Laboratories are essential to health services within the context of clinical care and treatment programmes as well as for public health prevention and control initiatives. The need for laboratory support within the Caribbean region has grown exponentially with the increase in incidence and prevalence of Chronic Non-Communicable Diseases (CNCDs) and HIV epidemic and the need for expansion of care and treatment programmes.
Given the small size of most of the countries (most of which have populations of <300,000), there is a need to consolidate approaches and services to ensure efficiency of resource usage through exploiting economies of scale. Use of referral systems to laboratories that have more sophisticated technological capabilities is a feasible option. In addition, standard and policy adoption for laboratory services are generally established through a process of regional consensus with leadership from key regional organizations such as CARICOM, CAREC, CARPHA and CMLF.
Effectiveness of laboratory support for clinical and public health programmes within the region dictate that key issues to be addressed must include:
- Accessibility of services for diagnosis and monitoring of treatment;
- Affordability of services, particularly as it relates to vulnerable groups in small countries, including women, children and the socially disadvantaged;
- Quality and reliability of laboratory testing services to ensure that those relying on laboratory services for diagnosis and effective support for treatment are provided with consistently accurate and timely results.
In strengthening laboratory services within the Caribbean region, CMLF has partnered with CARICOM PANCAP Global Fund Round 9 Programme and the Caribbean Cytometry and Analytical Society (CCAS) to implement the laboratory strengthening component of this HIV/AIDS focused programme.
CMLF has conducted baseline assessments of the current situation within the region with respect to medical laboratory services and provided countries with a regional summary baseline assessment report as well as individual country reports. Information on the status of laboratory information systems was also collected in collaboration with CCAS and a situation analysis on laboratory information systems report was prepared. Data from these assessments were used to conduct advocacy with CARICOM Ministers of Health.
CCAS meetings in 2011 and 2012 were used to discuss issues relative to the regional network for support to HIV/AIDS programmes. At these meetings the following were discussed:
- Criteria for regional reference node laboratories building on criteria developed in the earlier CAREC EU-funded laboratory strengthening project
- Indicators for monitoring HIV network success
National networks which underpin the development of successful regional networks are being supported through:
- Facilitation of stakeholder discussions to develop national laboratory network implementation plans
- Monitoring of implementation of national network plans by CMLF.