Qualitative assessment of the scale-up of COVID-19 testing network in Armenia: turning adversities into opportunities.

Abstract

Background: The COVID-19 pandemic reaffirmed the importance of high-quality laboratory services in the face of elevated demand for timely COVID-19 laboratory diagnosis. We explored the scale-up experience of the laboratory system in Armenia as well as the successes and challenges it brought to the overall laboratory system with the aim to identify lessons that can serve as opportunities for improvement.

Methods: We conducted a qualitative study to explore the experiences concerning the process of scale-up of the COVID-19 testing network through in-depth interviews with policymakers/experts (n = 6), heads (n = 6) and physicians (n = 3) of private and public laboratories conducting COVID-19 testing. Eight domains of the WHO Laboratory Assessment Tool System (S-LAT) questionnaire guided the study and directed the content analysis.

Results: According to the findings, within the COVID-19 testing network, numerous advancements were documented across all essential elements of the S-LAT as a result of the COVID-19 response. The most vivid improvements were related to the newly established network of public and private laboratories for COVID-19 testing and related coordination mechanisms, new laboratory information management practices, improved compliance with biosafety measures, novel quality assurance mechanisms as well as improved technical and human resources. However, suboptimal coordination of the COVID-19 testing network and the whole laboratory system, the gap between existing and proper biosafety management and quality control practices, and insufficient training of laboratory professionals were mentioned as potential challenges for the laboratory system in the future.

Conclusion: The assessment revealed challenges and achievements of the laboratory system during the COVID-19 response. Enhancement of coordination and cooperation mechanisms within and beyond the COVID-19 testing network, continuous improvement of human resources as well as quality and biosafety control practices throughout the whole system are crucial for sustaining the achievements and for strengthening future preparedness of the laboratory system to infectious disease outbreaks.