Background: Participation in External Quality Assessment (EQA) monitors laboratory performance and is a requirement for accreditation. The East African Regional External Quality Assessment Scheme (EA-REQAS), an integrated scheme initiated by the Ministries of Health of the East African countries in 2006 supports continuous quality improvement in peripheral health facilities.
Methods: Blood lysate for haemoglobin estimation is submitted to participants twice a year. Immediate feedback reports are generated for each laboratory and composite reports analysing performance and recommendations provided to the MOHs.
Results: Twelve surveys were completed by 2013 with 434 participants. Methods of haemoglobin estimation include manual colorimeters (43%), autoanalysers (19%) and comparator methods (9%); 29% of participants failed to indicate methodology used. Overall performance of laboratories using each method was comparable (62%; SD ±2); however, one third of laboratories do not attain the target value. Some Point of C are (POC) instruments fails to process blood lysate, a major constraint to EQA monitoring in resource limited countries. Comparator methods are subject to errors more than autoanalysers and manual colorimeters.
Conclusions: EQA evaluates laboratory performance and identifies errors in laboratory procedures. The data can be used for post-market surveillance and to influence national policy in selection of laboratory instruments and techniques.