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Submitted on 30 September 2014

A Hub is a centralized health facility with a laboratory that performs the routine diagnostic services to patients and provides specialized services of collecting laboratory referral samples as well as testing some of them from other laboratories or health facilities within its catchment area. The different samples transported and processed within the referral network include Early Infant Diagnosis of HIV Dry Blood Spot, TB sputum, Histopathology, Surveillance, Outbreak Investigations, External Quality Control panels, Sickle cell, CD4, Viral load and many more.

Certain laboratory investigations are recommended as the absolute minimum to manage patients on ART. These should either be available on site or by transportation of specimens to a local reference laboratory (in which case results should rapidly be returned to the requesting clinician). Such tests are needed to identify potential toxic reactions e.g. anemia due to ZDV, and then to trigger changes in drug regimens according to recommended protocols; or as adjuncts to monitoring the effectiveness of ART. These investigations have been classified as absolute minimum tests (HIV antibodies, HB and Urinalysis); basic recommended tests (WBC total/Differential, CD4, LFTs/RFTs and Glucose); desirable tests (Bilirubin, Lipids, and Lactate and Hepatitis B antibodies) and optional tests (Viral load).

To effectively perform these laboratory functions, a Hub needs to have the right equipment, adequate competent and committed personnel, sufficiently good infrastructure, a functional laboratory quality management system and good management of commodities and logistics system.

A Hub Coordination meeting was convened in the West Central district of Mbarara from the 14th and 15th of April 2014, during which MJAP the Implementing partner, several top district officials and facility in charges and laboratory personnel exhaustively discussed the strengths and challenges with implementing the National laboratory specimen referral and transport network. In the two days, district officers, the implementing partner and laboratory focal persons were oriented through their roles and responsibilities in the system