Laboratory Strengthening


A laboratory technician prepares samples at Kabale RRH.

Laboratory tests—such as CD4 counts, complete blood counts and renal and liver functioning—are a critical component of quality clinical HIV services. Laboratory services are also essential for diagnosis and management of opportunistic infections (such as tuberculosis), screening for HIV infection and disease surveillance. Since 2010, the USAID/SUSTAIN project has continued to implement laboratory systems strengthening activities at various public healthcare facilities in collaboration with the Ministry of Health. Areas of this support include: laboratory infrastructure improvement through renovations, laboratory skills strengthening, External Quality Assurance and quality improvement initiatives, supporting improvement efforts towards external accreditation, support for regional medical equipment maintenance workshops and support for the national laboratory sample and result transport network (hub) operations.

USAID/SUSTAIN supports routine technical, operational and coordination support to 18 hubs that serve 470 lower healthcare facilities in the respective catchment areas. The scope of laboratory test support includes DNA-PCR for early infant diagnosis, diagnosis of multi-drug-resistant TB, histopathology examination and disease outbreak investigations.


  • Renovation of laboratories was completed at 18 laboratories, including five hub laboratories in the Karamoja region (Moroto, Kaabong, Abim, Tokora and Kotido).
  • Automated machines for CD4, chemistry and hematology testing and ancillary laboratory equipment were procured and installed for 21 supported laboratories, four of which were later handed over to other implementing partners (Entebbe, Gombe, Moyo and Nebbi).
  • By September 2017, 17 supported laboratories were enrolled in the External Quality Assurance (EQA) scheme. Thirteen of the 17 laboratories received the United Kingdom National External Quality Assessment Service (UKNEQAS) CD4 EQA panels and 77% (10/13) submitted acceptable test results.
  • 683 laboratory personnel have been trained in: SLMPTA (Strengthening Laboratory Management towards Accreditation), laboratory logistics, proper: operations, care and maintenance of BD FASC Calibur CD4 machines, laboratory quality improvement, use of FACS Calibur, use of Sysmex XS 1000i, laboratory internal auditing, laboratory quality management, and participated in a SLIPTA process auditor training.

 Learn more in our Laboratory Services technical brief!