The Zimbabwe Health Interventions’ (ZHI) Accelerated and Comprehensive HIV Care for Epidemic Control in Zimbabwe (ACCE) project joined hands with the Manicaland Provincial Medical Director (PMD) and Biomedical Research and Training Institute (BRTI) to improve Viral Load (VL) and Early Infant Diagnosis (EID) testing scale up (specimen and results transportation) at Birchenough Bridge hospital in Buhera District, Manicaland Province.

Speaking at the Clinical Laboratory Interface (CLI) meeting held at Birchenough Bridge Hospital on 15 February 2022, the Manicaland PMD, Dr Simon Nyadundu, stressed the need to improve teamwork, accountability and patient care by the laboratory and clinic staff.

“Gaps in communication and coordination between clinical and laboratory counterparts can lead to suboptimal outcomes such as delay in collection and transportation of VL and EID samples to the laboratory for testing. This results in failure of results to reach clients in an efficient, timely and effective manner to inform their clinical management.”

Dr Nyadundu encouraged ZHI and BRTI to continue supporting quality improvement initiatives in health facilities for the benefit of people living with HIV (PLHIV).

The District Medical Officer (DMO) Dr Shelton Kwiri, added that clinical and laboratory interface should be strengthened through innovative solutions and implementation of best practices, including optimal use of point of care or near point of care diagnostics and an efficient transportation system to minimize interface gaps.

During the CLI meeting, representatives from BRTI explained the VL and EID processes including demand creation, sample collection, and transportation, laboratory testing, results transmission to clinics and correct use of tools.  The Ministry of Health and Child Care through BRTI as laboratory partner and ZHI as one of the clinical partners are implementing a quality improvement initiative to “Improve HIV Service Delivery Through Collaboration Across the Clinic-Laboratory Interface.” The CLI meeting at Birchenough Bridge hospital came at an opportune time as scale up to all health facilities offering HIV testing and care services is underway.

ZHI led discussions on process mapping for VL management analysing gaps and root causes. The discussions led to the selection of a quality improvement team which is responsible for oversight of the implementation of the quality improvement project. The gaps identified during the process mapping activity become the priority areas for process improvement to improve quality. Quality Improvement project implementation is a teamwork activity characterised by frequent meetings, defining and tracking performance of quality indicators and reports generation. It is a comprehensive activity which enhances and strengthens collaboration between the clinic and laboratory side to achieve the targeted results in the interest of improved patient care. The QI project team selected for Birchenough Bridge comprised of representatives from Ministry of Health and Child Care (including laboratory staff), ZHI and BRTI will be led by MOHCC through weekly performance review meetings.

 Starting from the left Dr Nyamundaya ACCE Project Chief of Party; Manicaland Project Manager, Dr Maravanyika, Bridget Mukundu, BRTI Clinic Laboratory Interface Laboratory Officer and , Billy Ndawana , BRTI Manicaland Provincial Laboratory Mentor.

ZHI supports 5 districts in Manicaland Province to provide HIV testing and treatment services with funding from PEPFAR through USAID. A total of 2 200 PLHIV receive HIV testing and treatment services including VL testing at Birchenough Bridge hospital.