Presentations for Day 3 Chair: Uganda Sessions started at 8:40 am with a prayer Summary of Day 2 presented by Burundi A small correction was made on items that appeared on that day’s presentation. An addition was made on Mulago’s renovation strategy

Waste Management by Kenya Focused on areas where waste was handled Purpose: to show the level of compliance to the waste mgt requirement and to identify gaps in the implementation 85% had shown partial compliance March 2017: 57% Partial compliance , 43% no compliance Recommendation All facilities need assistance to address areas to achieve full compliance Need for training in Biorisk Mgt, More funding

Waste management by Uganda Use SLIPTA checklist and focused on awareness, infrastructure and equipment Audits conducted in March and December 2016: In March, none of the sites were compliant – 90%, December: Tremendous improvement. Discussions: need to address gaps, Lack of training, Recommendations: ECSA to coordinate and support countries, UNHLS include waste mgt training included in curuculla

Discussions and Questions Waste mgt performance correlates to lab performance Key cross-cutting issues Any environmental issues on WM Data presented for which period Responses: Uganda There is a correlation between WM and Lab performance on SLIPTA Data for March & December 2016. No Data yet for 2017 Kenya Critical issues: Need for indepth analysis No correlation

Questions continued Any correlation when assessment is done by internal assessors and external assessor? Other countries have better data than what we are seeing Response: It was agreed assessment be done by trained peer assessors Performance does not show details of the quality of performance and therefore no evidence of correlation but need for further analysis Area for further study on evidence of the SLIPTA checklist on WM. Unpublished data show area of danger for waste handlers Need to Standardise the process bse SLIPTA checklist does not adequately cover area of WM since the Scope of WM is beyond the lab Double peer assessor with internal assessors to rule out bias

Satellite report - Kenya 3 staff 8 sites 9 under EAPHLN General performances were good March 2017 regional Peer review assessment Presented in terms of QSE Elements: Evaluation and audits improved but still needs more focus ID of NC major challenge. PBF funds used to purchase photocopier and printer

Burundi Satellite report 8 Labs in the Network: initially 5 then 3new ones Presentation about 5 labs Equipment has improved: Xpert, BSC, autoclaves, refrigerator, incubators,etc. Peer assessment results: 4 labs at 3 stars and 1 at 2 stars Challenges: Stockout, HR, sustained performance, equipment calibration & RCA Opportunities: QMS implemented, Capacity building, mentorship, supervision, infrastructure, equipment and peer and national audits

TZ Satellite report MMH a publc institution, started implementation of LQMS IN 2008 and accredited on July 2016 by SADCAS (FBC, TB,CD4, Malaria) Strength: referrals, infrastructure, modern equipment, strong Lab Mgt & documentation and adequate HR Challenges: No strategic plan, biomedical engineers, insufficient budget, weak supply chain mgt, insufficient knowledge on QMS by other HCHs and Hospital mgt Achievements: Technical & financial support, capacity building, equipment Priority areas for action: Equipment maintenance 7 calibration, availability of EQA materials, lab action plan, capacity building on hospital waste management – BRM, availability of funds

Questions and Discussions Results of EQA for TZ: Frequency? Do we have exchange visits within countries or across borders to learn from accredited peers? Other labs not supported by the project, what are we doing to share the knowledge from labs supported by the project? Sustainability? Responses TZ Exchange visit: Peer mentorships by excelling labs within country to motivate other labs EQA: Frequency – Biannually and adequate Professor Joloba: Which key to turn on to make the labs move Key lessons: Other projects have implemented their activities based on the model of the project Sustainability: Government commitment key, Coordinating exchange visit, Peer mentorship

Role of mentors Role: Guidance, leadership 7 championing LQMS & accreditation, link, training mentees, develop & ensure adherence to mentorship work plan and follow up on implementation. Approach: Two weeks contact time, follow up on implementation, development and sharingof action points & adherence to timelines Achievements: Improved TAT, increased beneficiaries, standardized LQMS, Team building, spearheading accreditation application

Questions and discussions Evaluate the performance of mentors Effect of delayed contact with mentees Adequate number of mentors Equipment sustainability (GeneXpert)