Background

Since 2014, the RTCQI (Rapid Test Continuous Quality Improvement) Program has been implemented at different levels in countries under the support of PEPFAR. The Centers for Diseases Control and Prevention (CDC), International Laboratory Branch (ILB) is organizing this workshop, in partnership with AFENET, to convene RTCQI country stakeholders to share best practices and lessons learned on RTCQI implementation across PEPFAR supported countries as well as tools available for analyzing and using RTCQI data. This workshop invited representatives from PEPFAR-supported countries implementing RTCQI in the Africa Region.

Workshop Objectives

• Countries to present best practices on 1) tester certification, 2) test site certification, 3) PT program, 4) kit quality post-market surveillance, 5) data collection and utilizations for continuous quality improvement, and 6) testing strategies.
• Demonstrations and country showcase of eTools for managing and analyzing RTCQI data, including ePT, SPI-RRT dashboard, Tester certification dashboard, HTS logbook data management tool, and other eTools.
• Discussion on country RTCQI implementation plan and roadmap for development of country quality assurance framework.

Expected Workshop Outcomes

• Facilitate cross-country experience sharing on RTCQI implementation/impact and data use.
• Raise awareness among countries about RTCQI eTools and their practical applications.
• Identify common challenges and propose solutions where possible.
• Country to share implementation plans for next steps.
• Official launching of the RTCQI website.

Participants

Representatives from MOH, CDC DGHT country office, and country implementing partners who are responsible for quality assurance and improvement of HIV rapid diagnostic testing.

Venue

Taj Cape Town Hotel, Cape Town, South Africa

Agenda at-a-glance

• Day 1: RTCQI Overview & Testing strategy
• Day 2: QA framework, Logbook, and Tester certificatic
• Day 3: Proficiency testing
• Day 4: Site certification & Kit quality monitoring
• Day 5: Country RTCQl plan

Day 1: June 3, 2024 - RTCQI Overview & Testing Strategy

Time	Session	Topic	Facilitator(s)	Downloads
08:30 - 09:15	Registration	Registration of all participants	-
09:15 - 09:30	Opening	Welcome remarks	Alarice Marsh (NDoH, South Africa), Heather Alexander (CDC, Atlanta), Lazarus Kuonza (AFENET Chair), Alaleh Abadpour (WHO, Geneva)
09:30 - 10:00	Introductions	Introductions of country delegation Review of workshop objectives and agenda Housekeeping	Ernest Yufenyuy (CDC, Atlanta), AFENET
10:00 - 10:30	Activity	Group Photo	AFENET
10:30 - 11:00	Tea/Coffee Break
11:00 - 12:10	Presentation	1.1 PEPFAR’s vision on RTCQI (20 min) 1.2 RTCQI Overview (20 min) The concept of RTCQI Tools currently available from HQ Country implementation status Q&A (30 min)	George Alemnji (GHSD/PEPFAR), Xiaojuan Tan (CDC, Atlanta) Moderator: Ernest Yufenyuy	1.1 PEPFAR's Vision Presentation 1.2 RTCQI Overview Presentation
12:10 - 13:00	Country Presentation & Discussion	1.3 Implementation and scale-up of RTCQI (15 min/country, 3 countries) An overview of RTCQI country implementation strategy and progress referring to five pillars of RTCQI Plans/strategy for scale up Lessons learned Discussion (20 min)	Country representatives: Rwanda, South Africa Moderator: Mireille Kalou (CDC, Eswatini)	1.3.1 Rwanda Presentation 1.3.2 South Africa Presentation
13:00 - 14:00	Lunch
14:00 - 14:40	Presentation	1.4 Testing strategy to ensure the quality of diagnosis (20 min) Rationale to use test algorithm 2- and 3-test algorithm Pros and cons The in-country verification process Verification prior to ART Q&A (20 min)	Alaleh Abadpour (WHO, Geneva), Nora Hennesy (CDC, Atlanta) Moderator: Chantelle Owens (CDC, Atlanta)	1.4.1 WHO Presentation 1.4.2 CDC Presentation
14:40 - 15:00	Activity	Ice breaker	AFENET
15:00 - 16:15	Country Presentation & Discussion	1.5 Country experience sharing on testing strategy (15 min/country, 4 countries) Strategy used on algo selection Implementation of HIV status verifications prior to ART as applicable Other measures to ensure the adherence to testing strategy such as Alternative algorithm Supply management Monitoring the performance of algo Lessons learned Discussion (15 min)	Country representatives: Ethiopia, Malawi, Nigeria, South Sudan Moderator: Chantelle Owens (CDC, Atlanta)	1.5.1 Ethiopia Presentation 1.5.2 Malawi Presentation 1.5.3 Nigeria Presentation 1.5.4 South Sudan Presentation
16:15 - 16:45	Tea/Coffee Break with eTool Open Booth Discussion

Day 2: June 4, 2024 - QA Framework, Logbook, and Tester Certification

Time	Session	Topic	Facilitator(s)	Downloads
09:00 - 09:15	Recap	Review of Day 1	Volunteer
09:15 - 10:15	Country Presentation & Discussion	2.1 Country HIV diagnostic quality assurance framework (15 min/country, 2 countries) Outline of country quality assurance framework for HIV diagnosis Strategy used for framework development, including but not limited to stakeholder engagement Implementation experience Lessons Learned Discussion (30 min)	Country representatives: Ethiopia, Zimbabwe Moderator: Heather Alexander	2.1.1 Ethiopia Presentation 2.1.2 Zimbabwe Presentation
10:15 - 11:15	Presentation	2.2 Using standard Logbook Monitor the data to ensure the performance of algo (15 min) How to use standard logbook How to use the data to monitor the performance of algo, supply chain management, potential training/site management gap Logbook Data Management Tool Demo (30 min) Demonstration on how the tool can be used for data monitoring Q&A (15 min)	Xiaojuan Tan (CDC, Atlanta), Amitabh Adhikari (CDC, Atlanta) Moderator: Nora Hennesy	2.2.1 Logbook Presentation 2.2.2 eTool Presentation
11:15 - 11:30	Tea/Coffee Break with eTool Open Booth Discussion
11:30 - 12:30	Country Presentation & Discussion	2.3 Country Experience Sharing - using standard Logbook (15 min/country, 3 countries) Country to share their experience of using standard logbook for such as monitoring performance of testing algo performance, supply chain management, potential training/site management gap and so on. Q&A (15 min)	Country representatives: Ethiopia, Cameroon, Rwanda Moderator: Kelsie Decker (CDC, Atlanta)	2.3.1 Ethiopia Presentation 2.3.2 Cameroon Presentation 2.3.2 Rwanda Presentation
12:30 - 13:30	Lunch
13:30 - 14:30	Country Presentation & Discussion	2.4 Overview of tester certification program (15 min/country, 3 countries) Overview of country tester certification Structure of certification program National curriculum Tool used for certification data management Lessons learned Discussion (15 min)	Country representatives: Côte d'Ivoire, Tanzania, Uganda Moderator: Makhosazana Makhanya (CDD South Africa)	2.4.1 Cote D'Ivoire Presentation 2.4.2 Tanzania Presentation 2.4.2 Uganda Presentation
14:30 - 15:40	Presentation	2.5 eTools for tester certification South Africa’s experience (20 min) South Africa team to share their experience of using eTool to manage tester certification data eTools developed by CDC (30 min) How the tool work What need to be done for implementation Q&A (20 min)	South Africa representative, Amitabh Adhikari (CDC, Atlanta) Moderator: Xiaojuan Tan	2.5.1 South Africa Presentation 2.5.2 eTool Presentation
15:40 - 16:00	Tea/Coffee Break with eTool Open Booth Discussion
16:00 - 17:30	Visit country booth	Poster/booth of 7 countries (highlight of country RTCQI implementation and achievement) eTool booth (CDC Atlanta)	Angola, Botswana, Burundi, Cameroon, Côte d'Ivoire, DRC, Eswatini

Day 3: June 5, 2024 - Proficiency Testing

Time	Session	Topic	Facilitator(s)	Downloads
09:00 - 09:15	Recap	Review of Day 2	Volunteer/Moderator
09:15 - 10:30	Country Presentation & Discussion	3.1 Overview of country PT program (15 min/country, 4 countries) Provide an overview of PT program including but not limited to: Coverage of the PT program Stakeholders and roles Panel production and distribution Scale up plans Lessons learned Discussion (15 min)	Country representatives: Eswatini, Ghana, Malawi, Mozambique Moderator: Floris Wray-Gordon (CDC, Atlanta)	3.1.1 Eswatini Presentation 3.1.2 Malawi Presentation 3.1.3 Cameroon Presentation 3.1.4 Mozambique Presentation
10:30 - 10:45	Tea/Coffee Break with eTool Open Booth Discussion
10:45 - 11:45	Country Presentation & Discussion	3.1 Overview of country PT program (15 min/country, 3 countries) Provide an overview of PT program including but not limited to: Coverage of the PT program Stakeholders and roles Panel production and distribution Scale up plans Lessons learned Discussion (15 min)	Country representatives: Mozambique, Nigeria, South Sudan, Zambia Moderator: Adeboye Adelekan (CDC South Africa)	3.1.5 Nigeria Presentation 3.1.6 South Sudan Presentation 3.1.7 Zambia Presentation 3.1.8 Sierra Leone Presentation
11:45 - 13:00	Country Presentation & Discussion	3.2 Manage and Use PT data (15 min/country, 4 countries) How the PT result is collected from testers How the PT evaluation report is returned to site/tester How the PT data is used to identify gaps for corrective action plan and implementation Lessons learned Q&A (15 min)	Country representatives: Kenya, Lesotho, Uganda, Zimbabwe Moderator: Xiaojuan Tan	3.2.1 Kenya Presentation 3.2.2 Lesotho Presentation 3.2.3 Uganda Presentation 3.2.4 Zimbabwe Presentation
13:00 - 14:00	Lunch
14:00 - 14:45	Presentation	3.3 ePT tool Presentation on ePT tools developed by CDC Atlanta (30 min) How it works Process of implementation ePT Q&A (15 min)	Amitabh Adhikari (CDC, Atlanta)	3.3 eTool Presentation
14:45 - 15:15	Discussion	Challenges on PT administration Gaps identified through PT & challenges on closing the gaps	Moderator: Ernest Yufenyuy
15:15 - 15:45	Tea/Coffee Break with eTool Open Booth Discussion
15:45 - 17:15	Visit country booth	Poster/booth of 7 countries (highlight of country RTCQI implementation and achievement) eTool booth (CDC Atlanta)	Ethiopia, Ghana, Kenya, Lesotho, Malawi, Mozambique, Namibia

Day 4: June 6, 2024 - Site Certification & Kit Quality Monitoring

Time	Session	Topic	Facilitator(s)	Downloads
08:00 - 08:15	Presentation	4.1 Refresher of site monitoring Quality elements & SPIRRT checklist for monitoring (15 min)	Floris Wray-Gordon (CDC Atlanta)	4.1 Presentation
08:15 - 09:15	Presentation	4.2 SPI-RRT dashboard Presentation on dashboard developed by CDC Atlanta (30 min) How it works Process of implementation Q&A (30 min)	Amitabh Adhikari (CDC, Atlanta)	4.2 eTool Presentation
09:15 - 10:20	Country Presentation & Discussion	4.3 Implementation and good practices on site monitoring toward accreditation (15 min/country, 3 countries) Overview of the progress in site preparation toward site accreditation, including but not limited to: Coverage TA/Mentorship activities Site assessments and monitoring Roadmap toward accreditation Share good practices on capacity building, logistic management, stakeholder buy-in/coordination at large scale, e.g. personnel training, site activation, site management and assessment Projections for further scale up Lessons learned Q&A (20 min)	Country representatives: Côte d'Ivoire, DRC, Tanzania Moderator: Mireille Kalou	4.3.1 Cote D'Ivoire Presentation 4.3.2 DRC Presentation 4.3.3 Tanzania Presentation
10:20 - 10:40	Tea/Coffee Break with eTool Open Booth Discussion
10:40 - 11:40	Country Presentation & Discussion	4.4 Good practices on collection, management, and use of site monitoring data (15 min/country, 3 countries) How the data is collected and managed (monitoring data and/or corrective action data) How the data is used to identify gaps and to inform the program of the progress toward site accreditation Lessons learned Discussion (15 min)	Country representatives: Botswana, Malawi, Rwanda Moderator: Kelsie Decker-Pulice	4.4.1 Botswana Presentation 4.4.2 Malawi Presentation 4.4.3 Rwanda Presentation
11:40 - 13:00	Discussion	Discussion: Site monitoring & Parking Lot questions	Moderator: Davis Ashaba
13:00 - 14:00	Lunch
14:00 - 14:45	Presentation	4.5 Monitoring the quality of kit Kit quality monitoring by PEPFAR procurement mechanism (20 min) How to conduct post-market kit quality monitoring in country (10 min) Q&A (15 min)	Ashini Fernando (USAID/FHI360), Kelsie Decker-Pulice (CDC, Atlanta) Moderator: Xiaojuan Tan	4.5.1 USAID/FHI360 Presentation 4.5.2 CDC Presentation
14:45 - 16:00	Country Presentation & Discussion	4.6 Experience sharing on kit quality monitoring (15 min/country, 4 countries) How to monitor the quality of kit at central/site level Key findings Lessons learned Discussion (15 min)	Country representatives: Burundi, Côte d'Ivoire, Namibia Moderator: Ashini Fernando	4.6.1 Burundi Presentation 4.6.2 Cote D'Ivoire Presentation 4.6.3 Namibia Presentation
16:00 - 17:00	Visit country booth	Poster/booth of 7 countries (highlight of country RTCQI implementation and achievement) eTool booth (CDC Atlanta)	Nigeria, South Africa, South Sudan, Tanzania, Uganda, Zambia, Zimbabwe

Day 5: June 7, 2024 - Country RTCQI Plan

Time	Session	Topic	Facilitator(s)	Downloads
09:00 - 09:10	Demo	Launch of RTCQI website (10 min)	Kelsie Decker-Pulice (CDC Atlanta)
09:10 - 09:40	Discussion	Opportunities to extend RTCQI concept to other POC diagnostic tests.	Moderator: Xiaojuan Tan
09:40 - 11:10	Group Discussion	Group Discussion – Next Step Prep for the country plan	Grouped by country
11:10 - 11:40	Tea/Coffee Break with eTool Open Booth Discussion
11:40 - 12:25	Presentation	Key Take Away Message	George Alemnji (GHSD/PEPFAR), Ernest Yufenyuy (CDC/ILB)	Closing Presentation
12:25 - 13:00	Wrap-up session	Poster award Logistics Final survey Closing Remarks	AFENET, Linda Fleming (CDC Atlanta)
13:00 - 14:00	Lunch