Masanza et al. BMC Public Health 2010, 10(Suppl 1):S8 http://www.biomedcentral.com/1471-2458/10/S1/S8 Working with CDC, in-country teams and the host country health ministries, 200 laboratory and non- laboratory testing sites in each country were selected. DTS panels are produced by the national reference laboratories and distributed to these sites on a quarterly basis (or depending on country algorithm) through the postal services. After testing at the sites, the results are sent back to the reference laboratories for analysis and scoring. Feedback reports are generated and poorly performing sites are provided with support supervision visits and/or retraining. The project supports the mailing costs, data entry and laboratory scientists to provide technical backup. Preliminary data received from the ﬁrst PT round reported 80% and 91% response rates in Uganda and Tanzania, respectively. Reasons for poor performance were identiﬁed per sites. Common problem areas include failing to follow national testing algorithms, not mastering proper pipetting technique, failing to follow DTS reconstitution procedures, new or untrained testing staﬀ, and clerical errors in recording test results in both registers and PT report forms. Proper corrective actions, including on-site training and demonstrations, were taken. This project provides an opportunity to assess parameters for eﬀective EQA systems in Africa, such as local production of EQA materials and the utilization of the local mailing and transport systems. Through this project we hope to identify cost-eﬀective ways of design- ing and implementing EQA systems, especially for rapid diagnostics that are expected to play an increasing role in the region. Basic Laboratory Information Systems (BLIS) project At the core of IHR practice is reliable information. In most African settings, laboratory data is stored in a format that makes retrieval, analysis and summarization for public health action diﬃcult. Laboratory information is often captured in multiple reports and may be inaccurate, non-standardized and illegible. The Basic Laboratory Information System (BLIS) is an easy-to-use software that can be used as an eﬀective alternative to paper-based approaches to enhance labora- tory data management. As such, labs move a step towards accreditation by using BLIS to improve laboratory infor- mation management. Moreover, if properly integrated into the laboratory management practices, BLIS addresses document and record management, inventory control and forecasting. Laboratory sites implementing BLIS receive an initial evaluation prior to installation of the software which is customised to the facility needs. The laboratory receives hardware as well as training. Ongoing information technology support is provided by AFENET personnel. Use and management of laboratory data is Page 4 of 7 assessed by monitoring ease of access and retrieval of patient data, as well as laboratory quality indicators like turnaround time. Lessons coming from the ﬁeld indicate that BLIS is making data storage and analysis easier. However, com- puter literacy at low-tier laboratories remains a challenge. With readily available and timely information, public health responses to diseases of international concern can be guided appropriately. Laboratory networking Where resources are scarce and inequitably distributed, networking may reduce the gaps between diﬀerent populations. WHO advocates for the establishment of national public health networks to ensure the timely exchange of information and the adequate support of laboratory services at all levels. At both the national and sub-national levels, only a few countries have functional public health laboratory networks in place. In order to strengthen public health capacity within Africa, AFENET created an AFENET-Lab unit to oversee the networking and implementation of laboratory strengthening initia- tives. One of the unit’s mandates is to promote public health networking and cross-border collaborations between sub-national, national, regional and international public health laboratories and laboratorians for infor- mation sharing, technical support, training and other capacity building programs. We believe that this will enhance laboratory capacity by reducing the isolation of peripheral laboratories and enabling them to access network resources. AFENET-Lab began a pilot laboratory networking project in Uganda in 2009, when a memorandum of understanding was signed with the Ministry of Health, Biomedical Laboratory Network (BLN), Uganda Medical Laboratory Technology Associa- tion (UMLTA) and Uganda Association of Biomedical Scientists (UABMS). Strengthening Laboratory Management towards Accreditation (SLMTA) program Accreditation is a means of certifying the competence of a laboratory to perform speciﬁc types of testing and it enhances customer conﬁdence in accepting testing results. Medical laboratories are accredited by attaining requirements for quality and competency based on international standards, namely ISO 15189. Accredited laboratories therefore play a critical role in providing reliable information to inform IHR decision-making and guiding public health response. Currently, there are very few accredited laboratories in Africa and most of these belong to private sector or international research organi- zations. The accreditation process requires stringent conditions that have been largely unattainable by most public health laboratories in Africa.