title: Piloting laboratory quality system management in six health facilities in Nigeria.
abstract: BACKGROUND
  Achieving accreditation in laboratories is a challenge in Nigeria like in most African countries. Nigeria adopted the World Health Organization Regional Office for Africa Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (WHO/AFRO- SLIPTA) in 2010. We report on FHI360 effort and progress in piloting WHO-AFRO recognition and accreditation preparedness in six health facility laboratories in five different states of Nigeria.
  
  
  METHODS
  Laboratory assessments were conducted at baseline, follow up and exit using the WHO/AFRO- SLIPTA checklist. From the total percentage score obtained, the quality status of laboratories were classified using a zero to five star rating, based on the WHO/AFRO quality improvement stepwise approach. Major interventions include advocacy, capacity building, mentorship and quality improvement projects.
  
  
  RESULTS
  At baseline audit, two of the laboratories attained 1- star while the remaining four were at 0- star. At follow up audit one lab was at 1- star, two at 3-star and three at 4-star. At exit audit, four labs were at 4- star, one at 3-star and one at 2-star rating. One laboratory dropped a 'star' at exit audit, while others consistently improved. The two weakest elements at baseline; internal audit (4%) and occurrence/incidence management (15%) improved significantly, with an exit score of 76% and 81% respectively. The elements facility and safety was the major strength across board throughout the audit exercise.
  
  
  CONCLUSIONS
  This effort resulted in measurable and positive impact on the laboratories. We recommend further improvement towards a formal international accreditation status and scale up of WHO/AFRO- SLIPTA implementation in Nigeria.
authors.affiliation: Family Health International (FHI360), Plot 1073-A1, GODAB Plaza, Area 3, Garki-Abuja, Nigeria.
authors.forename: Henry
authors.initials: H
authors.lastname: Mbah
authors.affiliation: Family Health International (FHI360), Plot 1073-A1, GODAB Plaza, Area 3, Garki-Abuja, Nigeria.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Ojo
authors.affiliation: Family Health International (FHI360), Plot 1073-A1, GODAB Plaza, Area 3, Garki-Abuja, Nigeria.
authors.forename: James
authors.initials: J
authors.lastname: Ameh
authors.affiliation: Family Health International (FHI360), Plot 1073-A1, GODAB Plaza, Area 3, Garki-Abuja, Nigeria.
authors.forename: Humphrey
authors.initials: H
authors.lastname: Musuluma
authors.affiliation: Family Health International (FHI360), Plot 1073-A1, GODAB Plaza, Area 3, Garki-Abuja, Nigeria.
authors.forename: Olubunmi Ruth
authors.initials: OR
authors.lastname: Negedu-Momoh
authors.affiliation: Family Health International (FHI360), Plot 1073-A1, GODAB Plaza, Area 3, Garki-Abuja, Nigeria.
authors.forename: Feyisayo
authors.initials: F
authors.lastname: Jegede
authors.affiliation: Family Health International (FHI360), Plot 1073-A1, GODAB Plaza, Area 3, Garki-Abuja, Nigeria.
authors.forename: Olufunmilayo
authors.initials: O
authors.lastname: Ojo
authors.affiliation: Family Health International (FHI360), Plot 1073-A1, GODAB Plaza, Area 3, Garki-Abuja, Nigeria.
authors.forename: Nkem
authors.initials: N
authors.lastname: Uwakwe
authors.affiliation: Family Health International (FHI360), Plot 1073-A1, GODAB Plaza, Area 3, Garki-Abuja, Nigeria.
authors.forename: Kingsley
authors.initials: K
authors.lastname: Ochei
authors.affiliation: Family Health International (FHI360), Plot 1073-A1, GODAB Plaza, Area 3, Garki-Abuja, Nigeria.
authors.forename: Michael
authors.initials: M
authors.lastname: Dada
authors.affiliation: Family Health International (FHI360), Plot 1073-A1, GODAB Plaza, Area 3, Garki-Abuja, Nigeria.
authors.forename: Donald
authors.initials: D
authors.lastname: Udah
authors.affiliation: Family Health International (FHI360), Plot 1073-A1, GODAB Plaza, Area 3, Garki-Abuja, Nigeria.
authors.forename: Robert
authors.initials: R
authors.lastname: Chiegil
authors.affiliation: Family Health International (FHI360), Plot 1073-A1, GODAB Plaza, Area 3, Garki-Abuja, Nigeria.
authors.forename: Kwasi
authors.initials: K
authors.lastname: Torpey
mesh_terms: D000068:Accreditation; D006268:Health Facilities / Q000592:standards; D006801:Humans; D007753:Laboratories / Q000592:standards; D009549:Nigeria; D011786:Quality Control; D058996:Quality Improvement