BACKGROUND: In sub-Saharan Africa, there is dearth of trained laboratorians and strengthened laboratory systems to provide adequate and quality laboratory services for enhanced HIV control . In response to this challenge, in 2007, the African Centre for Integrated Laboratory Training (ACILT) was established in South Africa with a mission to train staffs from countries with high burdens of diseases in skills needed to strengthen sustainable laboratory systems . This study was undertaken to assess the transference of newly gained knowledge and skills to other laboratory staff, and to identify enabling and obstructive factors to their implementation .
METHODS: We used Kirkpatrick model to determine training effectiveness by assessing the transference of newly gained knowledge and skills to participant's work environment, along with measuring enabling and obstructive factors . In addition to regular course evaluations at ACILT (pre and post training), in 2015 we sent e-questionnaires to 867 participants in 43 countries for course participation between 2008 and 2014 . Diagnostics courses included Viral Load, and systems strengthening included strategic planning and Biosafety and Biosecurity . SAS v9.44 and Excel were used to analyze retrospective de-identified data collected at six months pre and post-training .
RESULTS: Of the 867 participants, 203 (23.4 %) responded and reported average improvements in accuracy and timeliness in Viral Load programs and to systems strengthening . For Viral Load testing, frequency of corrective action for unsatisfactory proficiency scores improved from 57 to 91%, testing error rates reduced from 12.9% to 4.9% ; 88% responders contributed to the first national strategic plan development and 91% developed strategies to mitigate biosafety risks in their institutions . Key enabling factors were team and management support, and key obstructive factors included insufficient resources and staff's resistance to change .
CONCLUSIONS: Training at ACILT had a documented positive impact on strengthening the laboratory capacity and laboratory workforce and substantial cost savings . ACILT's investment produced a multiplier effect whereby national laboratory systems, personnel and leadership reaped training benefits . This laboratory training centre with a global clientele contributed to improve existing laboratory services, systems and networks for the HIV epidemic and is now being leveraged for COVID-19 testing that has infected 41,332,899 people globally.