Since October 2013, IDI has been providing technical assistance to strengthen Government labs in Swaziland in partnership with URC (University Research Corporation; a major US contractor) and with funding from CDC.

The aim has been to achieve WHO accreditation for several labs using the SLMTA/SLIPTA approach (Strengthening Laboratory Management towards Accreditation; Stepwise Laboratory Quality Improvement Process Towards Accreditation).

In 2013, URC decided to partner with IDI to fast track the lab improvement process in relation to 15 labs in Swaziland. IDI proposed the application of a unique high impact systems approach developed in Uganda in partnership with Accordia Global Health Foundation and with support from a Becton Dickinson / PEPFAR Pubic Private Partnership. The approach was based on the IDI default model for capacity development, the Capacity Building Pyramid  and other international models/frameworks.  This approach emphasises the resolution of systemic issues, by dealing with a hierarchy of capacity needs at five levels and linking these capacities to development of Lab Quality Management Systems.

Using this approach, labs which had remained at either WHO Star 0 or Star 1 for three years showed dramatic improvement after seven months of URC/IDI joint interventions. To obtain an objective view of the quality improvement effort, in June 2014, the African Society for Laboratory Medicine (ASLM) was invited to conduct an independent (third party) audit of five of the 15 labs.

Before the beginning of the partnership, only one of the five labs that were assessed by ASLM had achieved Star 1. In the seven months of interventions, the ASLM assessment showed that:

  • one lab (National TB Reference Lab) had shot up to Star 3;
  • three labs (Mbabane Government Hospital Lab, the National Molecular Reference Lab, and Piggs Peak Regional Hospital Lab) had progressed to Star 2; and
  • the Central Lab had risen to star 1.

IDI is looking forward to continuing to support lab development in Swaziland and aspires to apply the approach elsewhere in Sub-Saharan Africa.