Masanza et al. BMC Public Health 2010, 10(Suppl 1):S8 http://www.biomedcentral.com/1471-2458/10/S1/S8 To address the paucity of accredited laboratories in the African region, the WHO Regional Oﬃce for Africa (WHO AFRO) established a stepwise approach for labora- tories to attain the required standards. This approach supports laboratories at all levels through a series of evaluations using demonstrated improvements, which are recognized and rewarded for the progress [14,15]. To support this accreditation process, the Strengthen- ing Laboratory Management towards Accreditation (SLMTA) program — a training and mentoring toolkit for laboratory improvement and accreditation was developed. The purpose of the SLMTA trainings is to strengthen laboratory management for immediate and measurable laboratory improvement and to accelerate the process toward lab accreditation by WHO AFRO. AFENET, as a regional partner, took the lead in creating the momentum for the SLMTA roll out update which is posted on the AFENET-Lab website. AFENET, working with other partners, has so far provided technical assistance by conducting baseline assessments and trainings in Rwanda, Zimbabwe and Swaziland. AFENET is therefore well positioned to support diﬀerent countries in the roll out of SLMTA. To garner support for this eﬀort, AFENET collaborated with the WHO, CDC, and the Ugandan Ministry of Health to organize a workshop for senior policymakers to advocate for laboratory accreditation. Over 40 public health experts, including oﬃcials from the health minis- tries of Uganda, Kenya, Tanzania, Rwanda, and Ethiopia met in July 2010 in Kampala. Countries expressed their commitment to develop national laboratory policies and strategic plans that incorporate laboratory accreditation within the next coming year. Equipment calibration Laboratory equipment maintenance and calibration is one of the key components of improving the quality of laboratory services, and is also critical in moving labora- tories towards the stepwise WHO AFRO accreditation scheme. Additionally, quality equipment is essential to produce the valid and reliable laboratory results needed to inform decision-making in outbreak situations. The lack of working equipment has aﬀected the eﬀective delivery of health care in resource-poor settings. Often, laboratory equipment does not function properly because regular maintenance services are unavailable, particularly for ancillary equipment. Very little eﬀort has been directed towards laboratory equipment calibration. The few automated laboratory machines that come with service contracts are typically the only equipment that receive regular maintenance. Additionally, the existing commercial services providers have remained costly, making it diﬃcult for health ministries to be able to maintain all the laboratory equipment. Page 5 of 7 AFENET, in collaboration with CDC and other partners such as Global Health Systems Solutions (GHSS), has organized training sessions to create a pool of local and regional biomedical engineers and equipment technicians able to meet the demands of laboratory equipment maintenance and calibration on a regular basis. This training creates regional capacity that reduces the costs of having the laboratory equipment serviced and calibrated. The trained cadres are part of the health ministry institutions, thereby ensuring that capacity to address equipment calibration is readily available. The biomedical engineers and equipment technicians are trained on servicing and calibration of a variety of laboratory equipment. These cadres are then sent back to their countries to provide equipment servicing and calibration support, particularly to the laboratories enrolled for accreditation. Six participants, two from each country, from Kenya, Tanzania and Cameroon went through the rigorous practical training in calibration and maintenance of pipettes, microscopes, heating blocks, incubators, auto- claves, microplate washers and readers, vortex stirrer, centrifuges, refrigerators and freezers. Pre- and post- assessment tests were conducted, and results showed an increase in the knowledge gained during the training. Table 2 shows the scores. There is a great need to support these seed staﬀ so they can scale up this training and acquire standardized calibration tools for these countries. Harmonization of laboratory training materials Until recently, diﬀerent partners have been conducting various laboratory capacity building trainings in Uganda without following a standard curriculum or using standardized learning materials. A number of develop- ment partners have implemented various trainings to build laboratory capacity for health services in Uganda. Consequently, a single laboratory may receive a number of diﬀerent training materials from various well-meaning organizations, and this can be overwhelming to an already understaﬀed laboratory. To address this problem, the training sub-committee of the Uganda National Health Laboratory Technical and Advisory Committee (LTC) received ﬁnancial and technical support from AFENET to put together a comprehensive training package to equip laboratory workers with the manage- ment skills they require to be eﬀective in their positions. The training packages are a compilation of learning materials from various partners that were customized to meet the requirements of agreed upon curriculum. The curriculum is practical oriented and targets not only laboratory-speciﬁc needs, but also general management skills to achieve overall system strengthening for health services.