Data Form 1 (screenshots)

1. Recipient Information
Record ID

Global Antimicrobial Resistance Laboratory & Response Network M&E
Page 1

__________________________________

Global AR Laboratory & Response Network Performance Measures tool  
Form Approved
OMB Control Number: 0920-1282
Expiration Date: 06/30/2026

Thank you for completing the Global Antimicrobial Resistance (AR) Laboratory and Response Network (Global AR Lab
& Response Network) Performance Measures (PM) tool.  This tool is intended to establish and collect standardized
process and outcome metrics for recipients implementing Global AR Lab & Response Network projects.  Recipients
will be asked to complete this tool annually, in addition to the required Cooperative Agreement annual performance
and progress reporting. Please complete the tool using information that will be included in your organization's Year 3
performance narrative submission.  Please answer as many questions as possible.  If you need any assistance, please
contact [email protected].  
  Public reporting burden of this collection of information is estimated to average 4 hours per response per year,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a
person is not required to respond to a collection of information unless it displays a currently valid OMB control
number. Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS
D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-1282).

FORM 1.) RECIPIENT INFORMATION
Name of Recipient Organization:

Recipient HQ location:

GARLRN-Funded Strategy(s):
(Select all that apply)

__________________________________

__________________________________
Strategy 2: Assess Antimicrobial Resistance in
Enteric Pathogens
Strategy 3: Assess Antimicrobial Resistance in
Fungal Pathogens
Strategy 4: Assess Antimicrobial Resistance in
Invasive Bacterial and Respiratory Pathogens
Strategy 5: Assess Antimicrobial Resistance in N.
gonorrhoeae

Please list all project pathogens:
__________________________________________
(If unknown, enter 'N/A')

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SECTION 1: PROJECT IMPLEMENTATION Please answer the following questions about
[pilot_recipname]'s experiences with project implementation. Please use information that will
be included in [pilot_recipname]'s Year 3 performance narrative submission
1.  How many countries is this project being
implemented in during BP3?

2. What is the number of sites (laboratories,
hospitals, healthcare facilities, etc.) that were
supported as part of the project? Please answer for
each country.
3. How many sites received direct material support
(i.e., lab reagents/diagnostics, other lab equipment,
IT material, printed SOPs, etc.) from
[pilot_recipname] during this budget period as part of
the project?  Please answer for each country.
4. Is this project contributing to achieving the goals
of a country's national action plan (NAP) on
antimicrobial resistance?

Please list all countries and describe supporting
activities of NAP.

Please list barriers to participation and/or support
of the NAP in implementation country(s).

5. List any major product(s) (e.g., SOPs, job aids,
manuscripts, posters, trainings, etc.) developed
within this budget period and specify location (if
applicable).
6. Have CDC Subject Matter Experts (SMEs) reviewed
the major products listed?

__________________________________
(If none or unknown, enter 'N/A')

__________________________________________
(If none or unknown, enter 'N/A')

__________________________________________
(If none or unknown, enter 'N/A')

Yes, in all countries where project is implemented
Yes, in some countries
No
Don't Know
Does not apply / No NAP has been developed in
target country(s)

__________________________________________

__________________________________________
(If none or unknown, enter 'N/A')

__________________________________________
(If none or unknown, enter 'N/A')
Yes
No
Don't Know
Does not apply

6.b. If no, please explain.
__________________________________________
7.  What strategies or activities has
[pilot_recipname] implemented to sustain the efforts
and progress made with this project beyond the current
budget period? 

__________________________________________
(If none or unknown, enter 'N/A')

Please use this space to include any additional
information related to project implementation for this
budget period.

__________________________________________

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SECTION 2: LABORATORY CAPACITY SUPPORT Please answer the following questions based on
[pilot_recipname]'s current laboratory capacity enhancement activities for this Global AR Lab
& Response Network project.  Please use information that will be included in
[pilot_recipname]'s Year 3 performance narrative submission and be as thorough as possible.
1. Is regular external quality assurance performed for
AR testing at this project's participant laboratories?

Yes
No
Don't Know
Does not apply

1.a.i. Please describe the type and frequency of these
QA activities (e.g., WHO external program, PulseNet
EQA, 2 bacterial specimens/ year for identification
and AST, etc.).

__________________________________________
(If none or unknown, enter 'N/A')

1.a.ii. What is the total number of participant
laboratories currently enrolled in these QA testing
activities?

__________________________________
(If none or unknown, enter 'N/A')

2. Is there a national or central laboratory which
performs quality assurance (QA) testing for this
project?

2.a.i. List the number of labs where QA was performed
during this budget period, by country

2.a.ii. Describe the specimen submission criteria
(frequency and type of specimens submitted), by
country

During the current budget period, has
[pilot_recipname] provided training or support to any
laboratories in the following areas?
(Select all that apply)

Yes
No
Don't Know
Does not apply

__________________________________________
(If none or unknown, enter 'N/A')

__________________________________________
(If none or unknown, enter 'N/A')
Phenotypic Testing
Genotypic Testing
Antimicrobial Susceptibility Testing (AST and AFST)
Whole Genome Sequencing (WGS)
None of these

3.  PHENOTYPIC TESTING a. What is the total number of labs at which training or other capacity building activities
for performing phenotypic testing were implemented?
(Enter 999 if unknown)
______
b. Describe the education and training standards held to determine proficiency* in phenotypic testing. 
(Enter N/A if unknown)
*Proficiency defined as possessing a high degree of competence, expertise or skill in execution of tasks or
demonstration of knowledge related to specific subject matter
______

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4.  GENOTYPIC TESTING a. What is the total number of labs at which training or other capacity building activities
for performing genotypic testing were implemented (e.g., PCR) testing available?
(Enter 999 if unknown)
______
b. Describe the education and training standards held to determine proficiency in genotypic testing
(Enter N/A if unknown)
______

  5. ANTIMICROBIAL SUSCEPTIBILITY TESTING (AST), INCLUDING ANTIFUNGAL SUSCEPTIBILITY TESTING (ASFT) a.
What is the total number of labs at which training or other capacity building activities for achieving proficiency in
antimicrobial susceptibility testing (AST) and/or ASFT were implemented? 
(Enter '999' if unknown)
______
b. Describe the education and training standards held to determine proficiency in AST and/or ASFT
(Enter N/A if unknown)
______

6. WHOLE GENOME SEQUENCING (WGS)
a. Total number of laboratory personnel trained to proficiency in whole genome sequencing (WGS)
(Enter 999 if unknown)
______
b. Describe the education and training standards held to determine proficiency in WGS
(Enter N/A if unknown)
______

Please use this space to include any additional
information related to [pilot_recipname]'s laboratory
capacity support activities for this budget period.

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SECTION 3: SURVEILLANCE CAPACITY Please answer the following questions based on
surveillance efforts for [pilot_recipname]'s Global AR Lab & Response Network project during
this budget period. Do not answer questions based on future efforts.   Examples of newly
detected antimicrobial resistance include: 
1. Exceptional phenotypes that have not previously been reported or are very rare; and
2. Novel resistance genotypes that are associated with mechanisms of resistance that have a
high public health impact (i.e., high potential for spread and health impact) or pose serious
challenges in laboratory detection and surveillance 
Source:  GLASS Emerging antimicrobial resistance reporting framework (GLASS-EAR)

1. Are epidemiological data elements collected with
samples tested under this project?

Yes
No
Don't know

1.a.i. What data elements are being collected?
__________________________________________
(If unknown, enter 'N/A')
1.a.ii. List each of the sites collecting these
elements within the project and indicate if the
information is shared with local public health for
decision making.
1.b. Please list barriers to collecting epidemiologic
data elements at sites throughout the referral
network?

2. Are the collected data (e.g., phenotypic,
genotypic, NGS, etc.) integrated into subnational,
national, or global databases (e.g., GLASS)?
2.a.i. What database(s) were the data reported to?
Please list all.

2.a.ii. Select the frequency of data sharing with
nationl-level devision makers (e.g., MoHs or NPHIs,
etc.):

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__________________________________________
(If unknown, enter 'N/A')

__________________________________________
(If unknown, enter 'N/A')
Yes
No
Don't know

__________________________________________
(If unknown, enter 'N/A')
Daily
Weekly
Bi-weekly
Quarterly
Annually
Other ______
(If unknown, enter 'N/A')

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2.b. Please list any barriers to data integration:
__________________________________________
(If unknown, enter 'N/A')
3. Have any alerts* or findings from the lab or
facility required a local response (e.g., within
facility or local area, data sharing, PPS, etc.)?

Yes
No
Don't know

*Alert: Any newly detected** antimicrobial resistance
findings that may influence surveillance and control
practices. 
** Examples of newly detected antimicrobial
resistance include: 
1.    Exceptional phenotypes that have not
previously been reported or are very rare; and
2.    Novel resistance genotypes that are
associated with mechanisms of resistance that have a
high public health impact (i.e., high potential for
spread and health impact) or pose serious challenges
in laboratory detection and surveillance 
Source:  GLASS Emerging antimicrobial resistance
reporting framework (GLASS-EAR)
3.a. Please list the entities involved, response
activities and how data was shared.

4. Have any alerts been detected which required a
sub-national or national response (e.g., new
organism/type of resistance or large outbreak)?
4.a. Please list the entities involved, response
activities and how data was shared.

Please use this space to include any additional
information related to [pilot_recipname]'s
surveillance activities with GARLRN-funded projects.

__________________________________________
(If unknown, enter 'N/A')
Yes
No
Don't know

__________________________________________
(If unknown, enter 'N/A')

__________________________________________

SECTION 4: WORKFORCE DEVELOPMENT The following questions cover current education and
training activities for different personnel targeted by this Global AR Lab & Response Network
project. Do not answer questions based on future efforts, only established or current
opportunities.

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Please select the type of personnel that received
training from [pilot_recipname] (can be in
collaboration with partners): (Select all that apply)

LABORATORY PERSONNEL 1.  How many CDC-supported
education and training opportunities have targeted
laboratory personnel?

2. Are there any other partnerships (e.g.,
universities, hospitals, etc.) that provide mentorship
for laboratory personnel targeted by this project?

Laboratory
Data Manager
Healthcare Worker (including MOH/NPHL leadership)
Field-based personnel (Community interviewer,
environmental surveillance, etc.)
Other (specify): ______
(If unknown, enter 'N/A')

__________________________________________
(If none or unknown, enter 'N/A')
Yes
No
Don't know

2.a. If yes, please list these partnerships:
__________________________________________
3. How many laboratory personnel received training
under this project, during budget period 3?

4. Has a training curriculum been established for
training laboratory personnel?

__________________________________
(If none or unknown, enter 'N/A')
Yes
No
Don't know

4. Yes, training curriculum established for LABORATORY PERSONNEL:
i. Does the curriculum leverage a Train-the-Trainer (ToT) model? ______
ii.  What entity is responsible for facilitating the curriculum? ______
iii.  What assessments were conducted to ensure trainings and address knowledge gaps? ______
5. Has competency testing been performed among the
trained laboratory personnel?

Yes
No
Don't know

5.a. If yes, how often is this assessed?
__________________________________________
(If none or unknown, enter 'N/A')
5.b. If no, why hasn't this been performed?
__________________________________________
DATA MANAGEMENT PERSONNEL 1.  How many CDC-supported
education and training opportunities have targeted
data management personnel?

2. Are there any other partnerships (e.g.,
universities, hospitals, etc.) that provide mentorship
for data management personnel targeted by this
project?

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__________________________________________
(If none or unknown, enter 'N/A')
Yes
No
Don't know

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2.a. If yes, please list these partnerships:
__________________________________________
3. How many data management personnel received
training under this project, during budget period 3?

4. Has a training curriculum been established for
training data management personnel?

__________________________________
(If none or unknown, enter 'N/A')
Yes
No
Don't know

4. Yes, training curriculum established:
i. Does the curriculum leverage a Train-the-Trainer (ToT) model? ______
ii.  What entity is responsible for facilitating the curriculum? ______
iii.  What assessments were conducted to ensure trainings and address knowledge gaps? ______
5. Has competency testing been performed among the
trained data managment personnel?

Yes
No
Don't know

5.a. If yes, how often is this assessed?
__________________________________________
(If none or unknown, enter 'N/A')
5.b. If no, why hasn't this been performed?
__________________________________________
HEALTHCARE WORKER PERSONNEL 1.  How many
CDC-supported education and training opportunities
have targeted healthcare worker (HCW) personnel
(including MOH/NPHL leadership)?
2. Are there any other partnerships (e.g.,
universities, hospitals, etc.) that provide mentorship
for HCW personnel targeted by this project?

__________________________________________
(If none or unknown, enter 'N/A')
Yes
No
Don't know

2.a. If yes, please list these partnerships:
__________________________________________
3. How many HCW personnel received training under this
project, during budget period 3?

4. Has a training curriculum been established for
training HCW personnel?

__________________________________
(If none or unknown, enter 'N/A')
Yes
No
Don't know

4. Yes, training curriculum established:
i. Does the curriculum leverage a Train-the-Trainer (ToT) model? ______
ii.  What entity is responsible for facilitating the curriculum? ______
iii.  What assessments were conducted to ensure trainings and address knowledge gaps? ______

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5. Has competency testing been performed among the
trained HCW personnel?

Yes
No
Don't know

5.a. If yes, how often is this assessed?
__________________________________________
(If none or unknown, enter 'N/A')
5.b. If no, why hasn't this been performed?
__________________________________________
FIELD-BASED PERSONNEL  (e.g., community interviewer,
wastewater sample collection, etc.) 
1.  How many CDC-supported education and training
opportunities have targeted field-based personnel?
2. Are there any other partnerships (e.g.,
universities, hospitals, etc.) that provide mentorship
for field-based personnel targeted by this project?

__________________________________________
(If none or unknown, enter 'N/A')

Yes
No
Don't know

2.a. If yes, please list these partnerships:
__________________________________________
3. How many field-based personnel received training
under this project, during budget period 3?

4. Has a training curriculum been established for
training field-based personnel?

__________________________________
(If none or unknown, enter 'N/A')
Yes
No
Don't know

4. Yes, training curriculum established:
i. Does the curriculum leverage a Train-the-Trainer (ToT) model? ______
ii.  What entity is responsible for facilitating the curriculum? ______
iii.  What assessments were conducted to ensure trainings and address knowledge gaps? ______
5. Has competency testing been performed among the
trained field-based personnel?

Yes
No
Don't know

5.a. If yes, how often is this assessed?
__________________________________________
(If none or unknown, enter 'N/A')
5.b. If no, why hasn't this been performed?
__________________________________________
OTHER PERSONNEL TYPES  
1.  How many CDC-supported education and training
opportunities have targeted other types of personnel?

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__________________________________________
(If none or unknown, enter 'N/A')

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2. Are there any other partnerships (e.g.,
universities, hospitals, etc.) that provide mentorship
for other types of personnel targeted by this project?

Yes
No
Don't know

2.a. If yes, please list these partnerships:
__________________________________________
3. How many personnel in the "other" category received
training under this project, during budget period 3?

4. Has a training curriculum been established for
training other types of personnel?

__________________________________
(If none or unknown, enter 'N/A')
Yes
No
Don't know

4. Yes, training curriculum established:
i. Does the curriculum leverage a Train-the-Trainer (ToT) model? ______
ii.  What entity is responsible for facilitating the curriculum? ______
iii.  What assessments were conducted to ensure trainings and address knowledge gaps? ______
5. Has competency testing been performed among the
other types of trained personnel?

Yes
No
Don't know

5.a. If yes, how often is this assessed?
__________________________________________
(If none or unknown, enter 'N/A')
5.b. If no, why hasn't this been performed?
__________________________________________
Please use this space to include any additional
information about [pilot_recipname]'s workforce
development activities related to this project.

__________________________________________

Thank you for completing this form. Please be sure to complete Form #2 in this tool as well. For any assistance,
please email [email protected].

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