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Ensuring Quality in Provision of Laboratory Services

September 25, 2013

Interview with Principal Laboratory Technologist - Arua RRH

Principal Laboratory Technologist _Arua RRHName: Mary Amanziru

Title: Principal Laboratory Technologist

Hospital: Arua Regional Referral Hospital

Years of Public Service: 19 years


Consistent and dependable laboratory services are an essential component of HIV service delivery. In Uganda, the USAID-funded Strengthening Uganda’s Systems for Treating AIDS Nationally (SUSTAIN) project extends its support to 21 hospital laboratories through improvement of physical infrastructure, equipment supply and installation; staff recruitment and skills development; and strengthening laboratory supplies systems.


The SUSTAIN team recently spoke with Ms. Mary Amanziru, Principal Laboratory Technologist for Arua Regional Referral Hospital (RRH), about the critical role of the project’s support in improving the quality of laboratory services and management in the hospital.

What is your role in the management of laboratory services at the hospital?

This is an important supervisory position involving responsibility for planning and overseeing the operations of the laboratory. My role is to maintain proper laboratory quality control standards. I ensure that the laboratory has the resources required to meet our patients’ needs, that safety procedures are followed, and that staff is on duty and performing their tasks.

Describe the management and organization of laboratory services at the hospital. How has this changed since the USAID SUSTAIN project started supporting the hospital?

Arua RRH laboratory serves as a referral for all hospitals from eight districts within the West Nile region. Within the hospital, the laboratory offers services to Out-patient Department, In-patient wards as well as specialized services for diabetes, mental health, eye, ear, nose, and throat (ENT), chest and HIV clinics. The laboratory also provides HIV screening tests for all health care delivery units in the hospital. 

The SUSTAIN project has provided us with the basic equipment which was lacking in the past, such as the highly sophisticated and automated clinical chemistry (COBAS C311), hematology (SYSMEX XS 1000i) and CD4 (FACS Callibur) analyzers. The project has also supported recruitment of additional staff to fill critical staffing gaps. In addition, SUSTAIN trained all our senior laboratory staff on proper use of the various equipment, correct laboratory testing methods, and provided training and mentoring in quality improvement, increasing our capacity to meet the increased demand for services.

How have you contributed to improvement in laboratory service delivery at your hospital?

In my position, I was able to support building a dedicated team consisting of a laboratory manager, quality assurance officer, safety officer, and stores officer, to serve the out-patient department and I helped defining roles for each position. Holding regular meetings with the team provides an opportunity to exchange the ideas about how best to meet the laboratory service delivery objectives. I keep the hospital management informed about the work in the laboratory and various challenges that we face. Through a questionnaire I have developed, I was able to gather the staff feedback on general work conditions and procedures and initiated discussions on how to improve them going forward.

What motivates you to ensure the quality of care for clients and their families?

Allocation of resources to the laboratory has not been a priority in the past. Having sufficient resources, such as equipment and supplies to facilitate laboratory work, has improved laboratory testing—an important link in proper patient care.  Further, the support we have received from the hospital administration team, as well as the flexibility that I see in staff themselves who are willing and ready to contribute to and accept change and take on new assignments, re-energize me and the team. This attitude enriches our work lives and helps with understanding the path to better service delivery.

If you were orienting a new hospital laboratory technologist, what advice would you give them about managing laboratory services?

I would tell her about the importance of teamwork; the person should be a good team player.  My other advice would be to always make use of existing standard operating procedures and guidelines to guide the quality of her work. Lastly, I would tell her that giving the best to meet a patient’s needs and to collaborate well with fellow staff is the best way to have satisfaction at the workplace.

What support from the USAID SUSTAIN project has been most helpful for you as a laboratory manager?

It would have to be the support for enrollment into the Ministry of Health’s Strengthening Laboratory Management Towards Accreditation (SLMTA) training program. Through the skills gained from the training, the improvements in this laboratory rapidly improved, growing from Star 0 at baseline assessment to Star 4 in the final assessment, based on the WHO AFRO SLMTA scoring scale. The training helped with detecting, identifying, documenting, and reporting the gaps in the laboratory processes and developing a plan of action to drive the improvement process.

How has the recruitment of additional laboratory officers/personnel made a difference in your department?

The presence of three more new senior laboratory personnel has greatly reduced the work load. The bio-medical engineer now attends to minor repairs and maintenance of laboratory equipment in a timely and effective manner.

Where do you see laboratory services at Arua RRH by close of 2013?

I anticipate that our laboratory performance under SLMTA will improve to Star 5 (the highest score) and receive accreditation, with all the staff now well versed in continuous quality improvement processes.

We expect to perform a large number of HIV-related tests in the coming months.  Thanks to the new equipment from USAID’s SUSTAIN project, the turnaround time for referred samples has significantly decreased and we hope to see an increase in testing of samples from districts and lower health facility laboratories.


*Note: Parts of the interview have been slightly edited for consistency and clarification.


By SUSTAIN team with contributions from Julian Natukunda, Communications Specialist, Augustin Muhwezi, Deputy Chief of Party, Olivera Stojanovic, Program Officer and Jessica Ziegler, Knowledge Management Specialist  - URC