Table 1.

Results of Key Interventions Used in Strengthening and Monitoring the Specimen-Referral System in Ethiopia Under the Public-Private Partnership (PPP) Between Becton, Dickinson, and Company and the US President's Emergency Plan for AIDS Relief

Key Indicators	Before the PPP (2008–2010)	After the PPP (2010–2012)
Sites referring specimens	420	554
Sample transportation mechanism	Not standardized, laboratory personnel transport the specimen	Ethiopian Postal System, no laboratory personnel transport specimen in pilot sites
Time needed to transport specimen for ART-related monitoring after collection	4 h (range, 2–6 h) in Addis Ababa and >6 h (range, 3–14 h) in other regions	1 h in Addis Ababa (range, 0.5–2 h) and 4 h (range, 1–5 h) in other regions
Specimen-transport containers with triple-packaging capacity, no,	100	2132 (400 procured by BD and the rest procured by PEPFAR)
People trained on specimen-referral system, no.	85 laboratory personnel only	667, including laboratory personnel (n = 586) and postal workers (n = 81)
Training coverage	No structured training in any region except for demonstration of specimen-transport and standard operating procedures	Standard training module available for all regions
Turnaround timea for ART-related monitoring	7 d (range, 2–14 d) in Addis Ababa and 10 d (range, 6–21 d) in Amhara Region	2 d (range, 1–3 d) in Addis Ababa and 5 d (range, 2–6 d) in Amhara Region
GIS mapping of sites	No system	System installed, with provision of initial trainingb

Abbreviations: ART, antiretroviral therapy; GIS, geographic information system; PEPFAR, US President's Emergency Plan for AIDS Relief.

^a Defined as the time from referral of specimens collected from ART recipients to a laboratory (for monitoring CD4⁺ T-cell, chemical, and hematological parameters) to receipt of results by the referring facility. It does not account for the time needed to collect specimens.

^b Full implementation and evaluation of GIS mapping is planned for the second phase of the PPP.