ReacciónAs part of a wider quality management system (QMS) for testing services, quality assurance (QA) is defined as a set of planned and systematic activities to ensure that organizational quality requirements are met; this enables laboratories to maintain accuracy, reliability and reproducibility of results. Essential QA activities include training and competency assessments for staff, equipment verification and maintenance, method validation, lot testing for reagents, routine QC procedures, EQA such as proficiency testing, monitoring of quality indicators and continuous quality improvement actions. Cyclical feedback and corrective actions are crucial for sustaining and strengthening QA processes. These essential activities enhance confidence among clinicians and patients who rely on diagnostic services to guide decisions about care and treatment, which can in turn enhance demand for, and the impact of, clinical tests for patient management.
Key ongoing QA challenges in resource-limited settings include inconsistent practices, lack of systematic collection or monitoring of laboratory indicators, insufficient resource allocation for QC and EQA, and variability in the quality and timeliness of training and competency assessment provided to testing and clinical staff.
To address these challenges, programmes should review and budget for QA needs early in the processes for test consideration, selection and placement. Annex 1 provides budgeting considerations for TB tests, and the GLI planning and budgeting tool (55) for projecting testrelated costs, including required and recommended test-specific cost considerations. In addition, the GLI has produced a dashboard of EQA panels and programmes for TB tests (with details and contact information for providers), to help programmes select and budget for EQA service provision (56). Lastly, close collaboration between testing and clinical programmes, as well as between TB and other disease programmes where relevant, should be sought out and maintained during test implementation to help inform QA activities related to test selection, placement, training, usage and indicator measurement. Further practical considerations for QA of specific tests can be found at the Stop TB Partnership GLI website (12), for which WHO serves as the Secretariat.