Quality and resilience of clinical laboratories in Rwanda: a need for sustainable strategies

Background Quality healthcare is a global priority, reliant on robust health systems for evidence-based medicine. Clinical laboratories are the backbone of quality healthcare facilitating diagnostics, treatment, patient monitoring, and disease surveillance. Their effectiveness depends on sustainable...

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Main Authors: Vincent Rusanganwa, Innocent Nzabahimana, Magnus Evander
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Global Health Action
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Online Access:http://dx.doi.org/10.1080/16549716.2024.2358633
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author Vincent Rusanganwa
Innocent Nzabahimana
Magnus Evander
author_facet Vincent Rusanganwa
Innocent Nzabahimana
Magnus Evander
author_sort Vincent Rusanganwa
collection DOAJ
description Background Quality healthcare is a global priority, reliant on robust health systems for evidence-based medicine. Clinical laboratories are the backbone of quality healthcare facilitating diagnostics, treatment, patient monitoring, and disease surveillance. Their effectiveness depends on sustainable delivery of accurate test results. Although the Strengthening Laboratory Management Towards Accreditation (SLMTA) programme has enhanced laboratory quality in low-income countries, the long-term sustainability of this improvement remains uncertain. Objective To explore the sustainability of quality performance in clinical laboratories in Rwanda following the conclusion of SLMTA. Methods A quasi-experimental design was adopted, involving 47 laboratories divided into three groups with distinct interventions. While one group received continuous mentorship and annual assessments (group two), interventions for the other groups (groups one and three) ceased following the conclusion of SLMTA. SLMTA experts collected data for 10 years through assessments using WHO’s StepwiseLaboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. Descriptive and t-test analyses were conducted for statistical evaluation. Results Improvements in quality were noted between baseline and exit assessments across all laboratory groups (mean baseline: 35.3%, exit: 65.8%, p < 0.001). However, groups one and three experienced performance declines following SLMTA phase-out (mean group one: 64.6% in reference to 85.8%, p = 0.01; mean group three: 57.3% in reference to 64.7%, p < 0.001). In contrast, group two continued to enhance performance even years later (mean: 86.6%compared to 70.6%, p = 0.03). Conclusion A coordinated implementation of quality improvement plan that enables regular laboratory assessments to pinpoint and address the quality gaps is essential for sustaining quality services in clinical laboratories.
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spelling doaj-art-41d1305f4a604c4c87c9f6e1df2ca9f32025-02-05T12:46:14ZengTaylor & Francis GroupGlobal Health Action1654-98802024-12-0117110.1080/16549716.2024.23586332358633Quality and resilience of clinical laboratories in Rwanda: a need for sustainable strategiesVincent Rusanganwa0Innocent Nzabahimana1Magnus Evander2Umeå UniversityMinistry of HealthUmeå UniversityBackground Quality healthcare is a global priority, reliant on robust health systems for evidence-based medicine. Clinical laboratories are the backbone of quality healthcare facilitating diagnostics, treatment, patient monitoring, and disease surveillance. Their effectiveness depends on sustainable delivery of accurate test results. Although the Strengthening Laboratory Management Towards Accreditation (SLMTA) programme has enhanced laboratory quality in low-income countries, the long-term sustainability of this improvement remains uncertain. Objective To explore the sustainability of quality performance in clinical laboratories in Rwanda following the conclusion of SLMTA. Methods A quasi-experimental design was adopted, involving 47 laboratories divided into three groups with distinct interventions. While one group received continuous mentorship and annual assessments (group two), interventions for the other groups (groups one and three) ceased following the conclusion of SLMTA. SLMTA experts collected data for 10 years through assessments using WHO’s StepwiseLaboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. Descriptive and t-test analyses were conducted for statistical evaluation. Results Improvements in quality were noted between baseline and exit assessments across all laboratory groups (mean baseline: 35.3%, exit: 65.8%, p < 0.001). However, groups one and three experienced performance declines following SLMTA phase-out (mean group one: 64.6% in reference to 85.8%, p = 0.01; mean group three: 57.3% in reference to 64.7%, p < 0.001). In contrast, group two continued to enhance performance even years later (mean: 86.6%compared to 70.6%, p = 0.03). Conclusion A coordinated implementation of quality improvement plan that enables regular laboratory assessments to pinpoint and address the quality gaps is essential for sustaining quality services in clinical laboratories.http://dx.doi.org/10.1080/16549716.2024.2358633quality improvementslmtalaboratory assessmenthealth systemintervention
spellingShingle Vincent Rusanganwa
Innocent Nzabahimana
Magnus Evander
Quality and resilience of clinical laboratories in Rwanda: a need for sustainable strategies
Global Health Action
quality improvement
slmta
laboratory assessment
health system
intervention
title Quality and resilience of clinical laboratories in Rwanda: a need for sustainable strategies
title_full Quality and resilience of clinical laboratories in Rwanda: a need for sustainable strategies
title_fullStr Quality and resilience of clinical laboratories in Rwanda: a need for sustainable strategies
title_full_unstemmed Quality and resilience of clinical laboratories in Rwanda: a need for sustainable strategies
title_short Quality and resilience of clinical laboratories in Rwanda: a need for sustainable strategies
title_sort quality and resilience of clinical laboratories in rwanda a need for sustainable strategies
topic quality improvement
slmta
laboratory assessment
health system
intervention
url http://dx.doi.org/10.1080/16549716.2024.2358633
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AT innocentnzabahimana qualityandresilienceofclinicallaboratoriesinrwandaaneedforsustainablestrategies
AT magnusevander qualityandresilienceofclinicallaboratoriesinrwandaaneedforsustainablestrategies