"Stars" Aligning for Nigeria's Labs

Thanks to a project at the Nigerian Institute of Medical Research (NIMR), laboratories in Nigeria are now moving toward accreditation -- star by star. 

With IANPHI support, NIMR is implementing the Strengthening Laboratory Management toward Accreditation (SLMTA) program developed by WHO/AFRO.  The 18-month accreditation pathway model uses a 5-star rubric to evaluate laboratories as they progress toward international quality standards.  The program’s “train-the-trainer” approach also builds a critical mass of experts who can teach and mentor fellow laboratorians and audit and support laboratories for stepwise improvement.

Of the 5,349 diagnostic laboratories operating in Nigeria, only two are accredited by the International Organization for Standardization (ISO).  The result: misdiagnosed and mismanaged diseases, suspect data, and delayed recognition and control of outbreaks in Africa’s most populous country. 

In 2010 the U.S. government began supporting the SLMTA program in 23 PEPFAR-funded laboratories in Nigeria.  To help Nigeria expand its national capacity for diagnosis and data collection for other disease threats, IANPHI funded a pilot project at NIMR to support six non-PEPFAR laboratories (all rated at ‘0 stars’ at baseline). 

Training NIMR

After a year of implementation, one of the IANPHI-supported labs has already moved to 3-star status, with all expected to achieve 4-5 stars by the end of the project. 

The project’s first year also yielded 24 new SLMTA expert trainers (“SLMTANs”) -- increasing the number in the country to 31 (there are 294 trained SLMTANs globally).  In addition, the project trained and certified 3 new ‘master’ trainers -- the first in Nigeria (there are only 18 in all of Africa and 26 globally).  The strong new cadre of Nigerian experts is now primed to support a national roll-out of lab accreditation programs and will be a major source of expertise for Nigeria and the West African region.

According to Professor Oni Idigbe, NIMR’s Coordinator of Research Programs and project lead, this expertise and support are sorely needed in Africa, where less than 5% of health laboratories have any form of accreditation.  Moreover, most of these labs are still at the 0-star level based on the WHO/AFRO SLMTA accreditation scheme but are nonetheless providing services and test reports to patients and other laboratories.

“The crucial point is that there is still hope to significantly improve or change this situation,” says Professor Idigbe, “as data have shown that where laboratories are assisted to go through the SLMTA program there have been meaningful improvements in the labs’ quality management systems.”  He adds, however, that “in Africa, most health labs have yet to embrace SLMTA.   To improve the quality of laboratory test results and subsequently the overall healthcare delivery  in African nations, labs must be encouraged and supported to embrace SLMTA  or any other accreditation program.”  

SLMTA Training at NIMR

Featured Video: SLMTA SINGERS