CamLab Network

Background

A revised version of the International Health Regulations (IHR) was agreed by WHO Member States during the 2005 World Health Assembly. Under these regulations, countries are required to develop the capacity to detect, investigate and report to the international community through WHO, public health events of potential international concern. A credible and accessible laboratory service capable of producing results in a timely manner is a cornerstone of any country's capacity to investigate such events. The importance of having systems in place at the national level to ensure laboratory quality is now widely recognized.

Stepwise implementation of a laboratory quality management system (QMS) was one of the main recommendations arising from the WHO/CDC 2008 Lyon conference on quality systems. Countries were urged to implement quality standards in a stepwise manner, with the accreditation to ISO 15189, the International Standard for medical laboratories, being the ultimate goal for reference laboratories.

While some tools exist to explain what a QMS is, these tools do not provide day-to-day guidance in establishing a QMS. For this reason, the StopTB Global Laboratory Initiative developed an online tool to help Tuberculosis National Reference Laboratories to implement the standard in a stepwise manner with specific relevancy to TB laboratories. The tool was created by the Royal Tropical Institute of Amsterdam (Koninklijk Instituut voor de Tropen in Dutch, and hereforth abbreviated as KIT) under the umbrella of the Global Laboratory Initiative (GLI). The GLI TB tool has been discussed widely at GLI and WHO  meetings and was launched at the Union World Conference in Lille, France, in October 2011.

Following meetings and consultation with internal and external stakeholders, including Regional offices, the Health Laboratory Strengthening team within the Support to IHR Capacity Development Unit, decided to develop a generic tool based on the GLI tool, but specifically adapted to be applicable to any microbiology reference laboratory. The tool, called the WHO Laboratory Quality Stepwise Implementation tool or, more simply, the Stepwise tool, will translate the requirements of the ISO 15189 into step-by-step activities following a structured interactive roadmap and supported by templates, ultimately enabling national level microbiology reference laboratories to implement a QMS that meets international standards. KIT has been contracted to create the Stepwise tool, based on the model of the GLI TB tool.

The Stepwise tool is expected to be published and made publicly available on the WHO webpage in May 2013.

Quality Training Workshop

With support from WHO, the Ministry of Health of Cambodia will begin the implementation of a comprehensive laboratory quality assurance system in public laboratories that contribute to International Health Regulations (IHR) capacity. A training session on the new WHO Laboratory Quality Stepwise Implementation (LQSI) tool will be held from 7 to 9 May 2013 in Phnom Penh, Cambodia. The LQSI tool will facilitate implementation of a laboratory quality management system in laboratories of the National Medical Microbiology Laboratory Network of Cambodia.

The training objectives of the workshop are:

1. Review the basics of Laboratory Quality Management Systems.

2. Prepare laboratory officials and mentors for the implementation of a Laboratory Quality Management System in five referral laboratories.

3. Introduce the new Laboratory Quality Stepwise Implementation (LQSI) tool as developed for WHO LYON.

4. Train laboratory mentors on implementation of the LQSI tool.

Participants will include officials from the Cambodian Ministry of Health, representatives of the National Institutes of Public Health, and laboratory mentors supported by partners working in collaboration with MoH and WHO. Representatives of WHO LAOS will also join the training to support implementation of the LQSI in laboratories in Laos. Additional countries in the Western Pacific Region may benefit from additional trainings in the near future and from the experience accumulated during implementation of the LQSI in Cambodia.