Standardization of laboratory testing policies supports HIV/AIDS scale up

Issues: Management of laboratory testing supplies is complicated because laboratory instrumentation, testing techniques, and corresponding reagents and consumable supplies required to conduct a single laboratory test can vary by level and facility in the health system. A comprehensive HIV/AIDS program requires a wide range of laboratory testing.

Description: Strategies to reduce the complexity in providing laboratory testing services can improve the efficiency, quality, and affordability of testing. Standardization of laboratory instrumentation and operating procedures helps programs better allocate limited resources for laboratory services. Standardization involves definition of test menus, testing techniques, operating procedures, and selection of laboratory equipment to be used for each type of test, by level of the system.

Lessons Learned: In Kenya and Zambia, key stakeholders standardized the laboratory test menus, testing techniques, instrumentation, and operating procedures for HIV/AIDS–related laboratory services. This reduced the number of laboratory supplies in the national system from more than 3,000 to fewer than 300. Standardization also reduced the need for training while easing the burden on laboratory staff; maximized the use of limited resources for procurement; facilitated overall management of the laboratory system; increased efficiency of the laboratory supply chain; and resulted in improved quality of laboratory testing services for patients.

Recommendations: Standardization of national laboratory testing policies and procedures is a proven strategy for strengthening laboratory systems to support scale up of HIV/AIDS services. Active participation and consensus of all key stakeholders involved in management of the national laboratory system are critical for successful implementation of the standardization process.