Government Analyst and the (National Institute of Health Research) NIHR. These laboratories are community focused as opposed to clinical care of individual patients. The second arm of the laboratory system is the diagnostic laboratory service based in hospital institutions, independent private laboratory facilities and the National Blood Service of Zimbabwe (NBSZ), which is an independent body. The diagnostic laboratory services focus on patient clinical quality care. These laboratories include public health laboratories, mission laboratories, uniformed forces laboratories, local authorities, city council laboratories, national reference laboratories [National Microbiology Reference Laboratory ( NMRL), National Tuberculosis Reference Laboratory (NTBRL) & National Virology Reference Laboratory, (NVRL)], private clinical laboratories, veterinary laboratories, research laboratories, training institutions laboratories and Zimbabwe National Quality Assurance Programme,( ZINQAP).

1.1 Public facilities

1.1.1 National Reference laboratories/Central/Province/District/Rural health centres

A menu of tests for each level of services has been defined with reference laboratories offering reference services. Central hospital laboratories offer a greater range of more complex tests than provincial and district laboratories. At the lowest level the health centres offer low complexity testing (e.g. rapid HIV tests, malaria, malaria and TB smear microscopy and other point of care tests). Stand-alone VCT for HIV are also offered by NGO’s. Services are offered nationwide with an equitable distribution of health facilities.

1.1.2 The National Blood Services Zimbabwe (NBSZ)

The NBSZ is registered as a non-profit making company under section 26 of the Companies Act, Chapter 24:03 and is also registered as a private voluntary organization (WO/54/68) as required by the Private Voluntary Organizations Act, Chapter 17:05. The Service has managed to provide a nationally and internationally recognised and renowned blood service. The Service attained the WHO Collaborating Status and it was requested by WHO to be a Regional Quality Training centre. A Quality Management System based on ISO9001:2000 was introduced in 2004. The transfusion of blood and blood products is recognized as one of the essential therapeutic interventions in modern health care, hence, the service is commitment to provision of effective blood service. The donation of blood is governed by the Anatomical Donations and Post-Mortem Examinations Act, Chapter 15:01. The administration of the Act falls under the Ministry of Health and Child Care (MOHCC). Consequently, those operations of the NBSZ relating to the collection and use of donated blood are regulated by the Act. However, this does not make all the operations of the NBSZ accountable to the MOHCC. The National Committee is the

1


3

highest decision making body of NBSZ with responsibility to provide an enabling environment for management to implement agreed policies. The National Committee is made up of elected blood donors and co-opted members representing the MOHCC, the Secretary General of Zimbabwe Red Cross Society (ZRCS), National AIDS Council (NAC) and the Executive Secretary of National Association of Medical Aid Societies (NAMAS) and the Pledge 25Club Chairperson. From NBSZ, the Chief Executive Officer, Medical Director, Bulawayo Branch Manager are ex-officio members of the National Committee.

The NBSZ provides safe blood and blood products to all hospitals in Zimbabwe and is the sole provider of this service. Its main customers are MOHCC, mission and private hospitals. MOHCC by virtue of it being the largest provider of healthcare in Zimbabwe is also its largest customer. It is internationally accredited and recognized as a centre of excellence.

1.1.3 Government Analyst’s Laboratory

The Government Analyst’s Laboratory is funded directly by MOHCC and is situated in Harare. It is the reference laboratory for all chemical analysis in public health and organizationally it is divided into units namely: Customs and Industrial, Clinical and Toxicology; Food Unit, Waters Division, Urine and Iodine Laboratory.

1.1.4 National Institute of Health Research

The National Institute of Research formerly Blair Research Institute of the Ministry of Health & Child Care is situated in Harare and its core business is research in biomedical sciences, communicable and vectors borne diseases, health systems policies and technologies. It has well qualified staff and has an active research program that provides useful information to support government health policies and information to program managers to

combat the most prevalent diseases. It is organized into 3 sectional departments namely Vector Borne Diseases, Communicable & Infectious Diseases, Health Systems & Technologies and two support units. The Support units are divided into administration and technical support services; the laboratory is one of these support units that provide services to the research activities. The laboratories are in microbiology, immunology, molecular biology, schistosomiasis, serology and malaria and mainly support research activities.

1.1.5 Central Veterinary Laboratory

It belongs to the Department of Veterinary Services, Ministry of Lands and Agriculture. It is the referral laboratory and part of a network of veterinary laboratories with services decentralized to the provincial laboratories. It plays a key role in zoonosis control. Its main services are disease diagnosis, outbreak investigations and disease preparedness, specialist referral and advisory service, and research. It collaborates with a number of overseas research institutes in research projects and with the University of Zimbabwe (UZ) and National Institute of Health Research. It receives specimens from National Public Health Laboratories for specialist tests, Environmental Health Department and private veterinarians. It participates in reporting notifiable diseases to the Health Information System, Department of Epidemiology &Disease Control. It provides also attachment training for students from the UZ.

1.1.6 Zimbabwe National Quality Assurance Programme (ZINQAP)

The Zimbabwe National Quality Assurance Program (ZINQAP) was established in 1995 with a mandate to assist all laboratories in Zimbabwe attain and maintain a high standard of performance and to improve the quality of testing services. It is the only laboratory quality assurance body in Zimbabwe conducting a proficiency-testing

4


program. It attained international accreditation to SANAS ISO Guide 43 in February 2005 and later to the SANAS ISO 17043:2010, making it the first internationally recognized PT body in Zimbabwe and the second in Africa to attain this standard. It provides a comprehensive PT service to 130 medical laboratories both public and private and testing sites in Zimbabwe. These laboratories perform at different levels of participation and complexity in the major laboratory disciplines which include Immunology, Microbiology, Haematology/Blood Transfusion Medicine and Clinical Chemistry. ZINQAP’S organizational structure is made up of a Board of Trustees which oversees the work of the organization.

1.2 Private sector and other research institutions

In Zimbabwe, the capacity of the public sector to provide quality and accessible health care services

to the citizens is complimented by private providers. The largest of these are CIMAS Laboratories, Premier Laboratories and Clinical Laboratories. Public-private partnerships have existed at various levels for many years with cross referral of specimens and joint training and technical committees.Other non-governmental research institution exists and includes Biomedical Research and Training Institute (BRTI) and the African Institute of Biomedical Science & Technology (AIBST).


5

2.1 Laboratory organization and structure

Zimbabwe has a well-developed heath care delivery system. The laboratory services are coordinated by the Laboratory Directorate, a department under the Ministry of Health and Child Care. The Laboratory Directorate operates an integrated tiered network consisting of over 170 Registered diagnostic centres/ Laboratories operating at five main levels organized along the referral chain of health service delivery as indicated below:

SITUATION ANALYSIS

National Reference Laboratories

Central Hospital Laboratories

Provincial Hospital Laboratories

District / Mission Hospital

Rural Health Centres

The current laboratory services are organised to serve both clinical and public health needs. As a result, the national laboratory services, as part of the national health system, support curative, preventative and public health components of the health system.

The health laboratory services are geared towards clinical care and are based in health facilities which falls under the department of clinical services. This has raised complications in reporting, significantly compromising DLS ability to manage and coordinate the services in the country. Linkages

between the laboratories at different levels remain weak because of lack of focal persons at Provincial and District level. The DLS sometimes has an overwhelming task of directly interfacing with the more than 170 labs in the country which severely limits top supervision and technical support to these lower facilities. This also overwhelms the limited staffing at Directorate that currently consists of the Laboratory Director, Deputy Laboratory Director, TB Focal person and the Logistics Coordinator.

2.2 Laboratory tiered network and referral

Except for private laboratories, most laboratories in Zimbabwe are essentially based in health care facilities with their complexity increasing with the level of the facility. There is one district hospital in each district. District hospitals in turn refer to the provincial or central hospitals. Most the laboratories are at district level including mission hospitals. There are five central hospitals that provide tertiary and quaternary health care services in the country. Local authority or municipal clinics provide much of the primary health care in both rural and urban areas. Faith based organisations are a major provider of the health services in most rural areas.

There has been a general deterioration of laboratory services where the tiered system has failed to provide the standard package of laboratory tests in support of the health delivery system at each level of healthcare. Although test menu is defined at each level of the tiered system, many laboratories are not able to consistently fulfill the testing requirements due to lack of personnel, frequent stock out of supplies and lack of or frequent breakdown of equipment. This has resulted in patients seeking services from the private sector where the costs are unaffordable and continue to increase beyond the reach the average Zimbabwean. In some cases,

2

6


complex tests or functions are being performed in even lower tiers which previously would not.

The laboratory services are intended to function as a network with a system that allows for referral of specimens or patients to the next level. This type of referral system is currently not functional largely due to resources needed at each level. Only donor supported services such T.B, and early infant diagnosis of HIV, have clearly defined and functional referral systems that run from the lowest level to the central or national level. However, there have been recent efforts to build an integrated sample referral system to address this gap.

2.3 Legal and Regulatory Frameworks

The Medical Laboratory and Clinical Scientists Council of Zimbabwe is a statutory regulatory body enacted by an Act of Parliament of the Republic of Zimbabwe under the Health Professions Act Chapter 27:19 of 2001, which is responsible for the licensing of medical laboratory personnel, medical laboratories/test sites and setting of standards of training for medical laboratory personnel. The Council also oversees the regular monitoring of laboratories during regular supervisory visits.

Over the years, the capacity of the Council has been limited largely due to underfunding and understaffing. The lack of funding has restricted the council’s capacity to implement its regulatory role and this has led to many laboratories operating without proper registration of staff or the facilities themselves. With the advent of Point of Care testing, classification, registration and licensing of non-laboratory personnel has remained loosely defined.

2.4 Human Resources

The Department of Medical Laboratory Sciences at the University of Zimbabwe is involved in the training

of the bulk of the Medical Laboratory Scientists who are involved in carrying out laboratory diagnosis of various diseases. However, human resources remain a major challenge as experienced Medical Laboratory Scientists and those graduating from the Department of Medical Laboratory Sciences at the University of Zimbabwe College of Health Sciences continue to leave the country into the region and overseas. This has affected the capacity to provide laboratory services in most part of the countries especially in the peripheral areas. For those who have stayed, they are poorly motivated e.g. due to low remuneration.

Different strategies have been rolled out to ensure at least laboratory facilities are manned by trained cadres. Programs for training lower cadres such as SCMLT and microscopists are ongoing to try and address the staffing gaps in many laboratories.

The pre-service training curricula need to be revised and standardised to meet the country’s needs in terms of technology changes and new concepts. Laboratory associations are not yet visible in Zimbabwe and therefore there are no opportunities to train, motivate and improve ethical standards of their members.

2.5 Laboratory Equipment and Commodities

The Laboratory Directorate together with its partners have developed a Harmonisation and standardisation guideline for procurement and placement of equipment. This is a document that will be guiding the equipment selection, procurement and deployment to the different tiers of laboratory services. However, many laboratory stakeholders have not been sensitized on the Harmonisation and standardisation guidelines. As such, many partners purchase equipment with varying specifications leading to difficulties in their servicing and maintenance. Currently old and existing have no service and maintenance plans.


7

Mechanisms for disposal of obsolete equipment are not effective in most facilities leading to space challenges within the laboratories. Introduction of technology has been hampered by lack of clarity on the process of equipment evaluation and the institutions coordinating these evaluations.The establishment of a laboratory Logistician working with the logistics sub unit (LSU), has substantially improved coordination, procurement and supply management of laboratory commodities. This unit is responsible for forecasting, quantification, procurement and distribution of all commodities (Laboratory Equipment and Reagents/ Consumables). While the Logistic unit has greatly improved the supplies situation in the country, the list of supplies is usually HIV related and as a result other tests have stock outs. At the facilities, personnel are often not knowledgeable about logistics management and as a result there is overstocking in a bid to make sure their laboratories have adequate supplies. This has contributed to reagents expiring in many laboratories and in turn reducing the storage space. The process for disposal of expired reagent is not efficient.

2.6 Infrastructure

Most of the hospitals and health facilities in Zimbabwe benefited from the DANIDA project that built hospital laboratories. These laboratories were built following the standard laboratory infrastructural guidelines. However, there are some hospital that still are having infrastructural challenges where the laboratory space was not originally designed for laboratory testing. The majority of these health laboratory facilities in the country have not undergone regular routine maintenance since they were constructed years ago. Renovations are needed for some as scope of testing has been changing over time. The greatest challenge has been space that is being taken up by obsolete equipment and expired reagents.

2.7 Quality Management System (including Biosafety)

Since 2010, several Quality Management System training programs have been initiated in Zimbabwe to support laboratories improve their quality of testing and results. One of the training program was the Strengthening Laboratory Management Towards Accreditation (SLMTA) program and the WHO AFRO Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA) program. Although these programs were well received, they have had limited coverage in reaching to all laboratories. There has also been continuing challenges in the roll out of the Quality training programs resulting in declining culture of quality. This decline has caused loss of trust in the laboratory services by both clinicians and patients. Most laboratories are not verifiably compliant with basic quality standards. There is also lack of a national certification program to oversee the implementation of minimum standards for quality in Zimbabwe for all laboratories.An external quality assessment (EQA) scheme exist in the country and is overseen by the Zimbabwe National Quality Assurance Program (ZINQAP). However, the scheme is limited in scope and coverage. Participation of laboratories in the EQA programs is still left to the laboratories to decide and as such many laboratories participate irregularly and inconsistently.

Biosafety programs still need to be developed and rolled out to the laboratories.

2.8 Laboratory Information System

Paper based laboratory information system remains the main tool for the collection and storing of results of patients. In many laboratories, this

8


information is still kept in files and logbooks. However, there is no mechanism to ensure a flow of this information in a collated way to the next level up to the national level. There is a need for a National Laboratory Information System that manages and disseminates data.

There are electronic LIS platforms that have been developed and are in use to support delivery and management of laboratory results. However, these LIS are currently disease or program specific such as EID and TB program. An integrated LIS approach will address the disparities in managing and disseminating laboratory data. The currently laboratory paper based information is not linked to the MOHCCDHIS for effective integration of laboratory data.

2.9 Research, development and Collaboration

Currently, there are no coordinated mechanisms for conducting operational research geared at improving laboratory service delivery. While research institutions and Universities exists within the country, and have the capacity to conduct research, there not efforts to create linkages and

collaborations with the public health laboratories. This is also compounded by the inadequate capacity among the majority of laboratory professionals to exploit these data, develop proposals and conduct operational research.

2.10 Monitoring and Evaluation

Currently there is no effective system or measurable indicators to assess the laboratory system’s performance on whether it is effectively supporting the service delivery. There is lack of clearly defined laboratory indicators and M & E tools. Where M&E is happening, It is vertical and related to specific funded programs. There is a need to develop M&E tools and indicators that support the delivery of laboratory services.

2.11 Financing Laboratory Services

The health laboratory services are grossly under-funded. This urgently needs to be addressed. This has been compounded by inadequate systems and skills for planning the utilization and for accounting for the limited resources invested in laboratory service delivery.


9

2.12 SWOT ANALYSIS

Strengths

• Laboratory Directorate in place

• MLCSCZ in Place

• Logistic Unit in place

• Laboratory infrastructure in most hospital facilities

• Documented laboratory tiered system

• ZINQAP supporting the national EQA program

• Availability of research institutions and universities involved in research

• Training Universities for the Laboratory personnel

• Existence of laboratory budget line

Weaknesses

• Non-standardized equipment and reagents

• Stock-outs especially for non-HIV tests

• Lack of registering and monitoring of all laboratories

• Inadequate servicing and maintenance plans

• Frequent breakdown of equipment

• Inefficient obsolete equipment and expired reagents disposal mechanisms

• Weak specimen referral system

• Declining culture of quality

• Weak collaboration between the existing research institutions and the general health laboratories

• Lack of clearly defined laboratory indicators and M&E tools

• No National Laboratory Information System that manages and disseminates data

• Inadequate budgetary allocation for laboratory services

10


Opportunities

• Harmonisation and Standardisation guidelines in place

• Existing program specific sample referral systems and piloted integrated sample referral system

• Technical working groups

• Newly formed Laboratory association

• Existing program specific electronic LIS

• Role of laboratory recognized and elevated by programs such as UNAIDS 90-90-90 targets

• Funding support from laboratory partners

• Institutionalization of the SLIPTA program for certification of laboratories

Threats

• Limited staffing at Directorate level

• Lack of the National certification program and Quality Assurance department

• Lack of accredited NRLs

• Staffing challenges


11

This National Health Laboratory Strategic Plan (NHLSP) is developed to implement the Zimbabwe National Health Laboratory Policy - 2015. The NHLSP is an important document to articulate the shared vision, goals and targets for the laboratory services for the period 2016 – 2020. It will serve as a basis for advocacy, resource mobilisation and programming during this period. The five year NHLSP will provide a clear road map in the form of strategies and a plan of action. In the next five years, the NHLSP will execute the listed activities with the Director of Laboratory services providing leadership.

The NHLSP gives strategic direction in 11 strategic areas namely:

1. Laboratory organization and structure

2. Laboratory tiered network and referral

3. Legal and Regulatory Frameworks

4. Human Resources

5. Laboratory Equipment and Commodities

6. Infrastructure

7. Quality Management System (including Biosafety)

8. Laboratory Information System

9. Research, development and Collaboration

10. Monitoring and Evaluation

11. Financing Laboratory Services

Vision

To provide the best, high quality evidence based laboratory services, which are accessible and affordable to the population of Zimbabwe.

THE STRATEGIC PLAN

Mission Statement

To timeously provide the best quality laboratory services and results to clients, in order to fulfil the laboratory services role in the health delivery system.

Good governance

The following principles will guide the implementation of this policy:

a. Efficient and effective utilisation of resources

b. Integrity and honesty

c. A transparent system shall be in place to ensure programmatic and financial accountability of the laboratory services

d. Ethic

3.1 STRATEGIES

3.1.1 Laboratory organization and structure

Policy Objective

To have a clear organizational structure with appropriate authority to coordinate and manage the provision of comprehensive health laboratory services at all levels in the country.

Specific objective

1. To strengthen the Directorate in order

3

12


to provide adequate administrative and technical oversight over laboratory services across all agencies and the private sector.

2. To facilitate and enhance service provision across all tiers of the laboratory systems.

Strategic activities

1. Create and recruit focal persons for the following areas: Quality Assurance, M&E/ Research and Development, ICT & LIMS.

2. Support the national laboratory logistician to continue to have oversight on procurement of laboratory commodities

3. Strengthen the role of Laboratory Technical Working Group (TWG). There shall be one TWG with Terms of Reference (TORs) defined by DLS with members co-opted according to specific needs defined by DLS

4. Create posts for Provincial and district laboratory managers

5. Provide resources and technical capacity to the appointed focal personnel at all tiers

6. Conduct quarterly feedback meetings with all laboratory staff and key stakeholders

7. Conduct annual review of laboratory plans

3.1.2 Laboratory tiered network and referral

Policy Objective

To provide laboratory services appropriate to each level and that meets the needs for the delivery of health services at that level.

Specific objective

1. To ensure equitable coverage and access to high quality laboratory services

2. To strengthen the specimen referral system


1. Disseminate approved guidelines for the test menus for all tiers to all laboratories

2. List commodity requirements for the test menus to assist with annual budget planning

3. Approve and disseminate the harmonization and equipment standardization requirements for each level of health care

4. Procure conventional equipment and distribute according to testing complexity at each level

5. Develop and implement a plan to enhance the capacity for standardized laboratory testing

6. Increase access to laboratory services through appropriate POC diagnostics

7. Ensure appropriate deployment of skilled laboratory personnel to all levels

8. Promote rational and appropriate use of laboratory services among clinicians, laboratory practitioners, and the general public

9. Support and expand the NMRL into a multi-disciplinary referral laboratory

10. Strengthen the NRL’s to provide laboratory support necessary for disease surveillance, investigations and management of outbreaks


13

11. Design an integrated specimen and results transportation system

12. Develop effective guidelines for specimen referral and result reporting

13. Pilot the integrated specimen and results transportation system

14. Implement the integrated specimen and results transportation system in all the laboratories

3.1.3 Legal and Regulatory Frameworks

Policy Objective

To ensure registration, licensing, education and discipline in the medical laboratory professions and maintenance of quality standards for laboratories

Specific objectives

1. To strengthen professionalism among laboratory professionals

2. To ensure practising laboratory premises comply with applicable regulations


1. To enforce registration of practicing laboratory professionals and premises.

3.1.4 Human Resources

Policy Objectives

To ensure adequate availability of laboratory personnel with the appropriate skills and competencies to support the delivery of a comprehensive laboratory services at each level of health care

Specific objectives

1. To improve laboratory personnel recruitment and motivation to achieve the retention

2. To develop a career path for Laboratory professionals

3. To strengthen and standardize pre- service training programs for laboratory personnel.


1. Conduct human resources audits periodically to determine and fill staffing gaps within laboratories

2. Review the staff establishments in line with new technologies and disease trends

3. Define and provide incentives for staff in peripheral areas

4. Avail training opportunities for laboratory personnel to improve skills in management and leadership

5. Support training of lower cadres (e.g. SCMLT and microscopists) for deployment to lower levels

6. Support the establishment of a laboratory professional association to conduct Continuous Professional Development (CPD) point system

7. Design and develop a career path for laboratory staff including an agreed

14


internship period in lower level laboratories

8. Implement and evaluate CPD program and continually implement improvements

9. Support review and implementation of standardized curricula by training institutions to match the evolving laboratory testing

3.1.5 Laboratory Equipment and Commodities

A – Equipment

Policy objective

To ensure that laboratories are adequately and appropriately equipped in order to meet requirements of the service delivery system

Specific objectives

1. To harmonize and standardize equipment by level of testing

2. To ensure there is appropriate technology and equipment in place at all levels

3. To ensure all equipment have service and maintenance plan

4. To deploy all POC devices according to national guidelines


1. Launch the harmonization and standardization guidelines on equipment and personnel and disseminate them to all facilities and stakeholders

2. Operationalize harmonization and standardization of equipment guidelines (redistribute equipment if necessary)

3. Deploy all approved conventional equipment according to national guidelines

4. Develop an equipment replacement plan

5. Mobilize resources for procurement of equipment, servicing and maintenance of new and existing equipment

6. Dispose obsolete equipment according to the National guidelines

7. Review guidelines to ensure that every equipment that is procured has a service and maintenance plan

8. Strengthen coordination between DLS, partners and other MOH programs on laboratory equipment procurement

9. Coordinate the evaluation of all POC devices

10. Disseminate and operationalize the POC testing guidelines

11. Deploy POCs according to the POC guidelines

B – Commodities

Policy objective

To ensure uninterrupted supply of laboratory reagents and consumables at all levels of health care

Specific objectives

1. To strengthen management of laboratory commodities at the facility level

2. To harmonize procurement and distribution for integrated laboratory services

3. To provide pre-service supply chain management training for laboratory


15

undergraduates/trainees

4. To provide in service training in supply chain management

5. T o computerize the Logistics Management Information System (LMIS).

6. To facilitate and implement laboratory guidelines for environmentally safe disposal of laboratory commodities


1. Evaluate the laboratory logistics system

2. Review annually standard operating procedures and training curriculums for the laboratory logistics system

3. Train new and existing staff (refresher) on the laboratory logistics system

4. Maintain the existing laboratory logistics unit which integrates existing programs

5. Monitor and support the new laboratory logistics system with quarterly reviews

6. Provide product specifications as and when required by procurement agencies

7. Strengthen the technical working group on supply chain management

8. Conduct a forecasting and quantification of laboratory reagents and supplies at least twice a year

9. Maintain and monitor a national pipeline database including timeliness

10. Monitor the supplier performance and quality of deliveries

11. Develop supply chain curriculum for laboratory training institutions

12. Design and develop a computerized LMIS

13. I mplement and maintain the computerized LMIS

14. Develop laboratory guidelines and standard operating procedures for disposal of commodities

15. Facilitate disposal of expired laboratory commodities using government approved procedure at least once a year

3.1.6 Infrastructure

Policy objective

To ensure all laboratories meet minimum infrastructural requirements as defined by National Guidelines for Medical Laboratories

Specific objectives

1. To ensure infrastructure is available to match scope of testing at every health institution.

2. To ensure that all laboratory infrastructures are routinely inspected for compliance to National Guidelines for Medical Laboratories.


1. Conduct National Assessment on the state of laboratory infrastructure using the minimum set guidelines

2. Develop a work-plan with a list of prioritized labs for the upgrading of infrastructure

3. Source funding for the upgrading of the laboratory facilities

4. Work with Ministry of Public Works department to review specifications

16


for renovation/construction of public health laboratories to address identified infrastructural gaps

5. Develop a schedule for inspection to ensure that all the laboratories are inspected within the 5 years using a standardized checklist.

6. Conduct assessments according to schedule, develop and implement recommendations for improvement

3.1.7 Quality Management System

Policy objective

To provide quality laboratory services that meet international standards of practice.

Specific objectives

1. To ensure there is a Quality Assurance Unit for the Laboratory Directorate to oversee quality management programs.

2. To establish a national laboratory certification programme to support certification and accreditation of laboratories

3. To facilitate laboratories to participate in Quality Improvement programs

4. Strengthen current EQA systems to provide full scope of EQA services that cover all testing in Zimbabwe and provide for remedial action to poor PT/EQA performers

5. T o ensure all laboratories participate in PT schemes and/ or inter-laboratory comparison / IQC for all testing done including Point of Care.


1. Define TOR for Quality Assurance Unit

2. Recruit the Quality Assurance Coordinator and team for the Laboratory Directorate to oversee quality management programs.

3. Establish a TWG to spearhead the establishment of a national laboratory certification program

4. Set up the national laboratory certification program for laboratories and Point of Care testing sites

5. Adopt guidelines to use as minimum standards in certifying laboratories and enhancing quality.

6. Conduct national certification assessments for all laboratories

7. Accredit National Reference laboratories to international standards

8. Adopt a WHO recommended QMS Training Program for lab quality improvement and meet the requirements of Zimbabwe Medical Laboratory Guidelines.

9. Establish and refresh a national pool of trainers.

10. Roll out trainings using the adopted QMS training program

11. Develop national QMS documents (policies, SOPs and forms) for adaptation by laboratories

12. Designate and train staff to be responsible for implementation of quality management in every laboratory (including safety)

13. Allocate funding for PT participation for all labs & Point-of-Care testing sites.

14. Procure IQC panels for all disciplines for all laboratories

15. Register and ensure participation of


17

laboratories in PT schemes and/ or inter-laboratory comparison recognized by the MLCSCZ

16. Monitor the PT performance (and corrective actions taken) of all laboratories annually

3.1.8 Biosafety

Policy objective

To promote safe and secure laboratory practices at all levels.

Specific objectives

1. To ensure all facilities have appropriate space and safe environment for lab personnel, clients, the general public and environmentTo ensure lab workers are trained in Biosafety and Biosecurity

2. To ensure national reference laboratories have capacity and access control systems to handle highly infectious organisms and meet nationally acceptable containment standards.


1. Disseminate the minimum standards for appropriate space and safe environment for health personnel, clients, the general public and environment and framework for disposal of biological and bio-hazard material.

2. Conduct bio risk assessments in all laboratories to ensure they meet the minimum biosafety and biosecurity standards.

3. Develop and implement a plan to refurbish/

upgrade labs to meet minimum biosafety and biosecurity standards

4. Adopt a WHO recommended Biosafety Training Curriculum including IATA Specimen transportation regulations

5. Establish a pool of Biosafety and Biosecurity trainers

6. Train and sensitize laboratory personnel in biosafety and biosecurity

7. Adopt and implement the WHO Containment Standards

8. Develop and disseminate a national list of dangerous chemicals, infectious agents and other dangerous materials to facilities and personnel

9. Maintain inventory system to account for infectious and dangerous organisms

3.1.9 Monitoring and Evaluation

Policy objectiveTo monitor and evaluate the quality of the laboratory services using clearly defined laboratory indicators

Specific objectives

1. To develop and implement M & E system to assess performance of the laboratory services


1. Develop a laboratory M & E framework in alignment with the National M & E plan (indicators, reporting, sources of data, feedback mechanism)

18


2. Appoint/hire an M & E coordinator within DLS

3. Establish and implement detailed M & E procedures

4. Develop measurable indicators, tools and milestones for quality delivery of laboratory services

5. Train laboratory personnel on the M & E framework & procedures

6. Manage and use M & E data

3.1.10 Laboratory Information System

Policy objective

To ensure that all levels of laboratory services have a functional and comprehensive laboratory information system that manages and disseminates data for use by all relevant stakeholders

Specific objectives

1. To strengthen paper based laboratory information systems to promote laboratory performance, quality patient care, surveillance, evidence-based medicine and planning, policy formulation

and research

2. To implement an electronic Laboratory information systems


1. Develop guidelines and a standardized paper based system with tools e.g. Registers, request forms, monthly reporting tools for all indicators

2. Train laboratory staff on the paper based system

3. Disseminate and pilot the standardized paper based systems in selected districts

4. Roll out the standardized paper based systems

5. Develop guidelines and a standardised electronic LIS with tools e.g. Registers, request forms, monthly reporting tools for all indicators

6. Procure IT Hardware and infrastructure for the operation of the electronic LIS

7. Integrate laboratory electronic LIS with the MoHCC electronic system which covers other departments e.g. Pharmacy, PMTCT, EID

8. Train laboratory staff on the Electronic LIS system

9. Pilot the standardised Electronic LIS in selected laboratories.

10. Roll out the LIS to laboratories based on the work plan

11. Provide resources to ensure connectivity of LIS

3.1.11 Research, development and Collaboration

Policy objective

To promote the development of research that is relevant to the health priorities of the country

Specific objectives

1. To promote laboratory based operational research in line with priorities of the MOHCC.

2. To encourage collaborative research nationally, regionally and internationally


19

Specific strategic

1. Develop and disseminate research agenda/ priorities for Laboratory Services

2. Build capacity of Medical Laboratory Scientists on research methodology

3. Develop a mentorship program on operational research

4. Conduct research that responds to priority areas

5. Conduct research that complies with relevant ethical institutional and / or national review boards

6. Organize annual Laboratory research day

7. I mplement research findings/ recommendations

8. Promote data utilization at facility level to inform operations and improvement

3.1.12 Financing Laboratory Services

Policy objective

To ensure provision of sufficient funding for the implementation of the laboratory services

Specific objectives

1. Develop annual work plans and budgets

2. Encourage participation of laboratory personnel in budget planning Hospital Management meetings

3. Establish cost recovery mechanisms at all levels for chargeable tests

4. Revive the lab vote system at the hospitals

5. Develop costed operation plans based on the strategic plan

6. Present financial gap at least twice annually to stakeholders and partners

7. Train heads of laboratories on development of costed and timed work plans

8. Develop proposals for funding with evidence based information

9. Develop a framework for Private Public Partnerships (PPP)

20

National Health Laboratory Strategic Plan 2017-20214.

1 LA

BO

RAT

ORY

OR

GA

NIZ

ATIO

N A

ND

STR

UC

TUR

E:

To h

ave

a cl

ear

orga

niza

tiona

l stru

ctur

e w

ith a

ppro

pria

te a

utho

rity

to c

oord

inat

e an

d m

anag

e th

e pr

ovis

ion

of c

ompr

ehen

sive

hea

lth la

bora

tory

se

rvic

es a

t all

leve

ls in

the

coun

try.

Spe

cific

obj

ectiv

esA

ctiv

ities

Tim

efra

me

(200

0)R

espo

nsib

le

partn

ers

Out

com

es /

Pla

nned

re

sults

1718

1920

21To

stre

ngth

the

Dire

ctor

ate

in o

rder

to p

rovi

de

adeq

uate

adm

inis

trativ

e an

d te

chni

cal o

vers

ight

ov

er la

bora

tory

ser

vice

s ac

ross

all

agen

cies

and

th

e pr

ivat

e se

ctor

.

Cre

ate

and

recr

uit f

ocal

per

sons

for t

he

follo

win

g ar

eas:

Qua

lity

Ass

uran

ce, M

&E

/ R

esea

rch

and

Dev

elop

men

t, IC

T &

LIM

S.

x

DLS

Func

tiona

l Qua

lity

Ass

uran

ce, M

&E

/ R

esea

rch

and

Dev

elop

men

t, IC

T &

LI

MS

uni

ts w

ithin

the

Labo

rato

ry D

irect

orat

e

Sup

port

the

natio

nal l

abor

ator

y lo

gist

icia

n to

co

ntin

ue to

hav

e ov

ersi

ght o

n pr

ocur

emen

t of

labo

rato

ry c

omm

oditi

esx

xx

xx

DLS

and

Par

tner

sN

atio

nal l

abor

ator

y lo

gist

icia

n in

pla

ce

Stre

ngth

en th

e ro

le o

f Lab

orat

ory

Tech

nica

l W

orki

ng G

roup

s (T

WG

s)

xx

xx

x

DLS

/ N

atio

nal

Mic

robi

olog

y R

efer

ence

la

bora

tory

(NM

RL)

TWG

s m

eetin

g an

d de

liver

ing

as p

lann

ed

Pro

vide

reso

urce

s an

d te

chni

cal c

apac

ity to

th

e a

ppoi

nted

foca

l per

sonn

el a

t all

tiers

xx

xx

DLS

Foca

l per

sons

ca

paci

tate

d at

all

leve

lsC

ondu

ct q

uarte

rly fe

edba

ck m

eetin

gs w

ith

all l

abor

ator

y st

aff a

nd k

ey s

take

hold

ers

xx

xx

xD

LSQ

uarte

rly

Labo

rato

ry re

ports

Con

duct

ann

ual r

evie

w o

f lab

orat

ory

plan

sx

xx

xx

DLS

Ann

ual L

abor

ator

y re

view

repo

rt

4.2

LAB

OR

ATO

RY T

IER

ED N

ETW

OR

K A

ND

REF

ERR

AL:

To p

rovi

de la

bora

tory

ser

vice

s ap

prop

riate

to e

ach

leve

l and

that

mee

ts th

e ne

eds

for t

he d

eliv

ery

of h

ealth

ser

vice

s at

that

leve

l

Spe

cific

obj

ectiv

esA

ctiv

ities

Tim

efra

me

(200

0)R

espo

nsib

le

partn

ers

Out

com

es /

Pla

nned

re

sults

1718

1920

21To

ens

ure

equi

tabl

e co

vera

ge a

nd a

cces

s to

hi

gh q

ualit

y la

bora

tory

se

rvic

es

Dis

sem

inat

e ap

prov

ed g

uide

lines

for t

he te

st

men

us fo

r all

tiers

to a

ll la

bora

torie

sx

DLS

Test

ing

men

us

avai

labl

e an

d of

fere

d as

defi

ned

for e

ach

leve

lLi

st c

omm

odity

requ

irem

ents

for t

he te

st

men

us to

ass

ist w

ith a

nnua

l bud

get p

lann

ing

xx

xx

xD

LSLa

bora

tory

co

mm

oditi

es b

udge

t for

ea

ch y

ear

App

rove

and

dis

sem

inat

e th

e ha

rmon

izat

ion

and

equi

pmen

t sta

ndar

diza

tion

requ

irem

ents

fo

r eac

h le

vel o

f hea

lth c

are

xD

LSS

tand

ardi

zed

equi

pmen

t doc

umen

t in

use

Pro

cure

con

vent

iona

l equ

ipm

ent a

nd d

istri

bute

ac

cord

ing

to te

stin

g co

mpl

exity

at e

ach

leve

lx

xx

xx

DLS

and

pa

rtner

sA

dequ

atel

y eq

uipp

ed

labo

rato

ries

Dev

elop

and

impl

emen

t a p

lan

to e

nhan

ce th

e ca

paci

ty fo

r sta

ndar

dize

d la

bora

tory

test

ing

xx

xx

xD

LS a

nd

partn

ers

Sta

ndar

dize

d la

bora

tory

test

ing

plan

im

plem

ente

dIn

crea

se a

cces

s to

labo

rato

ry s

ervi

ces

thro

ugh

appr

opria

te P

OC

dia

gnos

tics

xx

xx

xD

LS a

nd

partn

ers

PO

CT

avai

labl

e an

d ac

cess

ible

to

appr

opria

te a

reas

Ens

ure

appr

opria

te d

eplo

ymen

t of s

kille

d la

bora

tory

per

sonn

el to

all

leve

lsx

xx

xD

LSA

dequ

atel

y st

aff

labo

rato

ries

STRATEGIC PLAN MATRIX (2017-2021)4


21

4.2

LAB

OR

ATO

RY T

IER

ED N

ETW

OR

K A

ND

REF

ERR

AL:

To p

rovi

de la

bora

tory

ser

vice

s ap

prop

riate

to e

ach

leve

l and

that

mee

ts th

e ne

eds

for t

he d

eliv

ery

of h

ealth

ser

vice

s at

that

leve

l

Spe

cific

obj

ectiv

esA

ctiv

ities

Tim

efra

me

(200

0)R

espo

nsib

le

partn

ers

Out

com

es /

Pla

nned

re

sults

1718

1920

21To

ens

ure

equi

tabl

e co

vera

ge a

nd a

cces

s to

hi

gh q

ualit

y la

bora

tory

se

rvic

es

Dis

sem

inat

e ap

prov

ed g

uide

lines

for t

he te

st

men

us fo

r all

tiers

to a

ll la

bora

torie

sx

DLS

Test

ing

men

us

avai

labl

e an

d of

fere

d as

defi

ned

for e

ach

leve

lLi

st c

omm

odity

requ

irem

ents

for t

he te

st

men

us to

ass

ist w

ith a

nnua

l bud

get p

lann

ing

xx

xx

xD

LSLa

bora

tory

co

mm

oditi

es b

udge

t for

ea

ch y

ear

App

rove

and

dis

sem

inat

e th

e ha

rmon

izat

ion

and

equi

pmen

t sta

ndar

diza

tion

requ

irem

ents

fo

r eac

h le

vel o

f hea

lth c

are

xD

LSS

tand

ardi

zed

equi

pmen

t doc

umen

t in

use

Pro

cure

con

vent

iona

l equ

ipm

ent a

nd d

istri

bute

ac

cord

ing

to te

stin

g co

mpl

exity

at e

ach

leve

lx

xx

xx

DLS

and

pa

rtner

sA

dequ

atel

y eq

uipp

ed

labo

rato

ries

Dev

elop

and

impl

emen

t a p

lan

to e

nhan

ce th

e ca

paci

ty fo

r sta

ndar

dize

d la

bora

tory

test

ing

xx

xx

xD

LS a

nd

partn

ers

Sta

ndar

dize

d la

bora

tory

test

ing

plan

im

plem

ente

dIn

crea

se a

cces

s to

labo

rato

ry s

ervi

ces

thro

ugh

appr

opria

te P

OC

dia

gnos

tics

xx

xx

xD

LS a

nd

partn

ers

PO

CT

avai

labl

e an

d ac

cess

ible

to

appr

opria

te a

reas

Ens

ure

appr

opria

te d

eplo

ymen

t of s

kille

d la

bora

tory

per

sonn

el to

all

leve

lsx

xx

xD

LSA

dequ

atel

y st

aff

labo

rato

ries

22

National Health Laboratory Strategic Plan 2017-2021To

stre

ngth

en th

e sp

ecim

en

refe

rral

sys

tem

Des

ign

an in

tegr

ated

spe

cim

en a

nd re

sults

tra

nspo

rtatio

n sy

stem

xD

LS a

nd

partn

ers

Inte

grat

ed s

ampl

e tra

nspo

rt sy

stem

de

sign

edD

evel

op e

ffect

ive

guid

elin

es fo

r spe

cim

en

refe

rral

and

resu

lt re

porti

ngx

DLS

and

pa

rtner

sR

efer

ral a

nd re

porti

ng

guid

elin

esP

ilot t

he in

tegr

ated

spe

cim

en a

nd re

sults

tra

nspo

rtatio

n sy

stem

x

xD

LS a

nd

partn

ers

Suc

cess

ful s

peci

men

re

ferr

al p

ilot

Impl

emen

t the

inte

grat

ed s

peci

men

and

resu

lts

trans

porta

tion

syst

em in

all

the

labo

rato

ries

xx

xD

LS a

nd

partn

ers

An

esta

blis

hed

inte

grat

ed

sam

ple

refe

rral

sys

tem

Pro

mot

e ra

tiona

l and

app

ropr

iate

use

of

labo

rato

ry s

ervi

ces

amon

g cl

inic

ians

, la

bora

tory

pra

ctiti

oner

s, a

nd th

e ge

nera

l pub

lic

xx

xx

xD

LSA

ppro

pria

te u

se o

f la

bora

tory

ser

vice

s at

ap

prop

riate

leve

lsS

uppo

rt an

d ex

pand

the

NM

RL

into

a m

ulti-

disc

iplin

ary

refe

rral

labo

rato

ryx

xx

xD

LSN

MR

L pr

ovid

ed

spec

ializ

ed s

ervi

ces

in

diffe

rent

dis

cipl

ines

Stre

ngth

en th

e N

RL’

s to

pro

vide

labo

rato

ry

supp

ort n

eces

sary

for

dis

ease

sur

veill

ance

, in

vest

igat

ions

and

man

agem

ent o

f out

brea

ksx

xx

xx

Enh

ance

d N

RL’

s pr

epar

edne

ss to

re

spon

se to

pub

lic h

ealth

th

reat

s


23

4.3

LEG

AL

AN

D R

EGU

LATO

RY F

RA

MEW

OR

KS:

To e

nsur

e re

gist

ratio

n, li

cens

ing,

edu

catio

n an

d di

scip

line

in th

e m

edic

al la

bora

tory

pro

fess

ions

and

mai

nten

ance

of q

ualit

y st

anda

rds

for l

abor

ator

ies

Spe

cific

obj

ectiv

esA

ctiv

ities

Tim

efra

me

(200

0)R

espo

nsib

le p

art-

ners

Out

com

es /

Pla

nned

re

sults

1718

1920

21

To e

nsur

e co

mpl

ianc

e of

th

e la

bora

tory

pro

fess

ion

with

the

requ

irem

ents

of

the

MLC

SC

Z.

Stre

ngth

en th

e ca

paci

ty o

f lab

orat

orie

s to

mee

t th

e re

quire

men

ts o

f reg

ular

insp

ectio

n an

d m

onito

ring

by th

e M

LCS

CZ

xx

xx

XD

LS a

nd M

LCS

ZM

onito

ring

syst

em in

pl

ace

Sup

port

mon

itorin

g an

d in

spec

tion

on th

e pr

ac-

tice,

use

of I

VD

s an

d te

st k

its in

clud

ing

PO

CT

xx

xx

XD

LS a

nd M

LCS

ZM

onito

ring

syst

em in

pl

ace

Sup

port

the

revi

ew o

f nat

iona

l gui

delin

es fo

r m

edic

al la

bora

tory

in Z

imba

bwe

xD

LS a

nd M

LCS

ZU

pdat

ed n

atio

nal

guid

elin

es fo

r med

i-ca

l lab

orat

ory

in

Zim

babw

eS

uppo

rt th

e de

velo

pmen

t of C

PD

poi

nts

syst

em a

s a

prer

equi

site

for r

egis

tratio

n fo

r la

bora

tory

per

sonn

el

xD

LS a

nd L

ab A

s-so

ciat

ion

CP

D p

oint

sys

tem

m

anda

ted

Sup

port

the

regi

stra

tion

of la

bora

tory

per

son-

nel b

y th

e M

LCS

CZ

xx

xx

XM

LCS

ZA

ll la

bora

tory

per

son-

nel r

egis

tere

d

To e

nsur

e al

l tra

inin

g in

stitu

tions

cur

ricul

a m

eet

the

min

imum

sta

ndar

ds

and

the

evol

ving

labo

rato

ry

test

ing

requ

irem

ents

Faci

litat

e a

revi

ew o

f the

Med

ical

Lab

orat

ory

Sci

ence

s Tr

aini

ng p

rogr

am a

cros

s al

l tra

inin

g in

stitu

tions

.

xx

DLS

, MLC

SC

Z &

Tr

aini

ng In

stitu

tions

Rev

ised

and

sta

n-da

rdiz

ed c

urric

ula

acro

ss tr

aini

ng in

sti-

tutio

ns

24


4 H

UM

AN

RES

OU

RC

ES:

To e

nsur

e ad

equa

te a

vaila

bilit

y of

labo

rato

ry p

erso

nnel

with

the

app

ropr

iate

ski

lls a

nd c

ompe

tenc

ies

to s

uppo

rt th

e de

liver

y of

a

com

preh

ensi

ve la

bora

tory

ser

vice

s at

eac

h le

vel o

f hea

lth c

are

Spe

cific

obj

ectiv

esA

ctiv

ities

Tim

efra

me

(200

0)R

espo

nsib

le p

art-

ners

Out

com

es /

Pla

nned

resu

lts17

1819

2021

To im

prov

e la

bora

tory

pe

rson

nel r

ecru

itmen

t and

m

otiv

atio

n to

ach

ieve

the

rete

ntio

n

Con

duct

hum

an re

sour

ces

audi

ts p

erio

dica

lly

to d

eter

min

e an

d fil

l sta

ffing

gap

s w

ithin

labo

-ra

torie

s

xD

LSS

taffi

ng n

eeds

do

cum

ente

d

Rev

iew

the

staf

f est

ablis

hmen

ts in

line

with

ne

w te

chno

logi

es a

nd d

isea

se tr

ends

xD

LSS

taff

esta

blis

h-m

ents

upd

ated

D

efine

and

pro

vide

ince

ntiv

es fo

r sta

ff in

pe-

riphe

ral a

reas

xx

xX

DLS

Lab

staf

f inc

entiv

-iz

ed to

wor

k in

pe

riphe

ral a

reas

Av

ail t

rain

ing

oppo

rtuni

ties

for l

abor

ator

y pe

r-so

nnel

to im

prov

e sk

ills

in m

anag

emen

t and

le

ader

ship

xx

xx

XD

LS a

nd p

artn

ers

Lab

pers

onne

l with

pr

ofes

sion

al d

evel

-op

men

tS

uppo

rt tra

inin

g of

low

er c

adre

s (e

.g S

CM

LT

and

mic

rosc

opis

ts) f

or d

eplo

ymen

t to

low

er

leve

ls

xx

xx

XD

LS a

nd p

artn

ers;

tra

inin

g in

stitu

tions

Low

er c

adre

s av

ail-

able

to m

an la

b fa

cilit

ies

To d

evel

op a

car

eer p

ath

for

Labo

rato

ry p

rofe

ssio

nals

Sup

port

the

esta

blis

hmen

t of a

labo

rato

ry p

ro-

fess

iona

l ass

ocia

tion

to c

ondu

ct C

ontin

uous

P

rofe

ssio

nal D

evel

opm

ent (

CP

D) p

oint

sys

tem

xD

LS a

nd L

ab A

s-so

ciat

ion

Func

tiona

l Lab

As-

soci

atio

n in

pla

ce

Des

ign

and

deve

lop

a ca

reer

pat

h fo

r lab

ora-

tory

sta

ff in

clud

ing

an a

gree

d in

tern

ship

per

iod

in lo

wer

leve

l lab

orat

orie

s

xD

LSC

arrie

r pat

h de

-si

gned

and

ad-

opte

dIm

plem

ent a

nd e

valu

ate

CP

D p

rogr

am a

nd

cont

inua

lly im

plem

ent i

mpr

ovem

ents

xx

xx

XLa

b as

soci

atio

nC

PD

pro

gram

in

plac

eTo

stre

ngth

en a

nd s

tand

ard-

ize

pre-

ser

vice

trai

ning

pr

ogra

ms

for l

abor

ator

y pe

rson

nel.

Sup

port

revi

ew a

nd im

plem

enta

tion

of s

tan-

dard

ized

cur

ricul

a by

trai

ning

inst

itutio

ns to

m

atch

the

evol

ving

labo

rato

ry te

stin

g ne

eds

xx

DLS

, par

tner

s an

d tra

inin

g in

stitu

tions

Upd

ated

and

sta

n-da

rdiz

ed c

urric

ula

in tr

aini

ng in

stitu

tes


25

4.5

LAB

OR

ATO

RY E

QU

IPM

ENT:

To e

nsur

e th

at la

bora

torie

s ar

e ad

equa

tely

and

app

ropr

iate

ly e

quip

ped

in o

rder

to m

eet r

equi

rem

ents

of t

he s

ervi

ce d

eliv

ery

syst

em

Spec

ific

obje

ctiv

esAc

tivit

ies

Tim

efra

me

(200

0)Re

spon

sibl

e pa

rtne

rsO

utco

mes

/

Plan

ned

resu

lts

1718

1920

21

To h

arm

oniz

e an

d st

anda

rd-

ize

equi

pmen

t by

leve

l of

test

ing

Laun

ch a

nd d

isse

min

ate

harm

oniz

atio

n an

d st

anda

rdiz

atio

n po

licy

on e

quip

men

t and

per

-so

nnel

to fa

cilit

ies

and

stak

ehol

ders

xD

LSH

arm

oniz

a-tio

n gu

idel

ines

la

unch

ed a

nd

wid

ely

dist

ribut

edO

pera

tiona

lize

harm

oniz

atio

n an

d st

anda

rdiz

a-tio

n of

equ

ipm

ent (

redi

strib

ute

equi

pmen

t if

nece

ssar

y)

x x

x X

DLS

and

par

tner

sH

arm

oniz

atio

n gu

idel

ines

bei

ng

used

Dep

loy

all a

ppro

ved

conv

entio

nal e

quip

men

t ac

cord

ing

to n

atio

nal g

uide

lines

D

LS a

nd p

artn

ers

Equ

ipm

ent p

lace

-m

ent f

ollo

win

g th

e H

arm

oniz

atio

n an

d st

anda

rdiz

atio

n gu

idel

ines

To e

nsur

e th

ere

is a

ppro

pri-

ate

tech

nolo

gy a

nd e

quip

-m

ent i

n pl

ace

at a

ll le

vels

Dev

elop

an

equi

pmen

t rep

lace

men

t pla

nx

DLS

Equ

ipm

ent r

epla

ce-

men

t pla

nM

obili

ze re

sour

ces

for p

rocu

rem

ent o

f equ

ip-

men

t x

xx

xD

LSFu

ndin

g se

cure

d fo

r rep

lace

men

t of

equi

pmen

tD

ispo

se o

bsol

ete

equi

pmen

t acc

ordi

ng to

the

Nat

iona

l gui

delin

esx

xx

xx

DLS

Obs

olet

e eq

uip-

men

t dis

pose

dTo

ens

ure

all e

quip

men

t ha

ve s

ervi

ce a

nd m

aint

e-na

nce

plan

Rev

iew

gui

delin

es to

ens

ure

that

eve

ry e

quip

-m

ent t

hat i

s pr

ocur

ed h

as a

ser

vice

and

mai

n-te

nanc

e pl

an

xD

LS a

nd p

artn

ers

All

equi

pmen

t with

se

rvic

e pl

ans

26

National Health Laboratory Strategic Plan 2017-2021S

treng

then

coo

rdin

atio

n be

twee

n D

LS, p

art-

ners

and

oth

er M

OH

pro

gram

s on

labo

rato

ry

equi

pmen

t pro

cure

men

tx

xx

xx

DLS

and

par

tner

sA

ll do

nate

d eq

uip-

men

t fol

low

Har

mo-

niza

tion

guid

elin

es

and

have

ser

vice

pl

ans

Mob

ilize

reso

urce

s fo

r ser

vici

ng a

nd m

aint

ain-

ing

exis

ting

equi

pmen

tx

xx

xx

DLS

E

xist

ing

equi

pmen

t ha

ve s

ervi

ce p

lans

To d

eplo

y al

l PO

C d

evic

es

acco

rdin

g to

nat

iona

l gui

de-

lines

Coo

rdin

ate

the

eval

uatio

n of

all

PO

C d

evic

esx

xx

xx

DLS

All

PO

Cs

eval

u-at

ed a

ccor

ding

to

Nat

iona

l gui

delin

esD

isse

min

ate

and

oper

atio

naliz

e th

e P

OC

test

-in

g gu

idel

ines

xD

LS a

nd p

artn

ers

PO

C g

uide

lines

di

ssem

inat

ed

Dep

loy

PO

Cs

acco

rdin

g to

the

PO

C g

uide

lines

xx

xx

x

DLS

and

par

tner

sA

ll P

OC

s ev

alua

ted

depl

oyed

acc

ordi

ng

to N

atio

nal g

uide

-lin

es


27

4.6

CO

MM

OD

ITIE

S:

To e

nsur

e un

inte

rrup

ted

supp

ly o

f lab

orat

ory

reag

ents

and

con

sum

able

s at

all

leve

ls o

f hea

lth c

are

Spe

cific

obj

ectiv

esA

ctiv

ities

Tim

efra

me

(200

0)R

espo

nsib

le p

art-

ners

Out

com

es /

Pla

nned

resu

lts17

1819

2021

To s

treng

then

man

agem

ent o

f la

bora

tory

com

mod

ities

at t

he

faci

lity

leve

l

Eva

luat

e th

e la

bora

tory

logi

stic

s sy

stem

xD

LS a

nd p

artn

ers

ZiLa

CoD

S e

valu

-at

ed a

nd re

c-om

men

datio

ns

avai

labl

e fo

r im

plem

enta

tion

Rev

iew

ann

ually

sta

ndar

d op

erat

ing

proc

e-du

res

and

train

ing

curr

icul

ums

for t

he la

bora

-to

ry lo

gist

ics

syst

em

x x

x x

XD

LS a

nd p

artn

ers

SO

Psa

nd C

ur-

ricul

a re

view

ed

and

upda

ted

Trai

n ne

w a

nd e

xist

ing

staf

f (re

fresh

er) o

n th

e la

bora

tory

logi

stic

s sy

stem

x x

x x

XD

LS a

nd p

artn

ers

Ref

resh

er tr

ain-

ing

cond

ucte

dS

uppo

rt on

goin

g da

ta c

olle

ctio

n an

d an

alys

is

to in

form

labo

rato

ry s

uppl

y ch

ain

deci

sion

s x

x x

xx

DLS

and

par

tner

sS

uppl

y ch

ain

data

ana

lyze

d an

d av

aila

ble

for

deci

sion

mak

ing

Mai

ntai

n th

e ex

istin

g la

bora

tory

logi

stic

s un

it w

hich

inte

grat

es e

xist

ing

prog

ram

s x

x x

x X

DLS

Lab

Logi

stic

Uni

t fu

nctio

nal

Mon

itor a

nd s

uppo

rt th

e ne

w la

bora

tory

logi

s-tic

s sy

stem

with

qua

rterly

revi

ews

x x

xx

x D

LS a

nd p

artn

ers

Qua

rterly

M&

E

revi

ew re

ports

To h

arm

oniz

e pr

ocur

emen

t an

d di

strib

utio

n fo

r int

egra

ted

labo

rato

ry s

ervi

ces

Pro

vide

pro

duct

spe

cific

atio

ns a

s an

d w

hen

requ

ired

by p

rocu

rem

ent a

genc

ies

x x

x x

XD

LS -

Logi

stic

s un

itS

peci

ficat

ions

av

aile

d

Stre

ngth

en th

e te

chni

cal w

orki

ng g

roup

on

supp

ly c

hain

man

agem

ent

xD

LSTW

G fu

nctio

nal

Con

duct

a fo

reca

stin

g an

d qu

antifi

catio

n of

la

bora

tory

reag

ents

and

sup

plie

s at

leas

t tw

ice

a ye

ar

xx

Xx

XD

LS -

Logi

stic

s U

nit

Upd

ate

Pro

duct

Q

uant

ifica

tion;

Mai

ntai

n an

d m

onito

r a n

atio

nal p

ipel

ine

data

-ba

se in

clud

ing

timel

ines

sx

xX

xX

DLS

- Lo

gist

ics

Uni

tU

pdat

ed p

ipel

ine

avai

labl

e

28

National Health Laboratory Strategic Plan 2017-2021M

onito

r the

sup

plie

r per

form

ance

and

qua

lity

of d

eliv

erie

sx

xX

xX

DLS

Sup

plie

r per

for-

man

ce d

ocu-

men

ted

and

used

fo

r to

guid

e fu

ture

pro

cure

-m

ents

To p

rovi

de p

re-s

ervi

ce s

uppl

y ch

ain

man

agem

ent t

rain

ing

for l

abor

ator

y un

derg

radu

ates

/tra

inee

s

Dev

elop

sup

ply

chai

n cu

rric

ulum

for l

abor

ator

y tra

inin

g in

stitu

tions

xC

urric

ulum

de-

velo

ped

To c

ompu

teriz

e th

e Lo

gist

ics

Man

agem

ent I

nfor

mat

ion

Sys

-te

m (L

MIS

).

Des

ign

and

deve

lop

a co

mpu

teriz

ed L

MIS

x

x

Com

pute

rized

LI

MS

dev

elop

ed

Impl

emen

t and

mai

ntai

n th

e co

mpu

teriz

ed

LMIS

x x

x x

XLI

MS

func

tiona

l an

d up

date

d

To fa

cilit

ate

and

impl

emen

t la

bora

tory

gui

delin

es fo

r en-

viro

nmen

tally

saf

e di

spos

al o

f la

bora

tory

com

mod

ities

Dev

elop

labo

rato

ry g

uide

lines

(inc

ludi

ng

SO

Ps)

for d

ispo

sal o

f com

mod

ities

x

N

atio

nal g

uide

-lin

es a

nd S

OP

s fo

r dis

posa

l of

lab

com

mod

ities

de

velo

ped

Faci

litat

e di

spos

al o

f exp

ired

labo

rato

ry c

om-

mod

ities

usi

ng g

over

nmen

t app

rove

d pr

oce-

dure

at l

east

onc

e a

year

x x

x x

XR

eage

nt d

ispo

sal

done


29

4.7

INFR

AST

RU

CTU

RE:

To e

nsur

e al

l lab

orat

orie

s m

eet m

inim

um in

frast

ruct

ural

requ

irem

ents

as

defin

ed b

y N

atio

nal G

uide

lines

for M

edic

al L

abor

ator

ies

Spec

ific

obje

ctiv

esAc

tivit

ies

Tim

efra

me

(200

0)Re

spon

sibl

e pa

rtne

rsO

utco

mes

/

Plan

ned

resu

lts

1718

1920

21

To e

nsur

e in

frast

ruct

ure

is

avai

labl

e to

mat

ch s

cope

of

test

ing

at e

very

hea

lth in

stitu

-tio

n.

Con

duct

Nat

iona

l Ass

essm

ent o

n th

e st

ate

of

labo

rato

ry in

frast

ruct

ure

usin

g th

e m

inim

um

set g

uide

lines

xD

LS &

MLC

SC

ZA

sses

smen

t Re-

ports

D

evel

op a

wor

k-pl

an w

ith a

list

of p

riorit

ized

la

bs fo

r the

upg

radi

ng o

f inf

rast

ruct

ure

xD

LSW

ork-

plan

dev

el-

oped

S

ourc

e fu

ndin

g fo

r the

upg

radi

ng o

f the

labo

ra-

tory

faci

litie

sx

xx

xX

DLS

Fu

ndin

g av

aila

ble

for u

pgra

ding

of

faci

litie

sW

ork

with

MoP

WD

dep

artm

ent t

o re

view

sp

ecifi

catio

ns fo

r ren

ovat

ion/

cons

truct

ion

of

publ

ic h

ealth

labo

rato

ries

to a

ddre

ss id

entifi

ed

infra

stru

ctur

al g

aps

xD

LS &

MoP

WD

Spe

cific

atio

ns

for r

enov

atio

n or

co

nstru

ctio

n of

la

bora

torie

s

To e

nsur

e th

at a

ll la

bora

tory

in

frast

ruct

ures

are

rout

inel

y in

spec

ted

for c

ompl

ianc

e to

N

atio

nal G

uide

lines

for M

edi-

cal L

abor

ator

ies.

Dev

elop

a s

ched

ule

for i

nspe

ctio

n to

ens

ure

that

all

the

labo

rato

ries

are

insp

ecte

d w

ithin

th

e 5

year

s us

ing

a st

anda

rdiz

ed c

heck

list.

xD

LS &

MLC

SC

ZA

sses

smen

t S

ched

ule

C

ondu

ct a

sses

smen

ts a

ccor

ding

to s

ched

ule

xD

LS &

MLC

SC

ZA

sses

smen

t Re-

ports

30


7 Q

UA

LITY

MA

NA

GEM

ENT

SYST

EM:

To p

rovi

de q

ualit

y la

bora

tory

ser

vice

s th

at m

eet i

nter

natio

nal s

tand

ards

of p

ract

ice.

Spec

ific

obje

ctiv

esAc

tivit

ies

Tim

efra

me

(200

0)Re

spon

sibl

e pa

rtne

rsO

utco

mes

/

Plan

ned

resu

lts

1718

1920

21

To e

nsur

e th

ere

is a

Qua

l-ity

Ass

uran

ce U

nit f

or th

e La

bora

tory

Dire

ctor

ate

to

over

see

qual

ity m

anag

emen

t pr

ogra

ms.

Defi

ne T

OR

for Q

ualit

y A

ssur

ance

Uni

t

x

DLS

TOR

for Q

A U

nit

R

ecru

it th

e Q

ualit

y A

ssur

ance

Coo

rdin

ator

and

te

am fo

r the

Lab

orat

ory

Dire

ctor

ate

to o

vers

ee

qual

ity m

anag

emen

t pro

gram

s.x

DLS

QA

Coo

rdin

ator

an

d Te

am re

-cr

uite

d

To e

stab

lish

a na

tiona

l lab

ora-

tory

cer

tifica

tion

auth

ority

to

supp

ort c

ertifi

catio

n an

d ac

-cr

edita

tion

of la

bora

torie

s

Est

ablis

h a

TWG

to s

pear

head

the

esta

blis

h-m

ent o

f a n

atio

nal l

abor

ator

y ce

rtific

atio

n au

thor

ityx

DLS

&M

LCS

CZ

TWG

est

ablis

hed

S

et u

p th

e na

tiona

l lab

orat

ory

certi

ficat

ion

auth

ority

for l

abor

ator

ies

and

Poi

nt o

f Car

e te

stin

g si

tes

x

DLS

&M

LCS

CZ

Nat

iona

l lab

ora-

tory

cer

tifica

tion

auth

ority

est

ab-

lishe

d

Con

duct

nat

iona

l cer

tifica

tion

asse

ssm

ents

for

all l

abor

ator

ies

x

xx

X

DLS

& N

atio

nal

labo

rato

ry c

ertifi

ca-

tion

auth

ority

Cer

tifica

tion

/ As-

sess

men

t rep

orts

Acc

redi

t Nat

iona

l Ref

eren

ce la

bora

torie

s to

in

tern

atio

nal s

tand

ards

x

DLS

All

Ref

eren

ce

labs

acc

redi

ted

(NM

RL,

Nat

iona

l TB

Lab

, Pol

io la

b)


31

To fa

cilit

ate

labo

rato

ries

pa

rtic

ipat

e in

Qua

lity

Im-

prov

emen

t pro

gram

s

Adop

t a W

HO

reco

mm

ende

d QM

S Tr

aini

ng

Prog

ram

for l

ab q

ualit

y im

prov

emen

t and

m

eet t

he re

quir

emen

ts o

f Zim

babw

e M

edi-

cal L

abor

ator

y Gu

idel

ines

.x

DLS

A QM

S tr

aini

ng

prog

ram

ado

pted

Es

tabl

ish

and

refr

esh

a na

tiona

l poo

l of

trai

ners

.x

DLS

& fu

ndin

g pa

rtne

rsPo

ol o

f tra

in-

ers t

rain

ed a

nd

refr

eshe

d

Roll

out t

rain

ings

usi

ng th

e ad

opte

d QM

S tr

aini

ng p

rogr

amx

xx

xX

QA d

epar

tmen

t&

fund

ing

part

ners

Lab

staf

f tra

ined

Deve

lop

natio

nal Q

MS

docu

men

ts (p

olic

ies,

SOPs

and

form

s) fo

r ada

ptat

ion

by la

bora

-to

ries

x

QA U

nit

Nat

iona

l QM

S do

cum

ents

dev

el-

oped

Desi

gnat

e an

d tr

ain

staf

f to

be re

spon

sibl

e fo

r im

plem

enta

tion

of q

ualit

y m

anag

emen

t in

eve

ry la

bora

tory

(inc

ludi

ng sa

fety

)x

xx

xX

DLS

Qual

ity O

ffice

r &

Saf

ety

Offic

er

desi

gnat

edTo

ens

ure

all l

abor

ator

ies

part

icip

ate

in P

T sc

hem

es

and/

or i

nter

-labo

rato

ry

com

pari

son

/ IQ

C fo

r all

test

ing

done

incl

udin

g Po

int

of C

are.

Allo

cate

fund

ing

for P

T pa

rtic

ipat

ion

for a

ll la

bs &

Poi

nt-o

f-Car

e te

stin

g si

tes.

xx

xx

X

DLS

& fu

ndin

g pa

rtne

rsFu

ndin

g fo

r PT

part

icip

atio

n so

urce

d

Pr

ocur

e IQ

C pa

nels

for a

ll di

scip

lines

for a

ll la

bora

tori

esx

xx

xX

DLS

& fu

ndin

g pa

rtne

rsIQ

C pa

nels

for a

ll di

scip

lines

Regi

ster

and

ens

ure

part

icip

atio

n of

labo

ra-

tori

es in

PT

sche

mes

and

/ or

inte

r-la

bora

to-

ry co

mpa

riso

n re

cogn

ized

by

the

MLC

SCZ

xx

xx

X

Labo

rato

ries

and

PO

CTAl

l Lab

orat

orie

s an

d PO

CT re

g-is

tere

d on

a P

T pr

ogra

ms

32


8 B

IOSA

FETY

:

To p

rom

ote

safe

and

sec

ure

labo

rato

ry p

ract

ices

at a

ll le

vels

Spe

cific

obj

ectiv

esA

ctiv

ities

Tim

efra

me

(200

0)R

espo

nsib

le p

art-

ners

Out

com

es /

Pla

nned

resu

lts17

1819

2021

To e

nsur

e al

l fac

ilitie

s ha

ve

appr

opria

te s

pace

and

saf

e en

viro

nmen

t for

lab

pers

onne

l, cl

ient

s, th

e ge

nera

l pub

lic a

nd

envi

ronm

ent

Dis

sem

inat

e th

e m

inim

um s

tand

ards

for a

p-pr

opria

te s

pace

and

saf

e en

viro

nmen

t for

he

alth

per

sonn

el, c

lient

s, th

e ge

nera

l pub

lic

and

envi

ronm

ent a

nd fr

amew

ork

for d

ispo

sal

of b

iolo

gica

l and

bio

-haz

ard

mat

eria

l.x

DLS

&M

LCS

ZM

inim

um s

tan-

dard

s se

t

Con

duct

bio

risk

ass

essm

ents

in a

ll la

bora

to-

ries

to e

nsur

e th

ey m

eet t

he m

inim

um b

iosa

fe-

ty a

nd b

iose

curit

y st

anda

rds.

xx

xx

X

DLS

, Cou

ncil

&

fund

ing

partn

erA

sses

smen

t re

ports

Dev

elop

and

impl

emen

t a p

lan

to re

furb

ish/

upgr

ade

labs

to m

eet m

inim

um b

iosa

fety

and

bi

osec

urity

sta

ndar

ds.

xx

xx

X

DLS

, Cou

ncil

&

fund

ing

partn

erP

lan

deve

lope

d &

im

plem

ente

d

To e

nsur

e la

b w

orke

rs a

re

train

ed in

Bio

safe

ty a

nd B

ios-

ecur

ity

Ado

pt a

WH

O re

com

men

ded

Bio

safe

ty T

rain

-in

g C

urric

ulum

incl

udin

g IA

TA S

peci

men

tran

s-po

rtatio

n re

gula

tions

x

DLS

, Cou

ncil

&

fund

ing

partn

erC

urric

ulum

ad-

opte

d

Est

ablis

h a

pool

of B

iosa

fety

and

Bio

secu

rity

train

ers

xx

xx

XD

LS, C

ounc

il &

fu

ndin

g pa

rtner

Poo

l of t

rain

ers

train

ed

Trai

n an

d se

nsiti

ze la

bora

tory

per

sonn

el in

bi

osaf

ety

and

bios

ecur

ity

xx

xx

XD

LS, C

ounc

il &

fu

ndin

g pa

rtner

Labo

rato

rians

tra

ined

To e

nsur

e na

tiona

l ref

eren

ce

labo

rato

ries

have

cap

acity

an

d ac

cess

con

trol s

yste

ms

to h

andl

e hi

ghly

infe

ctio

us

orga

nism

s an

d m

eet n

atio

n-al

ly a

ccep

tabl

e co

ntai

nmen

t st

anda

rds.

Ado

pt a

nd im

plem

ent t

he W

HO

Con

tain

men

t S

tand

ards

x

DLS

& F

undi

ng

Par

tner

sS

tand

ards

ad-

opte

d an

d im

ple-

men

ted


33

Dev

elop

and

dis

sem

inat

e a

natio

nal l

ist o

f dan

-ge

rous

che

mic

als,

infe

ctio

us a

gent

s an

d ot

her

dang

erou

s m

ater

ials

to fa

cilit

ies

and

pers

onne

l

xN

atio

nal l

ist o

f da

nger

ous

path

o-ge

ns a

vaila

ble

Mai

ntai

n in

vent

ory

syst

em to

acc

ount

for i

nfec

-tio

us a

nd d

ange

rous

org

anis

ms

xx

xx

Inve

ntor

y sy

stem

in

pla

ce

4.9

LAB

OR

ATO

RY IN

FOR

MAT

ION

SYS

TEM

:

To e

nsur

e th

at a

ll le

vels

of l

abor

ator

y se

rvic

es h

ave

a fu

nctio

nal a

nd c

ompr

ehen

sive

labo

rato

ry in

form

atio

n sy

stem

that

man

ages

and

di

ssem

inat

es d

ata

for u

se b

y al

l rel

evan

t sta

keho

lder

s

Spe

cific

obj

ectiv

esA

ctiv

ities

Tim

efra

me

(200

0)R

espo

nsib

le

partn

ers

Out

com

es /

Pla

nned

resu

lts17

1819

2021

To s

treng

then

pap

er b

ased

la

bora

tory

info

rmat

ion

syst

ems

to p

rom

ote

labo

rato

ry

perfo

rman

ce, q

ualit

y pa

tient

ca

re, s

urve

illan

ce, e

vide

nce-

base

d m

edic

ine

and

plan

ning

, po

licy

form

ulat

ion

and

rese

arch

.

Dev

elop

gui

delin

es a

nd a

sta

ndar

dize

d pa

per

base

d sy

stem

with

tool

s e.

g. R

egis

ters

, re

ques

t for

ms,

mon

thly

repo

rting

tool

s fo

r all

indi

cato

rs.

xD

LS &

Fun

ding

P

artn

ers

Pap

er b

ased

sy

stem

and

ne

cess

ary

tool

s.

Tr

ain

labo

rato

ry s

taff

on th

e pa

per b

ased

sy

stem

xx

xx

XD

LS &

Fun

ding

P

artn

ers

Trai

ned

labo

rato

ry s

taff

D

isse

min

ate

and

pilo

t the

sta

ndar

dize

d pa

per

base

d sy

stem

s in

sel

ecte

d di

stric

ts.

xD

LS &

Fun

ding

P

artn

ers

Res

ults

of t

he

pilo

t stu

dy

Rol

l out

the

stan

dard

ized

pap

er b

ased

sy

stem

sx

DLS

& F

undi

ng

Par

tner

sFu

nctio

nal L

ab

Info

rmat

ion

syst

em

34

National Health Laboratory Strategic Plan 2017-2021To

impl

emen

t an

elec

troni

c La

bora

tory

info

rmat

ion

syst

ems

Dev

elop

gui

delin

es a

nd a

sta

ndar

dise

d el

ectro

nic

LIS

with

tool

s e.

g. R

egis

ters

, re

ques

t for

ms,

mon

thly

repo

rting

tool

s fo

r all

indi

cato

rs.

x

DLS

& F

undi

ng

Par

tner

sP

aper

bas

ed

syst

em a

nd

nece

ssar

y to

ols.

P

rocu

re IT

Har

dwar

e an

d in

frast

ruct

ure

for t

he

oper

atio

n of

the

elec

troni

c LI

Sx

xD

LS &

Fun

ding

P

artn

ers

IT H

ardw

are

&

Infra

stru

ctur

e

Inte

grat

e la

bora

tory

ele

ctro

nic

LIS

with

the

MoH

CC

ele

ctro

nic

syst

em w

hich

cov

ers

othe

r de

partm

ents

e.g

. Pha

rmac

y, P

MTC

T, E

IDx

xx

DLS

& F

undi

ng

Par

tner

sIn

tegr

ated

sy

stem

Tr

ain

labo

rato

ry s

taff

on th

e E

lect

roni

c LI

S

syst

emx

xx

XD

LS &

Fun

ding

P

artn

ers

Trai

ned

labo

rato

ry s

taff

P

ilot t

he s

tand

ardi

sed

Ele

ctro

nic

LIS

in

sele

cted

labo

rato

ries.

xD

LS &

Fun

ding

P

artn

ers

Res

ults

of t

he

pilo

t stu

dy

Rol

l out

the

LIS

to la

bora

torie

s ba

sed

on

the

wor

k pl

anx

DLS

& F

undi

ng

Par

tner

sLa

bora

torie

s us

ing

Ele

ctro

nic

LIS

.

Pro

vide

reso

urce

s to

ens

ure

conn

ectiv

ity o

f LI

S

xD

LS &

Fun

ding

P

artn

ers

Ele

ctro

nic

repo

rts


35

4.10

. RES

EAR

CH

, DEV

ELO

PMEN

T A

ND

CO

LLA

BO

RAT

ION

:

To p

rom

ote

the

deve

lopm

ent o

f res

earc

h th

at is

rele

vant

to th

e he

alth

prio

ritie

s of

the

coun

try

Spec

ific

obje

ctiv

esAc

tivit

ies

Tim

efra

me

(200

0)Re

spon

sibl

e pa

rtne

rsO

utco

mes

/

Plan

ned

resu

lts

1718

1920

21

To p

rom

ote

labo

rato

ry

base

d op

erat

iona

l res

earc

h in

line

with

pri

oriti

es o

f th

e M

OHCC

.

Deve

lop

and

diss

emin

ate

rese

arch

age

nda/

pr

iori

ties f

or L

abor

ator

y Se

rvic

es

xDL

SRe

sear

ch a

gend

a di

ssem

inat

ed

Build

capa

city

of M

edic

al L

abor

ator

y Sc

ien-

tists

on

rese

arch

met

hodo

logy

x

xx

xX

DLS

and

part

ners

Lab

pers

onne

l con

-du

ctin

g re

sear

chDe

velo

p a

men

tors

hip

prog

ram

on

oper

a-tio

nal r

esea

rch

xDL

S an

d pa

rtne

rsRe

sear

ch m

ento

r-sh

ip p

rogr

am in

pl

ace

Cond

uct r

esea

rch

that

resp

onds

to p

rior

ity

area

sx

xx

xX

Lab

pers

onne

lRe

sear

ch a

nd p

ub-

licat

ions

Cond

uct r

esea

rch

that

com

plie

s with

rel-

evan

t eth

ical

inst

itutio

nal a

nd /

or n

atio

nal

revi

ew b

oard

s

xx

xx

XLa

b pe

rson

nel

Ethi

cal a

ppro

ved

rese

arch

Orga

nize

ann

ual L

abor

ator

y re

sear

ch d

ayx

xx

xX

DLS

and

part

ners

Prom

otio

n of

re-

sear

ch a

mon

g la

b pe

rson

nel

Impl

emen

t res

earc

h fin

ding

s/ re

com

men

-da

tions

xx

xx

XDL

SEv

iden

ce b

ased

de-

cisi

on m

akin

gPr

omot

e da

ta u

tiliz

atio

n at

faci

lity

leve

l to

info

rm o

pera

tions

and

impr

ovem

ent

xx

xx

XDL

SUt

iliza

tion

of la

b da

ta a

t all

leve

ls

To e

ncou

rage

colla

bora

tive

rese

arch

nat

iona

lly, r

egio

n-al

ly a

nd in

tern

atio

nally

Esta

blis

h co

llabo

ratio

ns w

ith U

nive

rsiti

es

and

rese

arch

inst

itute

sx

xx

xX

DLS

Colla

bora

tive

rese

arch

bei

ng

cond

ucte

d

36


11 M

ON

ITO

RIN

G a

nd E

valu

atio

n:

To m

onito

r and

eva

luat

e th

e qu

ality

of t

he la

bora

tory

ser

vice

s us

ing

clea

rly d

efine

d la

bora

tory

indi

cato

rs

Spe

cific

obj

ectiv

esA

ctiv

ities

Tim

efra

me

(200

0)R

espo

nsib

le p

art-

ners

Out

com

es /

Pla

nned

resu

lts17

1819

2021

To d

evel

op a

nd im

plem

ent M

&

E s

yste

m to

ass

ess

per-

form

ance

of t

he la

bora

tory

se

rvic

es

Dev

elop

a la

bora

tory

M &

E fr

amew

ork

in

alig

nmen

t with

the

Nat

iona

l M &

E p

lan

(indi

-ca

tors

, rep

ortin

g, s

ourc

es o

f dat

a, fe

edba

ck

mec

hani

sm)

x

DLS

Labo

rato

ry M

& E

fra

mew

ork

in p

lace

App

oint

/hire

an

M &

E c

oord

inat

or w

ithin

DLS

xD

LSM

& E

coo

rdin

ator

re

crui

ted

Est

ablis

h an

d im

plem

ent d

etai

led

M &

E p

ro-

cedu

res

xD

LSM

& E

pro

cedu

res

Dev

elop

mea

sura

ble

indi

cato

rs, t

ools

and

m

ilest

ones

for q

ualit

y de

liver

y of

labo

rato

ry

serv

ices

xD

LSC

lear

Lab

indi

ca-

tors

Trai

n la

bora

tory

per

sonn

el o

n th

e M

& E

fra

mew

ork

& p

roce

dure

sx

DLS

and

par

tner

Trai

ned

lab

staf

f on

M &

EM

anag

e an

d us

e M

& E

dat

ax

xx

xD

LSIm

prov

ed p

er-

form

ance

of L

ab

serv

ices


37

4.11

FIN

AN

CIN

G L

abor

ator

y Se

rvic

es:

To e

nsur

e pr

ovis

ion

of s

uffic

ient

fund

ing

for t

he im

plem

enta

tion

of th

e la

bora

tory

ser

vice

sSp

ecifi

c ob

ject

ives

Activ

itie

sTi

mef

ram

e (2

000)

Resp

onsi

ble

part

ners

Out

com

es /

Pl

anne

d re

sult

s17

1819

2021

To e

nsur

e re

sour

ce m

obi-

lizat

ion

for e

xpan

sion

of

labo

rato

ry se

rvic

es.

Deve

lop

annu

al w

ork

plan

s and

bud

gets

xx

xx

X

DLS

Annu

al w

ork

plan

s an

d bu

dget

s

Enco

urag

e pa

rtic

ipat

ion

of la

bora

tory

per

-so

nnel

in b

udge

t pla

nnin

g H

ospi

tal M

anag

e-m

ent m

eetin

gsx

xx

xX

DLS

Incr

ease

d la

b al

loca

-tio

n w

ithin

hos

pita

l bu

dget

Esta

blis

h co

st re

cove

ry m

echa

nism

s at

low

er le

vel(p

rovi

ncia

l dow

nwar

ds) f

or

char

geab

le te

sts

xx

xx

XDL

SIn

crea

se la

b bu

dget

Revi

ve th

e la

b vo

te sy

stem

at t

he h

ospi

tals

xDL

SLa

b vo

te sy

stem

in

plac

eDe

velo

p co

sted

ope

ratio

n pl

ans b

ased

on

the

stra

tegi

c pla

n x

x x

x X

DLS

and

part

ners

Cost

ed o

pera

tion

plan

sPr

esen

t fin

anci

al g

ap a

t lea

st tw

ice

annu

ally

to

stak

ehol

ders

and

par

tner

sx

xx

xX

DLS

Part

ner s

uppo

rt to

la

b bu

dget

Trai

n he

ads o

f lab

orat

orie

s on

deve

lopm

ent

of co

sted

and

tim

ed w

ork

plan

s x

DLS

and

part

ners

Trai

ned

lab

man

ag-

ers o

n pl

anni

ng a

nd

budg

etin

gDe

velo

p pr

opos

als f

or fu

ndin

g w

ith e

vi-

denc

e ba

sed

info

rmat

ion

xx

xx

XDL

S an

d pa

rtne

rsFu

nded

pro

posa

ls

Deve

lop

a fr

amew

ork

for P

riva

te P

ublic

Pa

rtne

rshi

ps (P

PP)

xx

DLS

and

part

ners

Expl

ore

oppo

rtun

ities

for P

riva

te P

ublic

Pa

rtne

rshi

p (P

PP)

xx

xx

XDL

SPP

P in

pla

ce

38


PRIORITY STRATEGIC ACTIVITIES5

1. I ncrease capacity of the Laboratory Directorate to coordinate Lab Services in the country through creating and recruiting focal persons for the following areas: Quality Assurance, M&E/ Research and Development, ICT & LIMS.

2. Harmonisation and standardisation of laboratory equipment

3. Service and maintenance plans for all laboratory equipment

6. Clearly defining laboratory indicators and using them to monitor performance of the Laboratory Services

4. Implementing the integrated sample referral system

5. Accreditation of National Reference Laboratories

Government of Zimbabwe

ministry of health & child care · 1.1.2 the national blood services zimbabwe (nbsz) the nbsz...

Documents