Interview to the external evaluator Mr. Duncan Ochieng
The external evaluator Mr Duncan Ochieng, laboratory specialist, came back to Probitas Foundation HQ to present the final evaluation results of the assessments of the laboratories in Lunsar (Sierra Leone) and Kumasi (Ghana)
You can read below the interview we made him about the process of assessing the GLI Projects mentioned above
1) First of all, which guidelines did you follow to make the evaluations?
There are two different orientations. The first one was to evaluate the project according to the relevance, efficiency, effectiveness, impact, viability and participation to see if the action coincides with the planned objectives and the needs identified. In order to get the information I developed and used specific questionnaires for different groups of people who were involved in the project. Once the specific data is analysed I can see the impact of the entire project. In addition to that, from the information I received I identified the challenges and the limitations and provide recommendations to improve the project and to consider them for future activities. This evaluation will help in the management of GLI projects.
The second tool was more specific on the technical laboratory activities.In this one I developed and checklist for laboratory assessments and this one was divided into 10 different parameters. These parameters refer to laboratories' structure, staff's competences, the activities they are doing, the biosecurity, etc. So from this, it is possible to identify the gaps in the technical activities of the laboratory.
So the findings of the second checklist will be most specific to ensure that the laboratories improve in terms of quality service. Through these questionnaires you can identify what are the areas that are not working well, which areas needs to be improved and what is need to be done. So with both tools/guidelines and the level of functional laboratory and the project itself then it's easy to identify if there are any gaps and what has been improved because of the project.
2) What can you explain of each laboratory?
The key in Ghana's laboratory is that is in a public hospital. The staff level in terms of training and qualification is higher than in Sierra Leone. In Ghana there is more activity at the hospital, the catchment area is much bigger and because of that they have students who come for internship in the laboratory because it has become a centre of reference.
Thanks to the activities that have been carried out in the project and the optimal conditions to do so many tests, healthcare staff and trainees are getting experience so they can be able to work in other laboratory's departments. In this laboratory there were working at the time I was there 7 staff, 10 students on internships and 10 national staff. One of the most remarkable things is that it has really improved the number of the tests done.
Sierra Leone (Lunsar)
Lunsar's laboratory is better organized in terms of structure. One of the key things is that they have more standard operations proceeds in right places. In addition, the staffs tend to follow best the procedures. In this laboratory there are six people as staff. And these six are supported by the catholic brother's hospital.
3) Which problems did you find during the evaluations?
When I went to Ghana there was a national laboratories' strike which caused that many workers were not there. Another problem was that the laboratory does not always follow standard procedures which are dictated by national protocols. Besides, some of the machines were not working and there were some specific tests that are not being done due to the lack of reagents. This happens because Probitas is no longer giving financial support and the laboratory cannot continue buying them.
Sierra Leone (Lunsar)
In the same way that in Ghana's laboratory there are some specific tests that are not being done because of the lack of reagents. Another problem is that the staff level is lower comparing to Ghana. However, Sierra Leone's laboratory is the reference for the entire community and the only one of the area capable of doing these kind of tests.
4) What do you think about GLI Program?
GLI Program itself is very relevant because it introduces tests, ensures the quality of them and supports the management of patients in areas that have not been done before. Then the areas that were targeted are also very good delimited. In Ghana, for example, there is an approximate population of 250,000 inhabitants and most of them come to the hospital when they have some health.
I can conclude that GLI Program is very complete because it strengthens basic infrastructures and provides laboratory equipment; it trains local staff in diagnostic techniques and laboratory management, promotes other health programs appropriate for each context and measures the effectiveness, efficiency and impact.