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Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries

In 2014, the Joint United Nations Programme on HIV/AIDS released its 90-90-90 targets, which make laboratory diagnostics a cornerstone for measuring efforts toward the epidemic control of HIV. A data-driven laboratory harmonization and standardization approach is one way to create efficiencies and e...

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Autores principales: Williams, Jason, Umaru, Farouk, Edgil, Dianna, Kuritsky, Joel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Global Health: Science and Practice 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5042701/
https://www.ncbi.nlm.nih.gov/pubmed/27688718
http://dx.doi.org/10.9745/GHSP-D-16-00004
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author Williams, Jason
Umaru, Farouk
Edgil, Dianna
Kuritsky, Joel
author_facet Williams, Jason
Umaru, Farouk
Edgil, Dianna
Kuritsky, Joel
author_sort Williams, Jason
collection PubMed
description In 2014, the Joint United Nations Programme on HIV/AIDS released its 90-90-90 targets, which make laboratory diagnostics a cornerstone for measuring efforts toward the epidemic control of HIV. A data-driven laboratory harmonization and standardization approach is one way to create efficiencies and ensure optimal laboratory procurements. Following the 2008 “Maputo Declaration on Strengthening of Laboratory Systems”—a call for government leadership in harmonizing tiered laboratory networks and standardizing testing services—several national ministries of health requested that the United States Government and in-country partners help implement the recommendations by facilitating laboratory harmonization and standardization workshops, with a primary focus on improving HIV laboratory service delivery. Between 2007 and 2015, harmonization and standardization workshops were held in 8 African countries. This article reviews progress in the harmonization of laboratory systems in these 8 countries. We examined agreed-upon instrument lists established at the workshops and compared them against instrument data from laboratory quantification exercises over time. We used this measure as an indicator of adherence to national procurement policies. We found high levels of diversity across laboratories’ diagnostic instruments, equipment, and services. This diversity contributes to different levels of compliance with expected service delivery standards. We believe the following challenges to be the most important to address: (1) lack of adherence to procurement policies, (2) absence or limited influence of a coordinating body to fully implement harmonization proposals, and (3) misalignment of laboratory policies with minimum packages of care and with national HIV care and treatment guidelines. Overall, the effort to implement the recommendations from the Maputo Declaration has had mixed success and is a work in progress. Program managers should continue efforts to advance the principles outlined in the Maputo Declaration. Quantification exercises are an important method of identifying instrument diversity, and provide an opportunity to measure efforts toward standardization.
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spelling pubmed-50427012016-10-06 Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries Williams, Jason Umaru, Farouk Edgil, Dianna Kuritsky, Joel Glob Health Sci Pract Original Article In 2014, the Joint United Nations Programme on HIV/AIDS released its 90-90-90 targets, which make laboratory diagnostics a cornerstone for measuring efforts toward the epidemic control of HIV. A data-driven laboratory harmonization and standardization approach is one way to create efficiencies and ensure optimal laboratory procurements. Following the 2008 “Maputo Declaration on Strengthening of Laboratory Systems”—a call for government leadership in harmonizing tiered laboratory networks and standardizing testing services—several national ministries of health requested that the United States Government and in-country partners help implement the recommendations by facilitating laboratory harmonization and standardization workshops, with a primary focus on improving HIV laboratory service delivery. Between 2007 and 2015, harmonization and standardization workshops were held in 8 African countries. This article reviews progress in the harmonization of laboratory systems in these 8 countries. We examined agreed-upon instrument lists established at the workshops and compared them against instrument data from laboratory quantification exercises over time. We used this measure as an indicator of adherence to national procurement policies. We found high levels of diversity across laboratories’ diagnostic instruments, equipment, and services. This diversity contributes to different levels of compliance with expected service delivery standards. We believe the following challenges to be the most important to address: (1) lack of adherence to procurement policies, (2) absence or limited influence of a coordinating body to fully implement harmonization proposals, and (3) misalignment of laboratory policies with minimum packages of care and with national HIV care and treatment guidelines. Overall, the effort to implement the recommendations from the Maputo Declaration has had mixed success and is a work in progress. Program managers should continue efforts to advance the principles outlined in the Maputo Declaration. Quantification exercises are an important method of identifying instrument diversity, and provide an opportunity to measure efforts toward standardization. Global Health: Science and Practice 2016-09-28 /pmc/articles/PMC5042701/ /pubmed/27688718 http://dx.doi.org/10.9745/GHSP-D-16-00004 Text en © Williams et al. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/3.0/. When linking to this article, please use the following permanent link: http://dx.doi.org/10.9745/GHSP-D-16-00004.
spellingShingle Original Article
Williams, Jason
Umaru, Farouk
Edgil, Dianna
Kuritsky, Joel
Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries
title Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries
title_full Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries
title_fullStr Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries
title_full_unstemmed Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries
title_short Progress in Harmonizing Tiered HIV Laboratory Systems: Challenges and Opportunities in 8 African Countries
title_sort progress in harmonizing tiered hiv laboratory systems: challenges and opportunities in 8 african countries
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5042701/
https://www.ncbi.nlm.nih.gov/pubmed/27688718
http://dx.doi.org/10.9745/GHSP-D-16-00004
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