Jijiga, Ethiopia – The Somali Regional Public Health Laboratory and Research Directorate’s Quality Assurance and Capacity Building case team has launched a comprehensive initiative to strengthen the quality and reliability of laboratory services across the region. This multi‑faceted program is designed to enhance diagnostic accuracy for Tuberculosis (TB) and Malaria, two of the most prevalent and high‑burden diseases impacting communities in the Somali Region. By improving laboratory practices, standardizing procedures, and investing in staff training, the initiative aims to ensure timely and accurate detection of cases, reduce misdiagnosis, and support more effective treatment outcomes. Beyond TB and Malaria, the program also reflects a broader commitment to building resilient laboratory systems that can respond to emerging public health threats, safeguard community health, and align with Ethiopia’s national strategies for disease control and prevention.

The initiative, which is a testament to the Region's commitment to quality improvement, is built on four core pillars:

Four Core Pillars of the Initiative

Onsite Support Supervision and EQA Slide Collection

The team is conducting onsite support supervision at 25 health facilities across five zones. This involves direct observation of laboratory practices, providing real-time feedback, and collecting External Quality Assurance (EQA) slides for rechecking by expert microscopists. This hands-on approach ensures that support is practical, relevant, and directly addresses the needs of each facility.

EQA Slide Readings

A crucial component of the program is the systematic re-reading of all EQA slides collected. By having experienced professionals perform a blinded re-check, the team can accurately verify the initial diagnoses, identify discordant results, and quantify the performance of each facility. This data-driven process provides a clear picture of diagnostic strengths and weaknesses.

Discordant Management and Corrective Actions

The findings from the EQA slide readings are not just for evaluation—they are for action. The case team is implementing a program to address all discordant results. This includes detailed root cause analysis and the development of targeted, hands-on training sessions to correct identified errors and refine the skills of the affected laboratory personnel.

On-site Training and Mentorship at Key EQA Centres

A pivotal part of the initiative is the capacity building program at six key EQA centres: Gode, Kabridahara, Dhagaxbur, Biki, Wardher, and Karamara General Hospitals. At each of these centres, a team of five members—including the laboratory head, quality and safety officers, and slide recheckers—is receiving intensive, on-site training and mentorship. This training focuses on integrated TB and Malaria EQA processes, as well as the preparation and distribution of high-quality reagents to their catchment health facilities.

The emphasis on on-site training and mentorship is a cornerstone of this initiative. This approach allows for direct application of learned skills in a real-world setting, immediate feedback from mentors, and the development of sustainable, in-house expertise. It builds a cadre of skilled professionals at the EQA centres who can, in turn, provide ongoing quality assurance support to their surrounding health facilities.

By investing in these comprehensive quality assurance measures, the Somali Regional Public Health Laboratory and Research Center is not only improving laboratory performance but also strengthening the entire diagnostic network. The ultimate goal is to ensure that every patient receives an accurate and timely diagnosis, leading to better treatment outcomes and a healthier community.