title: Strengthening national laboratory health systems in the Caribbean Region.
abstract: The President's Emergency Plan for AIDS Relief (PEPFAR) programme for the Caribbean Region was established in 2008 to address health system challenges, including fragile laboratory services and systems. The laboratory component of this programme consisted of several phases: assessment of laboratory needs of all 12 countries engaged in the programme; addressing gaps identified during the assessment; and monitoring and evaluation of the progress achieved. After one year of PEPFAR collaboration with national governments and other partners, laboratory services and systems greatly improved. Some of the milestones include: (1) the accreditation of a public laboratory; (2) improved access to HIV diagnosis with faster turnaround time; (3) establishment of capacity for platforms for DNA PCR, viral load and HIV drug resistance; (4) development of the laboratory workforce; and (5) establishment of a framework for implementation of sustainable quality management systems for laboratory accreditation. The progress recorded in strengthening laboratory health systems after one year of initiating this collaboration shows that with a rigorous initial assessment, programme design and intervention and strategic partnership, national laboratory health systems can be greatly enhanced to support programme implementation. Continued collaboration and country leadership is critical to create an integrated and sustainable laboratory network in the Caribbean.
authors.affiliation: Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Caribbean Regional Office, Bridgetown, Barbados. ikv3@cdc.gov
authors.forename: George A
authors.initials: GA
authors.lastname: Alemnji
authors.forename: Songee
authors.initials: S
authors.lastname: Branch
authors.forename: Anton
authors.initials: A
authors.lastname: Best
authors.forename: Mireille
authors.initials: M
authors.lastname: Kalou
authors.forename: Bharat
authors.initials: B
authors.lastname: Parekh
authors.forename: Wanjiru
authors.initials: W
authors.lastname: Waruiru
authors.forename: Eric
authors.initials: E
authors.lastname: Milstrey
authors.forename: William
authors.initials: W
authors.lastname: Conn
authors.forename: John N
authors.initials: JN
authors.lastname: Nkengasong
authors.forename: Shirley
authors.initials: S
authors.lastname: Lecher
mesh_terms: D000068:Accreditation; D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis* / Q000517:prevention & control; D017691:Caribbean Region; D019411:Clinical Laboratory Techniques / Q000592:standards; D003906:Developing Countries; D006801:Humans; D007753:Laboratories / Q000458:organization & administration* / Q000592:standards*; D017056:Medical Laboratory Personnel / Q000193:education / Q000592:standards; D009313:National Health Programs; D020380:Needs Assessment; D011785:Quality Assurance, Health Care; D013997:Time Factors