In this funding request, Global Health Systems Solutions (GHSS) will assist the government of Cameroon to strengthen and expand laboratory systems and services, and build the competencies of laboratory staff in order to improve the quality of testing needed to support HIV prevention, treatment and care goals in prioritized national and sub-national geographic locations of Cameroon that have been prioritized for intervention by CDC/PEPFAR. GHSS will leverage its vast experience acquired over the last 10 years, as the sole CDC/PEPFAR laboratory-implementing partner, to implement the activities outlined in this application and address existing gaps and challenges that hinder access to and availability of quality laboratory services. GHSS specific strategies for the Request for Funding Application (RFA) will include: 1) Implement laboratory QMS geared towards improving the quality of test results using innovative quality strategies, leading to the accreditation of VL/EID and regional hospital laboratories (RHLs); 2) Extend EQA coverage and participation for HIV, EID, viral load, CD4, TB and other HIV related metabolites to support CQI; 3) Provide technical assistance and support training/capacity building and mentoring of MOH laboratory personnel and Q-Corps to scale up CQI and ensure institutionalization and sustainability of CQI activities; 4) Establish and strengthen existing sample referral and transport networks for specimens and results for quality HTC, PMTCT, and ART coverage; 5) Provide technical assistance and support to implement LIMS in all VLRL and POC facilities to facilitate test ordering and real-time reporting and provision of buffer stock of reagents and cartridges to ensure continuous testing; and 6) Collaborate with and support the NPHL and DPML to review (existing), develop (New) and institutionalize policies, strategic plans, tools, SOPs, Job Aids and activities geared toward the coordination of QMS, QA, CQI and EQA, and to stre
ngthen the Lab network and sample referrals. At the end of the project period, GHSS expects to achieve the following outcomes: At the end of the project period, GHSS expects to achieve the following outcomes: 1) Improved QMS in 100 laboratories according to the WHO AFRO-CDC SLIPTA process, with 05 VL and 05 RHLs accredited, 05 VL and 03 RHLs attained at least 2 SLIPTA stars, and the current 5 already accredited labs maintained. 2) All PEPFAR-supported facilities testing for HIVRT, EID, VL, CD4, TB enrolled on EQA with 95% success rates; EQA for other HIV related metabolites supported for 23+ labs on accreditation; 3) 500 HIVRT testing sites, 80 HIV related testing sites and 1750+ testers certified, a network of 60 Q-Corps supporting hard to reach areas with improved quality of test results;4) A functional integrated specimen referral network in 10 regions with, 50% reduction in TAT on specimen transportation; 5) 80% of VLRL and POC facilities use LIS for managing laboratory data with an 80% reduction in delay in reporting patients test results and transcription errors; and 6) Existing policies, strategic plans, tools, SOPs and Job Aids reviewed and adopted; new policies and guidelines identified, developed and implemented. Our overall strategy to strengthen laboratory systems in Cameroon will include; building and improving on diagnostic capacity, leveraging and innovating national systems, and transitioning activities to MOH for sustainability.