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To Restore Continuous and Cost Effective testing
MINISTRY OF AGRICULTURE ( BOTSWANA):
Botswana

The Problem

During May to December 2007 the testing for Foot and Mouth Disease was conducted intermittently because antigens procured from various suppliers gave the expected results only when used undiluted (1/1) or partially diluted at (1/10) instead of at (1/100)

This resulted in frequent procurement of the antigens, a very costly undertaking indeed,
Hence 1191 samples were tested at a total cost of P56 000.00 which translates into a unit cost of P47.00/sample. Using correctly optimized liquid phase blocking enzyme-linked immunosorbent assay reagents, it was possible to test 17 200 samples at a cost of P33 000.00, which translates into a unit cost of P1.90/sample; a cost that is considered reasonable and cost effective.

Solution and Key Benefits

 What is the initiative about? (the solution)
Cattle farmers are now able to know the status of their animals on time and therefore plan accordingly the sale of their cattle.

Commercial and subsistence farmers can now sell their cattle to the Botswana Meat Commission (BMC); resulting in more revenues for the people and state thus alleviating poverty in the country.

Ban on restrictions on the exportation of beef that were imposed by the European Union in some districts have been lifted due to the success of this initiative. The export abattoirs have since resumed slaughter and sale of beef to the European Union and elsewhere.

The test is now accredited by the South African National Accreditation Systems (SANAS). This has promoted the competitiveness of Botswana’s beef in the international markets.

Turnaround time of the test results which was restored to agreed standard (7-21 days) and this has given customer satisfaction as far as service delivery is concerned.

As a result of resumption of testing, The Director of Veterinary Services is now able to make informed decisions pertaining to the control of Foot and Mouth Disease in Botswana.
The project ensures the sustainability of Botswana beef export (through Botswana Meat Commission) to lucrative markets by maintaining Foot and Mouth Disease free cattle without vaccination.

Actors and Stakeholders

 Who proposed the solution, who implemented it and who were the stakeholders?
Management of National Veterinary Laboratory proposed that this problem be resolved by Virose Work Improvement Team under the theme:

“To Restore Continuous and Cost Effective Testing of Foot and Mouth Disease at the National Veterinary Laboratory”

The solutions were proposed by Virose Work Improvement Team. The stakeholders are the Directors of Veterinary Services, livestock farmers and the Botswana Meat Commission.

(a) Strategies

 Describe how and when the initiative was implemented by answering these questions
 a.      What were the strategies used to implement the initiative? In no more than 500 words, provide a summary of the main objectives and strategies of the initiative, how they were established and by whom.
The main objectives were (i) to establish the proper reagent working dilutions that would give expected results in the test (ii) to test backlog samples using the standardized test. Possible causes were suggested by team members through brain storming and ultimately the most likely causes were identified by the team using the Cause and Effect Analysis.

(b) Implementation

 b.      What were the key development and implementation steps and the chronology? No more than 500 words
Before May 2007, testing for Foot and Mouth Disease at the National Veterinary Laboratory was going well with all the controls in the test giving expected results.

However, from May 2007 to December 2007, testing was conducted intermittently because antigens procured from various suppliers such as Botswana Vaccine Institute gave expected results only when used undiluted (1/1) or partially diluted (1/10).

This resulted in frequent procurement of the antigens, a very costly undertaking indeed. During the same period there was also occasional repeat testing.

(c) Overcoming Obstacles

 c.      What were the main obstacles encountered? How were they overcome? No more than 500 words
After an attachment of one analyst at Botswana Vaccine Institute, low colour intensity results were always obtained at with high concentration of reagents use in Foot and Mouth Disease testing (rabbit sera, antigen, guinea pig sera and the conjugate).
The force Field Principle

The team used the principle to determine the strength of the problems.
Table 1: Force Field Analysis: Current status, Gap and Required status
Current Status GAP Required Status
Inability to carry out Foot and Mouth Disease tests Testing reagent are not giving expected results Continuous Foot and Mouth Disease sample testing

Aim: To Establish the problems of relating to no Foot and Mouth Disease testing.
The driving and restraining forces were classified and weighed on a scale of 1-2 (weak), 3 (moderate) and 4-5 (strong). The results are summarized in Table 2.




Table 2: Evaluation of the restraining and driving forces
Restraining Forces Driving Forces
Reagents 5 2
ELISA plates 5
Testing techniques 5 1
Micropipettes 5
Test Procedure 5 1
Incubation temperature 4
Number of Analysts 1 1
Balance (Scale) 5
Skill 4 1
pH meter 5
Plate reader 5

Training 5
Outsource analysts 3
20 6 37

Note: Figures in black indicate the impact of forces before corrective action and those in red indicate the impact after corrective action.

Determination of the best solution
The Evaluation analysis tool which is used to determine the best solution in terms of:
i. Relevance
ii. Effectiveness
iii. efficiency-cost benefit analysis
iv. and the sustainability of objectives
The team employed the Evaluation Analysis to select the best option (Table 5). There were 4 alternatives as indicated below:
In-house training A
Outsource trainer B
Attachment C
Send out analysts for training D
Table 3: Evaluation Analysis to determine best option
Items Alternatives
A B C D
Cost Very Low High High Very High
Impact High Very High High Very High
Duration of training Flexible Fixed Situational Fixed
Sustainability Yes Situational Situational Yes


Based on these, the team opted for A and D alternatives
1. One analyst was sent to Botswana Vaccine Institute (BVI) on a two week training
2. An in-house training was conducted for the other analysts by the analyst who was trained at Botswana Vaccine Institute (BVI).

(d) Use of Resources

 d.      What resources were used for the initiative and what were its key benefits? In no more than 500 words, specify what were the financial, technical and human resources’ costs associated with this initiative. Describe how resources were mobilized
After evaluation it was clear that most of the restraining forces could be reduced through training. The latter could either be done by sending an analyst out or by bringing in an expert to our laboratory from an institution competent in the test. We resolved as a team to send one analyst to benchmark at the Botswana Vaccine Institute where the same test is also being done. This had not financial cost on the part of our institution.

Through the successful implementation of this initiative, it was realized that dilutions used for the liquid phase blocking enzyme linked immunosobernt assay are not static and hence have to optimize every time a new reagent is purchased for verification purposes.

Sustainability and Transferability

  Is the initiative sustainable and transferable?
In no more than 500 words, describe how the initiative is being sustained (for example in terms of financial, social and economic, cultural, environmental, institutional and regulatory sustainability). Describe whether the initiative is being replicated or disseminated throughout the public service at the national and/or international levels and/or how it could be replicated.

This initiative is sustainable and transferable. The test has been done repeatedly with successful results. The test method for the standardization of reagents has since then been reviewed and approved by our institution. The Quality Manager of our laboratory conducts periodic audits to ensure compliance.

The project can be applied in any veterinary set up where tests are undertaken particularly for diagnosis and / or research of animal diseases. However if other institutions for Foot and Mouth Disease testing are established elsewhere in the country they can come and benchmark. Regionally, several laboratories from the Southern African Development Community region involved in Foot and Mouth Disease testing can come and benchmark.

Lessons Learned

 What are the impact of your initiative and the lessons learned?
The resumption Foot and Mouth Disease testing has enabled effective disease surveillance, monitoring and diagnosis of all specimens submitted

The driving force behind this was the resumption of testing and the declaration of some areas of the country to be “Foot and Mouth Disease free without vaccination areas” and therefore enabling the country to export beef and animal products to lucrative markets especially in the European Union.

Tangible
i. An appropriate reagent –antigen mix has been developed
ii. The Section has resumed Foot and Mouth Disease sample testing and all the 3 000 samples backlog were all tested in a period of 2 weeks
iii. There was a saving of P45.10/sample




Non-tangible
i. Production of accurate and reliable test results.
ii. Turnaround time met by release of results within 7days.
iii. Winning the trust and confidence of our customers
iv. Improvement in testing skills (competence on trouble shooting of test).
v. The test has now been accreditation.
vi. Reduced delay in release of test reports
vii. Team work spirit was restored

Contact Information

Institution Name:   MINISTRY OF AGRICULTURE ( BOTSWANA):
Institution Type:   Government Agency  
Contact Person:   Emmanuel Galeforolwe
Title:   Mr  
Telephone/ Fax:   +267 392 8816
Institution's / Project's Website:   +267 392 8956
E-mail:   egaleforolwe@gov.bw  
Address:   Private Bag 0035, Gaborone, Botswana
Postal Code:  
City:   Gaborone
State/Province:  
Country:   Botswana

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