WEST AFRICAN NETWORK OF BIOMEDICAL ANALYSIS LABORATORIES

Transcription

1 WEST AFRICAN NETWORK OF BIOMEDICAL ANALYSIS LABORATORIES WEST AFRICAN COUNTRIES UNITE TO IMPROVE QUALITY AND ACCESS FOR BIOLOGICAL DIAGNOSTICS

2 A NOVEL PROGRAM In West Africa, laboratories lack the resources that clinicians need to provide reliable diagnoses. The field of diagnostics has received the least amount of aid and funding from governments in the last few decades. RESAOLAB *, the West African Network of Biomedical Analysis Laboratories, is the first regional program to respond to this public health problem by addressing all the factors that affect the management and performance of laboratories. Designed in collaboration with West African health professionals, it is adapted to the realities in the field. * Réseau d Afrique de l Ouest des Laboratoires d Analyses Biomédicales 02

3 CAPE VERDE MALI NIGER SENEGAL A NATIONAL AND REGIONAL APPROACH THE GAMBIA GUINEA- BISSAU SIERRA LEONE GUINEA LIBERIA IVORY COAST BURKINA FASO GHANA TOGO BENIN NIGERIA Fondation Mérieux launched the RESAOLAB program in 2009 at the request of the health ministries of Burkina Faso, Mali, and Senegal, with support from the Agence Française de Développement (AFD). Four new countries joined the network in 2013: Benin, Guinea, Niger, and Togo. This program is part of the regional health policy established by the West African Health Organization (WAHO). ECOWAS MEMBER STATES INCLUDING RESAOLAB MEMBERS RELIABLE AND ACCESSIBLE DIAGNOSTICS ARE THE KEY TO EFFECTIVE TREATMENT Dr. Sonia Kaboret, Pediatrician, Charles de Gaulle University Hospital, Ouagadougou Improving laboratories means saving many patients lives, making treatments more effective and reducing hospital stays. A clinical biology system that provides high-quality services is essential to improve public health and monitor epidemics. 03

4 5 MAJOR OBJECTIVES Improve regional and national governance of laboratory systems by helping define development policies. Improve laboratory services by setting up a standardized quality system. Strengthen initial and continuing training for laboratory staff. AREAS OF ACTION STRENGTHENING GOVERNANCE EXPANDING TRAINING REINFORCING QUALITY SUPPORTING SURVEILLANCE BUILDING NETWORKS RESAOLAB helps health ministries and laboratory directorates establish national policies for developing clinical biology laboratories to improve the quality of their services. The program seeks to implement action plans to improve the skills of laboratory staff, the quality of analyses, surveillance of infectious diseases, and the creation of laboratory networks at the national and regional level

5 4 5 Establish a Laboratory Information Management System (LIMS) in the network s main laboratories and improve infectious disease surveillance through better Health Information Systems (HIS). Support national laboratory networks and build a functional regional network to share expertise and resources. STRENGTHENING GOVERNANCE SUPPORTING NATIONAL LABORATORY POLICIES RESAOLAB s goal is to strengthen regional and national governance of laboratory systems. Its members work together to create national policies to develop clinical biology laboratories and to implement plans for procurement, waste management, maintenance, and laboratory management. At the national level, RESAOLAB supports the creation of directorates and national laboratory networks in the 7 countries that participate in the program. Each laboratory directorate is essential to ensure optimal performance and guarantee ongoing laboratory development. Its role is to coordinate a network that includes all the public and private medical analysis laboratories in the country, and to ensure the quality of their analyses. With the help of RESAOLAB, both Senegal and Niger have a laboratory directorate like that of Burkina Faso. 05

6 EXPANDING TRAINING ENHANCING HUMAN RESOURCES IN THE LAB HARMONIZE NATIONAL TRAINING POLICIES AND PLANS As part of RESAOLAB, experts and human resource development managers organize national and regional workshops in the seven countries. These workshops are designed to establish a consensus on how to implement the WAHO s regional directives and national training plans. STRENGTHEN INITIAL TRAINING RESAOLAB helps develop and support clinical biology training curricula and the training of professionals in the region. Each year, 35 scholarships (5 per country) provide healthcare personnel with the opportunity to obtain a Biology degree (D.E.S., Master). RESAOLAB is also participating in the creation of a Master II in Biology to help technicians become engineers, in accordance with the WAHO s harmonized curriculum. STRENGTHEN CONTINUING TRAINING RESAOLAB supports continuing training of laboratory staff, particularly through the creation of modules that are developed in collaboration with the network s experts. This skills development program includes 14 modules on such topics as biosafety, data management, diseases with epidemic potential, biochemistry, hematology, etc. These modules are made available in an "e-learning" format on Fondation Mérieux s web portal, GLOBE (Global Link for Online Biomedical Expertise). Trainer training is a cornerstone of the program: RESAOLAB now has a network of more than 120 instructors who have been trained in training engineering, teaching techniques, and the content of the skills development program. All laboratory staff in the member countries will gradually be trained in this harmonized skills development program. To address problems related to laboratory equipment maintenance, RESAOLAB has developed an innovative program to teach groups of technicians how to maintain basic equipment in the biomedical laboratories. 06

7 INFRASTRUCTURE IMPROVING THE LABORATORIES TEACHING AND MANAGEMENT STRUCTURES RESAOLAB helps to expand training in member countries through the construction and renovation of structures that house laboratory directorates or training facilities for laboratory technicians (5 buildings have already been built and 4 have been renovated). The centers that were built and renovated by the program provide lab technicians with optimal training facilities including a classroom, multimedia room, and rooms for practical training. The RESAOLAB teams are responsible for design and project management (design, specifications, calls for tender), in collaboration with local health ministries. RESAOLAB helps to improve teaching conditions for initial training in terms of both infrastructure and equipment. REINFORCING QUALITY IMPROVING THE RELIABILITY OF BIOMEDICAL ANALYSES To ensure access to a reliable diagnosis, RESAOLAB has taken several steps to improve quality expertise, processes, and supervision in medical analysis laboratories: Defining and implementing a quality plan in each country to lay out best practices for laboratory operations. Providing quality training in the laboratories. Offering support to laboratory directorates in each country to help them supervise all the labs. Establishing an external quality assessment system. The results of external quality control are used to assess the progress made by the labs after measures have been implemented. 07

8 SUPPORTING SURVEILLANCE PROVIDING SUPPORT FOR EPIDEMIOLOGICAL SURVEILLANCE AND HEALTH DATA MANAGEMENT Epidemiological surveillance requires a reliable system to collect data from laboratory analyses. RESAOLAB improves surveillance of infectious diseases through daily management of laboratory data and better collection and transmission of epidemiological data to the national governing structures. MANAGEMENT OF LABORATORY DATA Many laboratories lack IT systems to automatically process their data. Daily patient information and test results are collected on paper. As a result, there is a high risk of error and the data is hard to compile and process. To address this problem, RESAOLAB developed Labbook, a data processing software program for laboratories. Labbook is open source and can be downloaded by any laboratory that requests it. TRANSMISSION OF EPIDEMIOLOGICAL DATA In West Africa, laboratories must file a monthly report on the number of cases detected for a dozen notifiable diseases, validated by the health ministries in partnership with the WHO. Since this information is usually collected and transmitted on paper, very few laboratories participate in national surveillance systems and the limited information that is transmitted is hard to process. In order to improve the collection of data that is needed for surveillance of notifiable diseases, RESAOLAB initiated I-LAB. This WAHO-approved system collects data automatically for instant, guaranteed transmission of information. Accessible through the web and smartphone, it operates on a DHIS2 open source platform. 08

9 BUILDING NETWORKS SHARING EXPERTISE AND RESOURCES THROUGH NATIONAL AND INTER-COUNTRY NETWORKS At the regional level, the creation of an intercountry network allows laboratories to pool lessons learned and harmonize national clinical biology policies. This network promotes exchanges and helps strengthen South-South cooperation. It also provides member countries with greater leverage to advocate on behalf of laboratories. PROGRAM STRUCTURE Close collaboration between health ministries in the 7 member countries is the key to the program s success. Operational units in each ministry are responsible for implementing the program s initiatives, following guidelines set out by an International Steering Committee (comprised of representatives from the 7 health ministries, Fondation Mérieux, regional health organizations and financial partners), which meets at least once a year. Fondation Mérieux oversees RESAOLAB and helps the program run smoothly with the support of the health ministries. The WHO, WHO-AFRO, the West African Health Organization (WAHO), and the West African Economic and Monetary Union (WAEMU) are all part of this initiative. RESAOLAB ON THE FRONT LINES OF THE EBOLA CRISIS TRAINING More than 500 health professionals in the network received training on biosafety and hemorrhagic fevers thanks to the course modules developed by RESAOLAB and its partners. RESAOLAB is heavily involved in the response to the Ebola virus disease outbreak and plays an important role in strengthening diagnostic capacities. EXPERT MISSIONS Experts from the program provided on the ground support in Guinea, Burkina Faso and Sierra Leone. SAMPLE TRANSPORT A system for secure transport of samples was established to obtain a rapid and reliable diagnosis. This system was used to transport suspicious samples to the P4 Jean Mérieux-Inserm Laboratory in Lyon. Drawing from lessons learned through the epidemic in 2014 and 2015, RESAOLAB is poised to take the necessary actions should a new threat arise. 09

10 RESAOLAB TOMORROW To continue and further develop its activities in West Africa, RESAOLAB is strengthening its regional presence in all the countries of the Economic Community of West African States (ECOWAS), particularly through the WARDS project. This will enable the training component of RESAOLAB to be deployed in the 15 ECOWAS member states, under the auspices of the WAHO and according to recommendations from the International Health Regulations (IHR) and the Global Health Security Agenda (GHSA). ARDS West Africa Regional Disease Surveillance Capacity Strengthening Project Funded by the World Bank and coordinated by the WAHO, the WARDS project aims to improve disease surveillance and response in the 15 ECOWAS countries. More specifically, it seeks to increase human resource capacity in 60 epidemiological surveillance centers. In light of RESAOLAB s achievements, the WAHO asked Fondation Mérieux and other partners to help implement WARDS. Fondation Mérieux is coordinating the laboratory part and providing its expertise and technical support to improve the skills of laboratory professionals in the other ECOWAS countries: Cape Verde, the Gambia, Ghana, Guinea-Bissau, the Ivory Coast, Liberia, Nigeria, and Sierra Leone. EXPECTED RESULTS FOR THE LABORATORY PART BETWEEN 2014 AND 2017 Conduct 3 training sessions for trainers: a target of 25 trainers. Conduct 12 training sessions for lab technicians: covering close to 180 lab technicians. Translate teaching material into English and Portuguese and make it more widely available: 8 continuing training modules in paper and multimedia formats. Initiate exchanges coordinated by the WAHO to develop a regional laboratory policy. WARDS presents an opportunity to further RESAOLAB s achievements, develop networks in new countries, and strengthen the surveillance system at the peripheral level, where potential threats reside. FOR MORE INFORMATION: wards@fondation-merieux.org 10

11 RESAOLAB International Steering Committee, Benin, 2013 PROGRAM COORDINATION COUNTRY COORDINATORS Fondation Mérieux is an independent family foundation with public interest status. Increasing access to diagnostics by strengthening clinical biology capabilities in developing countries is one of Fondation Mérieux s main objectives to reduce the impact of infectious diseases on vulnerable populations. FOR MORE INFORMATION: resaolab@fondation-merieux.org BENIN Prof. FRÉDÉRIC LOKO BURKINA FASO Prof. JEAN SAKANDÉ GUINEA Dr. KABINÉ SOUARE MALI Prof. FLABOU BOUGOUDOGO NIGER Dr. MAMANE MATY SENEGAL Prof. AHMAD IYANE SOW TOGO Dr. MONIQUE JAMESON DORKENOO 11

12 ACHIEVEMENTS RESAOLAB has already made possible the launch of major continuing training programs, the construction and equipment of training and quality control laboratories, the establishment of epidemiological surveillance tools, and the creation of an inter country network. OVER 500 PUBLIC AND PRIVATE LABORATORIES IN THE NETWORK AND UNDER SUPERVISION IN 7 COUNTRIES MORE THAN 800 LAB TECHNICIANS TRAINED IN OVER 100 TRAINING SESSIONS 45 LABORATORIES EQUIPPED WITH A LABORATORY INFORMATION MANAGEMENT SYSTEM (LIMS) TO SUPPORT EPIDEMIOLOGICAL SURVEILLANCE A SKILLS DEVELOPMENT PROGRAM INCLUDING 14 TRAINING MODULES 7 CONTINUOUS TRAINING CENTERS BUILT OR IN DESIGN PHASE IN 7 COUNTRIES MORE THAN 200 LABORATORIES WITH AN EXTERNAL QUALITY CONTROL PROGRAM Phase I I Budget I 4 million Phase II I Budget I 8 million PARTNERS RESAOLAB s achievements have been made possible thanks to the confidence and commitment of its funding partners. November 2015 Printed in France on recycled paper - Photos: Martin Grosjean, Bernard Seytre, Fondation Mérieux, RESAOLAB Graphic design: H. Bories