Project Abstract Summary
Over the past 10 years, the Republic of South Sudan (RSS), with the support from the President’s Emergency Plan for AIDS Relief (PEPFAR) and partners, has made progress towards 95/95/95 goals despite a challenging context defined by conflict and severe poverty and food insecurity. Through this proposed project, ICAP at Columbia University (ICAP) will drive innovations in laboratory quality, safety, equipment maintenance, supply chain, data use for program management, and build RSS Ministry of Health (MOH) capacity to ensure better access to HIV diagnosis, treatment monitoring, and cross-disease detection.
ICAP, a key partner to MOH since 2012, has delivered transformative solutions in laboratory diagnostics and partnered with MOH and the National Public Health Laboratory (NPHL) to support groundbreaking interventions, including differentiated service delivery; international accreditation of the HIV Reference Laboratory under NPHL; implementation of continuous quality improvement, with corresponding delivery of Strengthening Laboratory Management Towards Accreditation training for staff; and the establishment of early infant diagnosis (EID), viral load (VL), and tuberculosis (TB) point-of-care testing services, decentralizing access to quality diagnostics for improved health equity. ICAP’s support has been characterized by a consistent focus on health systems strengthening, and human resources for health strengthening and capacity building towards local ownership and stewardship of the laboratory system.
ICAP proposes to strengthen the capacity of RSS MOH to provide improved access and quality laboratory testing services that support HIV/AIDS diagnosis, treatment monitoring, prevention, and laboratory-based surveillance of HIV and other conditions. ICAP will expand continuous quality improvement services, enhance biosafety and waste management practices, strengthen systems for equipment and stock management across tiered laboratory network, facilitate a sustainable and reliable laboratory information system, build resilient monitoring and evaluation systems and data utilization for policy and programming, integrate specimen referral systems and introduce new technologies including for diagnosis of complications among RoC with advanced HIV disease. ICAP will build individual, organizational, and system-wide capacity in laboratory service organization and management at national and sub-national laboratory services structures.
Short-term outcomes of the project include improved coverage and quality of HIV diagnosis and VL monitoring; improved efficiency of integrated national sample and results referral system; improved participation and performance in laboratory CQI activities; improved site biosafety and waste management; improved performance monitoring of assays, personnel, and testing facility; reduced testing interruptions at all PEPFAR-supported testing points due to equipment downtime or stock out of reagents or supplies; improved data quality and access through integrated dashboards at the tiered diagnostic network; and improved capacity of laboratory managers to coordinate and supervise laboratory services. Intermediate outcomes include increased access to quality-assured HIV rapid testing, VL, EID, TB, CD4, and cross-disease diagnostics; improved utilization of laboratory services throughout the tiered laboratory network; improved sample management system at NPHL and regional laboratories; improved equipment maintenance and monitoring of stack across tiered laboratory network; and increased capacity of monitoring and evaluation (M&E) in program data management and utilization. Long-term outcomes include improved clinical outcomes for HIV and TB clients; sustained capacity to provide, monitor, and improve quality laboratory services; enhanced utilization and management of data for program and laboratory improvement and sustainability; and autonomous medical laboratory regulatory council.
