Strategic plans and national lab policy
APHL’s “Guidance for Development of National Laboratory Strategic Plans,” a dynamic living document developed in collaboration with CDC and WHO, is assisting health systems worldwide to understand every stage of strategic planning, from setting goals and timelines to determining needed human resources and aligning national policy.
But our work goes beyond this theoretical level to the practical realities of collaborating with ministries of health throughout Africa to convene key stakeholders and develop strategic plans. For instance, in Kenya, APHL contributed to development of the National Policy Guidelines for Medical Laboratory Services, the blueprint for the country's national laboratory system, now approved by the Ministry of Health and in implementation.
Laboratory Information Management Systems (LIMS)
APHL Global Health supports countries in evaluation, design and implementation of LIMS for more efficient management and reporting of lab data. The goal: quality information that can be appropriately used and shared, in both paper- and computer-based systems. To get there, APHL Global Health assists with a full range of activities, including high-level system requirements, RFP development, LIMS hardware and software contract management and database design — as well as project management to ensure on-time deliverables.
APHL understands how electronic data management systems impact laboratories and larger country and regional public health systems. Training, networking with ministries of health, planning for sustainable long-term solutions and aligning with accreditation and quality improvement efforts are all part of our multifaceted approach.
Surveillance and evaluation
From early recognition of outbreaks to population-based surveillance that shapes public health programs, APHL has experience with the role of the laboratory in surveillance. For instance, during the 2009 outbreak of novel influenza A (H1N1), APHL was at the hub of national response efforts.
Its longstanding relationship with CDC means that APHL keeps current with the latest in effective surveillance and evaluation and is experienced in coordinating diverse partners and agencies. APHL also has experience supporting antenatal care surveys in areas including Sierra Leone.
Next to personnel, this can be the area of most pressing need for laboratory systems internationally. What legacy infrastructure can you leverage to improve your lab? What Biosafety Level laboratory do you need, and what is the appropriate technology to implement within that site? How would that lab be aligned with your overall country needs and services? What if you need to move a lab? What construction materials are appropriate for use when building a laboratory?
These are just a sample of the infrastructure questions you can expect APHL consultants to ask—and help answer. From assistance in aligning existing systems and purchases from approved vendors to streamlining the process of instrument validation, APHL considers the full range of needs of your laboratory system. Our big-picture perspective helps guard against laboratories getting stuck with unusable or misaligned instruments or infrastructure.
APHL’s systems approach ensures that infrastructure, personnel, policy and overall strategic planning align with accreditation activities and needs. Our close work with ministries of health and our training, mentorship and technical assistance efforts help laboratories meet the high quality standards of external accreditation.
As a partner in
Strengthening Laboratory Management Toward Accreditation (SLMTA) and Strengthening Laboratory Improvement Program Toward Accreditation (SLIPTA) programs developed by WHO/AFRO, we have helped several laboratories make significant strides towards accreditation.
Training in laboratory management is one of the APHL capabilities countries worldwide most frequently seek. We have developed custom-tailored workshops and curricula that focus on eliminating immediate gaps, but we are also comprehensively addressing the broad range of skills laboratory managers require: strategic planning, financial management, team building, organizational structure and problem solving, among others. The result is increased system-wide capacity of supervisory and management staff who now operate as effective leaders.
Good laboratory practice training, however, is another critical need—and we offer similarly customized training in a range of skills including quality control and quality assurance, equipment maintenance and collaboration within the health system.
APHL is committed to making sure that laboratory twinning benefits both sides, increasing the knowledge and understanding of all in the relationship. APHL was a partner in the World Health Organization’s Laboratory Twinning Initiative, a program that matched laboratories in under-resourced countries and institutions with particular expertise. The goal was improving laboratory practice and international infectious disease surveillance and response.
APHL member laboratories have partnered with national laboratories in several under-resourced countries—such as the Utah State Laboratory with the National Laboratory of Barbados, a partnership focused on laboratory design and biosafety projects. Recently, we have launched a twinning initiative between the Scientific Laboratory Division at the New Mexico Department of Health and the Uganda Central Public Health Laboratory—a partnership designed to support Global Health Security Initiative goals.
Database development and management
Data is the bedrock of public health action, showing us what needs to be targeted and what practices are getting results. APHL works globally to help countries develop, manage and continuously improve databases, using both existing systems and new or adapted technology.
For instance, our work with PulseNet Africa and Asia Pacific allows us to transfer our expertise at US regional database development and the alignment of databases, communications and laboratory systems to international preparedness and response. And a human resources database at laboratories in Mozambique allow the ministry of health to track laboratory personnel resources and levels of training to better prepare for and respond to changing conditions.
Assuring laboratory quality, from validation to follow-up, is a continuous and overarching goal. Through our close partnerships in the United States and internationally with CDC, APHL develops and implements effective, flexible quality improvement and quality assurance programs, including designing and implementing national EQA programs.
APHL consultants are cognizant of the ways quality systems tie in with policy. Setting quality standards has a ripple effect that both improves overall health systems and can provide a strain on resources in several areas. We support labs in getting a higher-level view to better manage this process—and better benefit people.
Network and partnership building
Professional networks and partnerships are of enormous practical value—they make response faster and more efficient. APHL’s experience in building networks and partnerships is evident in its founding role in the Laboratory Response Network, which responds to all hazards with a team of state and local public health, federal, military and international laboratories. For 10 years, APHL has worked in up to 22 countries under the US President’s Emergency Plan for AIDS Relief (PEPFAR), partnering with numerous groups and systems.
As a professional association, APHL provides valuable resources in shared knowledge and best practices in areas ranging from human resources to academic partnerships. Seeking neither to replicate nor supplant existing networks and partnerships, APHL is adept at expanding and encouraging new connections. For instance, APHL contributed to the development of both the Ethiopia Public Health Laboratory Professionals Association (EPHLA) and the African Society for Laboratory Medicine (ASLM).