Evaluation of the decentralisation strategy for HIV/TB care in Shiselweni, Swaziland: laboratory services – learning from experience

In order to decentralise the laboratory services in the Shiselweni region, to increase the capacity of overall turn-out and to improve the quality of the diagnostic process, the following technologies were installed in the health facilities of this rural region: point-of-care tests for CD4 cell, clinical chemistry and haemoglobin in primary health care clinics (overall 22 clinics); thin layer agar and HIV viral load in a referral laboratory in Nhlangano; Xpert®MTB/RIF in all three secondary health care facilities of Shiselweni. The implementation process of each of the components demonstrates an excellent example of integration between the national health care system, the scientific institutions and international agencies.