Bihar laboratory system strengthening (Bihar LSS)

What is the project?

FIND is supporting Government of Bihar (GoB) in improving the availability of and access to quality diagnostic services, by strengthening, expanding, and integrating the existing tiered-laboratory referral networks to build a robust diagnostic and surveillance system.

The project follows a “hub and spoke model”, establishing referral linkages between public health laboratories at district and sub-district levels, to promote access to quality diagnostic services aiding clinical management, and diagnosis of communicable and non-communicable diseases.

Further, the project aims to build capacity of district laboratories for lab-based surveillance and analysis of generated data to rapidly detect and respond to public health threats.

Why are we working on it?

A responsive, accessible, and pandemic resilient public health system is critical towards early detection, accurate treatment, and continued care management. In this context, the public health laboratories must be fortified to provide quality assured diagnostic services aiding clinical management, public health surveillance and outbreak investigations.
Bihar is committed to improving the status of its public health sector laboratories under the guidance and financial provisions of Pradhan Mantri Ayushman Bharat Health and Infrastructure Mission (PM ABHIM) to drive effective and timely implementation of this plan. The aim is to demonstrate that ramped-up diagnostic services ensure standardized, accessible and quality care.

What does it involve?

Specifically, the project is:

• Strengthening availability of diagnostics: by augmenting diagnostic testing services as per the Essential Diagnostic List (EDL), up skilling laboratory technicians, and enhancing testing through improved utilization of the available equipment.
• Supporting quality diagnosis: establish robust quality management systems (QMS) including external quality assurance programs and bolster mentoring, monitoring, and testing linkages within the tiered laboratory system. The project will also engage higher-tiered laboratories (including those in medical colleges and district hospitals) in providing mentorship and technical support to lower-tiered laboratories (includes the sub-district facilities) and assist the state implementation body, i.e., the State Health Society Bihar (SHSB) in policy decisions.
• Improving efficiency of the state surveillance system: support accurate and timely testing, confidential data collection and analysis, as well as reporting into relevant Ministry of Health and Family Welfare (MoHFW) databases to improve surveillance.
• Building an ecosystem to support laboratory system strengthening in Bihar: advocate for policy and guidelines, to build sustainability through participatory approach from government stakeholders and identification of apex/referral institutes for capacity building and eventual transition.

What is the expected outcome?

The project has identified the following outcomes:

• Develop an ecosystem for integrated and sustainable laboratory response in Bihar through advocacy and a concerted multi-stakeholder response.
• Improved access to diagnostic services through successful implementation of public-private partnership models and in-house testing.
• Ensure availability of a tiered mentoring system for capacity building on National Essential Diagnostic List roll-out and QMS for public laboratories in Bihar.
• Improve monitoring and early identification of infectious disease outbreaks through efficient surveillance systems.

What is the time scale?

April 2022 to April 2024.

Partners and funding

This project is a Government of Bihar initiative, supported by the Bill & Melinda Gates Foundation.