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AIHA News Hub
In this section, you can access a range of information that will keep you up-to-date on all things AIHA, including press releases, newsletters, success stories, reports, and information about funding opportunities when they become available.
Our projects are dynamic, our partners are amazing, and we’ve got a lot of powerful stories to share about how they are making a real and sustainable impact on health systems in low- and middle-income countries around the globe!
AIHA Concludes Biosafety Cabinet Calibration and Certification Training Program in Uganda, Opens National Calibration Center
AIHA recently concluded the third and final phase of a year-long biological safety cabinet calibration and certification (BSCC) training program in Uganda. Four local biomedical engineers were trained through the program and a new National Laboratory Equipment Calibration Center was commissioned.
This BSCC training represents an important step forward in Uganda’s efforts to build the local capacity it needs to ensure this essential equipment remains calibrated and certified. An integral part
of laboratory systems, biological safety cabinets (BSCs) protect lab personnel, products, and the environment from exposure to biohazards and cross-contamination during routine procedures – but only if they are certified, maintained, and used as recommended by international standards. Across the African continent, there is limited capacity to conduct this crucial work, which negatively impacts the safety and can pose serious health risks. As Uganda works to attain the global 90-90-90 targets, BSCs are an essential piece of equipment for reaching the third 90 used in viral load testing. They are used to ensure the safety of the preparation process for dry blood spot samples for viral load testing and monitoring.
“You have not given us fish, but you have taught us how to fish and given us the fishing rod,” said Dr. Diana Atwiine, Permanent Secretary of Uganda’s Ministry of Health. “I commend AIHA for addressing this critical need in the country and building our capacity to work towards freeing us from the exorbitant reliance we have placed on outside entities for many years.”
Working in partnership with the Ministry of Health’s Central Public Health Laboratories (CPHL), Health Infrastructure Division (HID), and the Eagleson Institute in Sanford, Maine, AIHA supported this comprehensive BSCC training as part of an in-service biomedical engineering program launched in 2015 with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the U.S. Centers for Disease Control and Prevention (CDC) in Uganda. In addition, AIHA supported the team in their assessments of nearly 80 BSCs during 15 rounds of field practicum, which took place between each phase of training to ensure full comprehension and acquisition of hands-on skills.
At the same time, AIHA and CPHL commissioned a new National Laboratory Equipment Calibration Center on the Uganda National Health Laboratory Services campus in Kampala. This facility will serve as a national reference center for the calibration of laboratory equipment across the country, which is critical as Uganda works to have more of its medical labs accredited. This is a component that has often been outsourced to the private sector at a high expense, both in Uganda and internationally. In response, AIHA is working to build the capacity of the staff who will be assigned to the new center with the goal of attaining ISO17025-2005 accreditation. Dr. Atwiine and other Ministry officials, along with U.S. Government donors and other development partners, attended the center’s opening.
“Gone are the days when accuracy of equipment used to be assumed. The launching of this new calibration center will allow our laboratories to ensure increased accuracy in the quality of results offered to the Ugandan population,” said AIHA Uganda Program Coordinator Abdul Mutaka. “By building our internal capacity, Uganda will now have the technical expertise to conduct timely and cost-effective calibration of our equipment.”
CPHL National Laboratory Logistics Coordinator Wilson Nyegenye agreed, saying, “A small key can open a very big lock. AIHA has opened the lock and opened the door for improving laboratory services in the country as we move towards accreditation.”
In close collaboration with the Ministry’s CPHL and HID, AIHA is taking a step-wise approach to build capacity of biomedical engineers and equipment technicians across the country, with a particular focus on laboratory equipment critical to the HIV clinical cascade. Starting with non-automated equipment, AIHA is addressing all levels of lab equipment as we build the capacity of these biomedical engineers and equipment technicians in this specialized field. This equipment often requires costly service contracts, but there are a limited number of service contractors in the country. Through this program, AIHA and our partners are strengthening this cadre at government facilities with the goal of decreasing equipment downtime and maintenance costs and increasing timely, accurate test results.
Noting that through a partnership approach with both the public and private sectors, AIHA is working to address these bottlenecks to ensure equipment functionality and the timely provision of diagnostic services, AIHA Acting Country Director for Uganda Silas Goldfrank said, “AIHA looks forward to continuing to support the Ministry of Health, CPHL, and HID in building the capacity of personnel in this essential technical area. We are dedicated to working in partnership with the Ministry to build local ownership to ensure continued sustainability in strengthening the health system nationally.”
This project is implemented through AIHA’s HIV/AIDS Twinning Center Program, which is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services. AIHA manages similar biomedical engineering projects in Ethiopia, Kenya, Tanzania, and Zambia – each designed to help these countries meet the demands of today’s technology-driven healthcare systems, particularly in the context of providing high quality HIV/AIDS-related diagnostic, treatment, and care services.
Dr. Debrework Zewdie Visits AIHA Partners at Debre Berhan Hospital
“I was so impressed,” Dr. Debrework said of her visit to Debre Berhan. “I must say, in my 35 years of development work I have never seen a cleaner or more well-run hospital in any of the developing countries I visited — and I have visited many,” she recounted, noting, “It is also a testament that with the right leadership one can do so much with very little.”
Thanks to that leadership, and the technical assistance provided by AIHA and their partners at Elmhurst, Debre Berhan has emerged as a national benchmark and been recognized as a top-performing hospital by Ethiopia’s Ministry of Health for the last three years in a row.
Click here to learn more about AIHA’s Debre Berhan / Elmhurst partnership, which was funded by the U.S. Centers for Disease Control and Prevention (CDC) in Ethiopia through a cooperative agreement with the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services.
Blood Safety Project Ushers in New Focus on Quality Management, Expanded National Capacity of Blood Services in Ukraine
The Ukrainian Ministry of Health recently recognized a team of local quality managers and laboratory specialists as national trainers, empowering them to provide training and mentoring in quality management systems to blood services throughout Ukraine.
The national trainers represent partner sites in a blood safety project implemented in Ukraine since 2012 by AIHA. This project supports the US President’s Emergency Plan for AIDS Relief (PEPFAR) and is funded by the US Centers for Disease Control and Prevention (CDC).
Soon after the launch of the project in Ukraine, quality management systems emerged as a key technical assistance priority. Starting in 2013, AIHA began developing the capacity of 12 blood service workers with expertise in various aspects of blood establishment operations, including collections, laboratory, quality, and information services. The training started with basic quality management concepts then progressed to more advanced topics. Following three years of targeted technical assistance, they are now national-level experts fully capable of training and mentoring other blood services personnel as the country works to attain international standards.
In accordance with international best practices and standards, the team developed a Quality Management Manual, which was reviewed by Dr. Oleksandr Serhiienko, National Technical Expert for the AIHA Blood Safety Project, and Jean Stanley, Principle Investigator. Further, it was approved by the National Academy of Post-Graduate Medical Education and recognized by the Ministry of Education, making it an official part of governmental postgraduate education in Ukraine.
Following a Training of Trainers workshop on December 5-6, 2016, the team presented the manual at a Conference of the All-Ukrainian Blood Service Association. The event was conducted on December 9 in Kyiv and attended by head physicians from all blood establishments in Ukraine. The manual covers key elements of a quality management system for blood establishments and includes practical examples for implementation.
The manual dissemination conference on December 9 provided a venue for the national trainers to share their unique experiences, including successes and challenges with implementing key elements of a quality system in their own institutions. This was beneficial for others in attendance who will soon began the process at their respective blood centers.
Over the course of project implementation, AIHA played critical role in development of Ukraine’s national strategy for reforming the country’s blood services, according to Dr. Anatoly Chuhriiev, head physician of Zhytomyr Oblast Blood Center and president of the All-Ukrainian Association of Blood Services.
“The activities of this project have helped ensure that all demonstration sites are now implementing real quality management systems, as well as developing a strong culture of quality overall,” Dr. Chuhriiev explains, noting that this has resulted in blood center staff becoming much more confident in their knowledge, skills, and the excellence of their products and services.
The comprehensive quality management system adopted by the project sites encompasses the organizational structure, policies, processes, procedures, and resources required to achieve and ensure the quality of products and services provided by a blood establishment, Dr. Chuhriiev continues. “As a result,” he says, “these centers are actively ensuring the availability of safe blood for all patients who may need a transfusion.”
During the conference, Dr. Oksana Syvak, Deputy Minister of Health of Ukraine, stressed that the Ukrainian blood system is undergoing radical reform and development in accordance with an agreement between the country and the European Union (EU) ratified in September 2014.
“The Ministry of Health highly appreciates the role AIHA’s blood safety project has played in assisting the country to start the process of developing an efficient blood service, not to mention the harmonizing of local legislation with EU Directives,” Dr. Syvak told participants. She went on to day that the recommendations provided by AIHA for an initial assessment report were fully accepted by EU counterparts, who conducted a separate blood service assessment in 2015.
Dr. Syvak expressed her gratitude for how AIHA and CDC conducted all project activities in full coordination with the Ministry of Health. “This was — and continues to be — crucial as ongoing health sector reforms are being implemented in a time of many challenges and frequently changing priorities,” she noted.
Over the coming months, AIHA will continue to collaborate closely with the Ministry of Health and CDC to help address identified gaps through targeted, practical technical assistance designed to yield sustainable improvements in the way blood centers operate throughout Ukraine. Future activities include the development of national teams of experts in the clinical use of blood, screening of blood donors for transfusion transmissible infections, and appropriate storage and distribution of blood components for transfusion.
The activities described in this article are supported by the US Centers for Disease Control and Prevention (CDC) under Cooperative Agreement Number 1U2GGH000861. The contents of this document are solely the responsibility of the authors and do not necessarily represent the official views of the CDC, the US President’s Emergency Plan for AIDS Relief, or the US Government.
US Delegation Visits AIHA Biomed Project in Uganda
AIHA’s PEPFAR-supported partnership is building Uganda’s capacity to train and support biomedical engineers and technicians as a way to improve health services
In the global fight against HIV/AIDS, physicians, nurses, and community health workers are on the front lines of the response. No less important, however, are the many health workers who toil behind the scenes every day to help ensure the quality of clinical care provided to people living with HIV.
Biomedical engineers and technicians (biomeds) are one of those oft forgotten cadres. They play a crucial role in the day-to-day operations of hospitals and other clinical sites by ensuring that laboratory equipment and medical devices are in optimal working order. Their efforts underpin accurate and efficient diagnosis, treatment, and management of HIV, as well as other acute and chronic conditions.
A high-level delegation from the US Department of Health and Human Services (HSS) and the US Centers for Disease Control and Prevention (CDC) got a first-hand look at the contributions biomeds make to the care and treatment of people living with HIV during a visit to health facilities in the Eastern Uganda town of Jinja, some 40 miles from the capital of Kampala.
There, the US officials learned about the impact that a capacity building project being implemented by AIHA through our HIV/AIDS Twinning Center Program is having on the local health system.
“The successes seen in Jinja are one example of a national-level program experiencing a similar ripple effect regionally across the country,” explains AIHA Program Manager Silas Goldfrank.
“Starting with non-automated laboratory equipment, AIHA is taking a step-wise approach to build the capacity of biomeds to become specialized in conducting preventive maintenance, repair, and calibration of laboratory equipment critical to the HIV clinical cascade,” Goldfrank says, noting that the end goal is training them to maintain the highly automated equipment required for viral load testing in support of the UNAIDS 90-90-90 targets.
As the US President’s Plan for AIDS Relief (PEPFAR) and national ministries of health shift focus to receiving SLMTA and/or ISO accreditation for their labs, having in-house biomeds with the skills necessary to work alongside laboratory technicians and conduct routine preventive maintenance and repair is essential to that process.
Through our Twinning Center Program, which is supported by the US Department of Health and Human Services, Health Resources and Services Administration (HRSA), AIHA has adpoted a multi-pillar approach to ensure the work being has lasting, sustainable impact in Uganda.
Though our direct partners are the Ugandan Ministry of Health’s Infrastructure Division (HID) and Central Public Health Laboratories (CPHL), AIHA is also collaborating with educational institutions and regulatory bodies to ensure what is being implemented builds on existing programs and will eventually become the national standard for laboratory equipment management and maintenance.
Some highlights of the site visit included the hospital blood bank, automated laboratory, new biomed workshop, mortuary, and operating theater, where the equipment is similar to what is required for large-scale freezers used in laboratory cold chain systems and labs when they shift to high tech VL machines, for example.
AIHA has similar in-service biomed programs in Kenya and Zambia, as well as a combined pre-service and in-service biomed program in Ethiopia, where we are seeing similar impact on the ground. In the coming year, we will be launching a new biomed project in Tanzania and hope our work in this technical area will be able expand in future funding cycles.
From AIHA’s perspective, it’s great to see PEPFAR supporting the need to continue building the capacity of this cadre and expanding from one project that launched in 2012 in Ethiopia to now to a total of five countries across sub-Saharan Africa.
AIHA’s substance abuse and HIV prevention partnership in Zanzibar graduated in 2013, but the seeds planted by the partnership are still flourishing today!