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Decentralised facility-based training as an alternative model for SLMTA implementation: The Cameroon experience.

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Decentralised training for the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme effectively improved laboratory quality. This approach trained more staff at a similar cost to the traditional centralised model.

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Area of Science:

  • Laboratory Management
  • Healthcare Quality Improvement
  • Public Health Training

Background:

  • The Strengthening Laboratory Management Toward Accreditation (SLMTA) programme enhances institutional capacity for tiered laboratory systems.
  • Most countries utilize a centralized SLMTA model, requiring participants to travel for training.

Purpose of the Study:

  • To compare the effectiveness and cost of decentralized SLMTA training against the traditional centralized approach.
  • To evaluate the impact of different training delivery models on laboratory quality improvement.

Main Methods:

  • SLMTA was implemented in five pilot laboratories in Cameroon (2010-2012) using workshops, improvement projects, and on-site mentorship.
  • The initial workshop followed a centralized model, while subsequent workshops were decentralized, delivered on-site.
  • Laboratory quality was monitored using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist.

Main Results:

  • All laboratories showed consistent improvement in audit scores throughout the program.
  • Median improvement was 11 percentage points after centralized training and an additional 24 percentage points after decentralized training.
  • The per-laboratory cost was similar for both models (approx. US$21,000), but decentralized training involved five times more staff and trainer time.

Conclusions:

  • Decentralized SLMTA training is an effective strategy for enhancing laboratory quality.
  • The findings support considering decentralized training as a viable alternative to centralized models for laboratory capacity building.