Title:
Factors Affecting Access to Quality HIV Diagnostic Services in Liberia: From a Laboratory Perspective
Authors:
Rupelle, Cecile Boucher de la
Place:
Amsterdam, The Netherlands
Publisher:
KIT - Royal Tropical Institute [etc.]
Year:
2021
PAGE:
vii, 42
Language:
En
Subject:
Governance & HIV and AIDS
Keywords:
Diagnostics, HIV, Laboratory, Liberia, Laboratory system
Abstract:
Background: At the end of 2019, Liberia was still lagging behind the 2020 UNAIDS 90-90-90 target. Meanwhile, the 2014 Ebola epidemic had exposed the country health system weaknesses, in particular regarding its laboratory capacity. Objectives: Identify factors affecting access to quality HIV diagnostics in Liberia, from a laboratory perspective. Method: A literature review, using an adapted version of the Conceptual framework for testing process and associated errors in sample processing after Hickner and al and Carraro and Plebani. Results: Our review highlighted a laboratory system in its initial stage of development, with the recent creation of the National Public Health Institute of Liberia and elaboration of national strategy and policy documents. Yet responsibilities for moving the agenda forward and funding needs are not clearly defined. Stock-out of health products, shortage of laboratory staff, an unoptimized diagnostic network and sample transportation system, with no quality assurance system in place, negatively impact the delivery of quality HIV diagnostic services (analytical phase), which constitutes a barrier to test commissioning by health workers and may reduce clinicians’ trust in the results. At health facility level, lack of knowledge, heavy workload and stigma impact offering of services (pre-analytical phase) and may jeopardize adequate use of results, when returned (post-analytical phase). There was limited research identified for Liberia, in particular regarding HTC practice, laboratory procedures, turnaround times and quality assurance activities. Conclusion: The development of a National Laboratory system in Liberia needs to be accelerated. Supply chain weaknesses and human resources gaps have to be addressed structurally. Implementation of task-shifting, optimization of the diagnostic network and practical quality assurance improvement processes, can already improve access to quality HIV diagnostic services. Operational research needs to be undertaken to fill the knowledge gaps.
Organization:
KIT - Royal Tropical Institute , VU - Vrije Universiteit Amsterdam
Institute:
KIT (Royal Tropical Institute)
Country:
France
Region:
Western Europe
Training:
Master in International Health
Category:
Research
Right:
@ 2021 Rupelle
Document type:
Thesis/dissertation
File:
tlB5hcfG3Y_2023050916023469.pdf