Strategy and Program for Blood

Safety and Availability

DR. MAHMOUD MOHAMED HASSAN
DG OF NATIONAL BLOOD TRANSFUSION SERVICE
CEO OF NATIONAL PLASMA PROJECT
Contents

 Introduction
 Objectives of the Strategic Framework
 Factors on which Depend the Safety and Availability of Blood Transfusion
 Status of blood supply in Egypt
 Coordination and Collaboration
 Requirements for Safe Blood Provision
 Link for the WHO Strategic framework for blood safety and availability
 Introduction

 There is an increased demand of blood transfusion, this is due to:

 The growth of the population.
 Aging of the population.
 The availability of, and access to, increasingly sophisticated medical and surgical procedures.
 The Ministry of Health and Population (MoHP) is responsible for meeting the increasing clinical needs
of patients for safe blood components.
 MoHP also ensures the quality, safety, availability and equitable distribution of these products through
the establishment of an effective national blood supply and transfusion service that is integrated into the
national health system
 WHO has set a strategic framework for the safety of blood and blood components.
 Objectives of the Strategic Framework

 Ensuring access to a safe and sufficient supply of blood and blood components.
 Achieving complete reliance on regular voluntary non-remunerated donors for blood and blood
components.
 Preventing transfusion transmitted infections (TTIs) through quality-assured screening of all donated
blood and blood components, and ensuring quality assured testing for blood grouping and compatibility
(immunohaematology).
 Developing quality and quality management systems throughout the blood transfusion chain.
 Promoting appropriate clinical use of blood and blood products.
 Factors on which Depend the Safety and
Availability of Blood Transfusion
 Availability of a well-organized and adequately funded nationally coordinated blood transfusion
service, with an effective blood component programme under well-defined regulatory oversight.
 Collection of blood and blood components from voluntary, non-remunerated and regular blood
donors from low risk populations.
 Quality-assured testing of all donated blood, including screening for TTIs, ABO and Rhesus D
grouping, and compatibility testing.
 Reduction in unnecessary transfusions through appropriate clinical use and safe administration of
blood and blood products.
 Implementation of effective quality systems in all areas, including quality management, development
and implementation of quality standards, effective documentation systems, training of all staff and
regular quality assessment, including hemovigilance, based on a national quality policy and strategy.
Status of Blood Provision in Egypt

% Blood Supply

NBTS MoHP Hospitals

33.3% 33.3%

Other Sectors Military Blood Banks

33.3% Police Blood Banks
Universities Blood Banks
Private Sector
 Coordination and Collaboration (1/2)

 In Egypt, there is a specific directorate for blood transfusion services exists within MoHP, that is
separate from laboratories department. There is a mandate to implement this strategy in all hospitals.
 NBTS is a project that was done as collaboration between Egyptian MoHP and Swiss Red Cross aiming
for restructuring of Blood Transfusion Services in Egypt through the centralization of blood donation
and testing. Currently centralized testing is implemented in each governorate for all MoHP facilities.
 Stock management is an integral part of the quality system and its management. Interruption of this
kind is a major obstacle for the collection, screening and processing of blood donations.
 National systems for standardized data collection and reporting encompassing all activities from
blood donation to distribution to hospitals, issuing to patients and the recording of transfusions of blood
and blood components to patients are necessary to facilitate monitoring and evaluation of the vein-to-
vein transfusion chain, including traceability and surveillance (hemovigilance).
 Coordination and Collaboration (2/2)

 The current information management systems still are not well implemented countrywide.
 There is a National Policy and Standards for blood transfusion, strict regulations are required for their
implementation allover all sectors.
 Staff should be vaccinated against hepatitis B virus (HBV).
 Strategic partnerships and collaborations with blood donor organizations, patient associations,
academic and research institutions, scientific and professional societies, and industry is needed
 In addition, there is an some linkages with key health programs, such as 100 Million Seha, and HIV
program.
Requirements for Safe Blood Provision (1/2)

 Facilities and infrastructure that are adequately planned and constructed with respect to requirements
for space, design, utilities and waste disposal.
 Trained specialized staff in blood transfusions services, together with opportunities for professional
development and inadequate staff retention strategies and remuneration, which need to be at the same
level as other health care workers.
 Trained biomedical engineers for maintenance and repair of equipment and facilities
 Implemented strategies for voluntary non-remunerated donors motivation and retention.
 Well- developed national donor selection criteria.
Requirements for Safe Blood Provision (2/2)

 Donated units screen for HIV, HBV (HBsAg), HCV and syphilis, using enzyme-linked immunoassay
(EIA) or chemiluminescence.
 Nucleic acid amplification testing (NAT).
 Confirmatory testing for TTI, and collaboration with the central laboratories for confirmation of HIV
reactive samples.
 Effectively maintaining the blood cold chain system and a maintenance program for cold chain
equipment should be in place.
 Incomplete collections and problems in processing, storage, transportation and dates of expiry also
contribute to the discard and wastage of blood and blood components. Data should be available on
donor exclusions due to anemia, underweight or other reason.
WHO Strategic framework for blood safety
and availability

https://applications.emro.who.int/dsaf/EMROPub_2017_EN_19608.pdf