Impact of Training and Program Expansion on Proficiency Testing Performance in the Western Cape Province, South Africa.
1
HIV and AIDS and STI, National Department of Health, Pretoria, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1063
ABSTRACT
BACKGROUND:
Strengthening diagnostic quality systems is essential for improving clinical decision-making and public health outcomes. In many low- and middle-income settings, the Proficiency Testing (PT) program is an essential mechanism for monitoring testing accuracy, identifying quality system gaps and guiding targeted corrective actions. Prior assessment revealed persistent challenges in the Western Cape province, including inconsistent PT performance, limited adherence to standard operating procedures, and insufficient facility participation in the external quality assurance activity. These gaps underscored the need for strengthening capacity building initiatives, improved quality assurance oversight and expansion of the PT coverage to ensure equitable access to quality diagnostic services across the province. Interventions A targeted, province wide training program was implemented by the National Department of Health in collaboration with the National Health Laboratory Services (NHLS) and Centers for Disease Control (CDC) focusing on PT handling, testing accuracy, corrective action procedures, and adherence to standard operating protocols. Simultaneously, the PT program was expanded to include over 45 additional healthcare facilities, significantly increasing program reach and enabling comprehensive quality monitoring across more service points
RESULTS:
Following implementation, the PT performance increased from below 80% to 95%. This improvement reflects enhanced technical proficiency, strengthened understanding of quality assurance systems, and more consistent performance across testing sites. The expansion of PT participation further enabled broader quality monitoring and increased equity, particularly for previous underrepresented facilities.
CONCLUSIONS:
The strategic combination of structured training and strategic program expansion led to significant measurable improvements in the provincial PT outcomes. These results highlight the effectiveness of targeted capacity-building and scale-up initiatives in strengthening diagnostic quality. Continued investment in staff training, monitoring systems, and facility inclusion will be essential and advance gains and to ensure that the province sustains and build on these achievements
Strengthening diagnostic quality systems is essential for improving clinical decision-making and public health outcomes. In many low- and middle-income settings, the Proficiency Testing (PT) program is an essential mechanism for monitoring testing accuracy, identifying quality system gaps and guiding targeted corrective actions. Prior assessment revealed persistent challenges in the Western Cape province, including inconsistent PT performance, limited adherence to standard operating procedures, and insufficient facility participation in the external quality assurance activity. These gaps underscored the need for strengthening capacity building initiatives, improved quality assurance oversight and expansion of the PT coverage to ensure equitable access to quality diagnostic services across the province. Interventions A targeted, province wide training program was implemented by the National Department of Health in collaboration with the National Health Laboratory Services (NHLS) and Centers for Disease Control (CDC) focusing on PT handling, testing accuracy, corrective action procedures, and adherence to standard operating protocols. Simultaneously, the PT program was expanded to include over 45 additional healthcare facilities, significantly increasing program reach and enabling comprehensive quality monitoring across more service points
RESULTS:
Following implementation, the PT performance increased from below 80% to 95%. This improvement reflects enhanced technical proficiency, strengthened understanding of quality assurance systems, and more consistent performance across testing sites. The expansion of PT participation further enabled broader quality monitoring and increased equity, particularly for previous underrepresented facilities.
CONCLUSIONS:
The strategic combination of structured training and strategic program expansion led to significant measurable improvements in the provincial PT outcomes. These results highlight the effectiveness of targeted capacity-building and scale-up initiatives in strengthening diagnostic quality. Continued investment in staff training, monitoring systems, and facility inclusion will be essential and advance gains and to ensure that the province sustains and build on these achievements
| eISSN: | 2654-1459 |
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