Optimizing diagnostic services in Madagascar: the Mérieux Foundation helps to set up DNO in Madagascar

Participants at the workshop to set up a DNO
Participants at the workshop to set up a DNO

A workshop took place on August 18th, 2023, in Madagascar on Diagnostic Network Optimization, an approach that examines how a country’s diagnostic systems are organized to enable better healthcare. Targeted at biologists, laboratory technicians and doctors, the workshop aimed to review progress and define targets for the next stage. Financed by the Global Fund, the project is being managed on the island by the Mérieux Foundation, collaborating with local institutions, including the Ministry of Public Health, prior to the introduction of DNO.

This workshop on Diagnostic Network Optimization (DNO) attracted over 30 attendees – medical biologists, laboratory technicians and family doctors from all four corners of the island, all active in the health system and in close touch with the population’s needs. The event presented the opportunity to define two areas of operation that will serve as a basis for collecting information and data about what is available in terms of medical biology tests.

The members of the Technical Working Group (TWG) and the 19 representatives of public health organizations present discussed priorities for strengthening laboratory systems with a focus on two subjects: Mother & Child (the 1,000 days program) and Infectious Diseases. Both these topics correspond to public health problems in Madagascar and demand from clinicians. They are also among the areas of intervention of the Global Fund, which is financing the project.

The Global Fund wants to strengthen capacity in the laboratory system, an essential component of a country’s health system. The end goal is to enable laboratories to offer long-term tests and a wider range of analyses and diagnostics to ensure appropriate healthcare for the population. Introducing a tool such as DNO in Madagascar will contribute to this objective.

Dr. Catherine Ainamalala Razafindrakoto, the laboratory service manager at Morafeno University Hospital in Toamasina, said: ‘Today’s workshop achieved its basic end goals, which were to present DNO in order to improve understanding among the participants, confirm the areas of operation and list the representative laboratories for data collection.’ 

She then added: ‘Despite the difficulties and flaws that have emerged and may still emerge, I am enthusiastic about the outcome of the project. It represents the prospect of strengthening laboratory systems in Madagascar to enable them to expand their services.’

Luciana Rakotoarisoa, Madagascar Manager at the Mérieux Foundation, agreed: ‘This technical support is fully aligned with the foundation’s strategy and expertise, aiming to increase access to diagnostics by bolstering the national laboratory system. This is a very innovative approach and, with the help of local stakeholders, we will work together to establish the country’s priorities for the analyses to be carried out to meet the population’s needs.’ 

The next step will involve collecting data from the representative laboratories that attended the workshop on the tests they offer. Ultimately, it will be possible to produce a mapping of the tests available and identify any gaps to constitute an up-to-date database.

What is DNO?

Diagnostic Network Optimization is a tool that aims to redefine the organization of a country’s diagnostic network in order to improve access, maximize impact and improve efficiency. It involves aligning demand for tests with capacity as cost-effectively as possible. 

In this context, the Global Fund has commissioned the Mérieux Foundation to coordinate the steps prior to implementing the tool in Madagascar.