During the supervisory visits, a check list is used to assess performance in technical activities, the extent of compliance with SOPs, the quality and reporting of results, record keeping, internal quality controls, instrument performance (especially microscopes and spectrophotometers), availability and quality of reagents, and management of consumables. The extent of reliably available utilities (such as water and electricity), laboratory space and standard biosecurity capacities are also assessed. There are 420 facilities that receive at least one visit per year. Some may receive two or three visits during the year depending on the supervisory results. The number of actual supervisory visits to laboratory sites is maintained at a high level, e.g., 517 in 2005, 862 in 2006, and 689 in 2007. The supervisory visit data is analyzed and feedback is given to the respective health facilities. When results are not satisfactory, the NRL intervenes for corrective actions, in the form of retraining or amelioration of other causes of poor performance. Plans are underway to decentralize quality control and supervisory activities. In the new plan, the district hospital laboratories will take charge of the health centers while the NRL will supervise the referral hospitals, the district hospital and private laboratories.