Weighing the costs: Implementing the SLMTA programme in Zimbabwe using internal versus external facilitators

Area of Science:

• Health Systems Strengthening
• Laboratory Quality Management
• Health Economics

Background:

• Zimbabwe adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) program in 2010.
• The program aims to enhance laboratory quality systems.
• SLMTA implementation is crucial for improving healthcare diagnostics.

Purpose of the Study:

• To evaluate the financial costs of SLMTA implementation using external versus internal facilitators.
• To estimate the resources required for national scale-up of the SLMTA program in Zimbabwe.
• To compare the cost-effectiveness of different facilitator models.

Main Methods:

• Cost analysis based on accounting records, excluding in-kind contributions and salaries.
• Calculation of average expenditure per laboratory for both facilitator models.
• Estimation of theoretical financial costs and resource needs for national expansion.

Main Results:

• SLMTA implementation cost was approximately $5800 per laboratory with external facilitators and $6000 with internal facilitators.
• Theoretical cost for a 12-laboratory cohort was $58,000 (external) vs. $15,000 (internal) plus facilitator training.
• National scale-up to 120 laboratories estimated at $580,000 (external) vs. $322,000 (internal).

Conclusions:

• Training internal facilitators leads to significant cost savings for SLMTA program scale-up.
• Investing in local facilitator training is more cost-effective for national laboratory strengthening.
• Findings support policy development for strategic investment in laboratory quality systems.