Blood Transfusion Services in Kenya NBTS March 2012 Naivasha - - PowerPoint PPT Presentation

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Blood Transfusion Services in Kenya NBTS March 2012 Naivasha - - PowerPoint PPT Presentation

Mar 06, 2024 34 likes •296 views

MINI NISTRY OF OF MEDICAL L SERVICES Blood Transfusion Services in Kenya NBTS March 2012 Naivasha History MINI NISTRY OF OF MEDICAL L SERVICES The need for Adequate and reliable supply of blood became apparent immediately after the

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Blood Transfusion Services in Kenya NBTS

March 2012

Naivasha

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History

  • The need for Adequate and reliable supply of blood

became apparent immediately after the August 7, 1998 Bomb explosion in Nairobi.

  • The service was established with the assistance of US

Govt

– Financial partners: US government and its international development agencies (USAID), MOH, FHI, Red Cross – Technical assistance - CDC, KEMRI, MoH, NASCOP

  • Currently: PEPFAR/AABB, KRC, JICA, CDC, USAID,

Blood Link, Hope World Wide

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MINI NISTRY OF OF MEDICAL L SERVICES

Background of Blood Transfusion Services in Kenya

  • 1930s: transfusions were organized around surgical practice.
  • 1950s: with increasing demand, BRCS organized BTS.
  • 1964: after independence the GOK with KRCS support took over.
  • Late 1960s: BTS was run as part of hospital laboratory services with no

dedicated budget line, staff, or equipment. Each hospital sourced for their

  • wn blood.
  • From 1985: with advent of HIV/AIDS, reduced blood collections, increased

cost of blood and increased emphasis on blood safety became more critical.

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Kenya’s Key Milestones

  • In 1994 Kenya recognised the need to set up a national blood service in line

with WHO recommendations and WHA resolutions.

  • Recommendations were made to establish a regional network of transfusion

centres under central coordination

  • In 2001 Kenya’s first ever blood policy guidelines were developed and

launched and first Regional blood transfusion centre (RBTC) and national coordinating office were established in Nairobi.

  • Progressively 6 regional and 9 satellite centres have been established.
  • Blood policy guidelines developed: National standards, Hemovigilance,

Appropriate use of blood and blood products, among others

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Organizational structure

  • f NBTS

PS/ DMS National board of directors National blood transfusion centre Regional Blood transfusion centre Satellite centres Hospital Centres

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Map of KNBTS RBTCs and Satellite Centres

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Regional Centres

Nairobi RBTC Nakuru RBTC

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Mombasa RBTC Kisumu RBTC

Regional Centres

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Embu RBTC Eldoret RBTC

Regional Centres

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KNBTS Head Office

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KNBTS Key Achievements

  • Established visible integrated service
  • Trained and dedicated personnel
  • Infrastructure developed
  • Management system in place
  • Increased blood collection
  • Reduced prevalence of TTIs
  • Policy guidelines developed
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Current NBTS (head office, RBTCs & Satellites) Staffing Levels

Cadre Optimum Inpost Variance National Director 1 1 Regional Director 6 all part time ? National Project Coordinator 1 1 National Blood Donor Recruiter 1 1 Secretary 2 1 1 National ICT Manager 1 1 Senior Project Accountant 1 1 Regional Accountant 6 6 Regional Blood Donor Recruiter 6 6 Regional ICT Manager 6 6 Medical Laboratory Technologist 133 85 48 Enrolled Community Nurse 82 7 75 Registered Community Nurse 34 7 27 Driver 46 34 12 Receptionist 9 7 2 Health promotion officers 8 9

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MINI NISTRY OF OF MEDICAL L SERVICES 20,000 40,000 60,000 80,000 100,000 120,000 140,000 2003 2004 2005 2006 2007 2008 2009 40,857 47,661 80,762 113,080 123,787 95,325 124,019

Blood Units Year

NBTS Annual Blood Collection 2003-2009

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Blood collection Aug 2011 to January 2012

RBTC/SATEL ITTE August September October November December January Collection for 2 Quarters NAIROBI 1869 5739 2532 1676 3934 1909 17659 MOMBASA 607 1050 1453 758 392 770 5030 KISUMU 776 1037 967 640 620 2125 6165 NAKURU 873 1469 1195 1766 720 1493 7516 ELDORET 2630 2012 1922 1580 1163 2185 11492 EMBU 625 1371 1256 1359 493 1565 6669 KISII 269 566 422 632 392 745 3026 KAKAMEGA 135 143 392 352 49 639 1710 MACHAKOS 178 490 210 197 354 781 2210 MERU 123 67 8 11 59

  • 268

NYERI 209 419 224 292 351 550 2045 GARISSA

  • 175

158 113 173 619 TOTAL

63199

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MINI NISTRY OF OF MEDICAL L SERVICES 5,000 10,000 15,000 20,000 25,000 30,000 35,000 2003 2004 2005 2006 2007 2008 2009 3,642 5,451 10,706 21,485 26,783 27,599 30,915

Donors Year

NBTS Repeat Donors

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Blood Screening

  • 100% of collected blood is screened
  • TTIs screened for include HIV,HBV,HCV and syphilis
  • Improvement in donor selection and deferrals has lead to decrease in

sero-prevalence

  • Screening has been centralized to the RBTCs
  • Blood testing a logarithm in line with WHO recommendations has been

adopted

  • Quality assurance systems are in place.
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MINI NISTRY OF OF MEDICAL L SERVICES 2.50 6.00 0.70 0.28 1.23 2.77 0.83 0.28 1.50 2.57 0.95 0.16 1.22 2.64 0.99 0.15 0.00 1.00 2.00 3.00 4.00 5.00 6.00 7.00 HIV HBV HCV Syphilis

% TTI

NBTS TTI Trends 2006 - 2009

2006 2007 2008 2009

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MINI NISTRY OF OF MEDICAL L SERVICES 1 2 3 4 5 6 AUG SEPT OCT NOV DEC JAN Percentage Prevalence

TTI Prevalence in Donated Blood Between Aug 2011 - Jan 2012 in KNBTS

HIV HB HC SYP

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Blood Storage & Release

  • Each centre has cold room storage and appropriate blood bank fridges

to store up to 5,000 units of blood

  • Unsafe units are sorted and incinerated
  • Each centre has an incinerator and a standby generator
  • Safe units are stored at appropriate temperatures
  • Proper blood inventory is kept by type and product
  • Blood is released to the user institutions as per their orders subject to

availability of stock and based on FIFO policy

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Cold Room

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Incinerator

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Appropriate Use of Blood

  • Distribution of blood and blood products to hospitals
  • Ensuring blood cold chain up to hospitals
  • Blood use guidelines development and distributed
  • Linkage to hospital transfusion units through HTCs
  • Monitoring blood use, haemovigilance and investigations of adverse

transfusion reactions is done through HTCs

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Challenges

  • Sustainability: KNBTS operations are largely supported by PEPFAR.

A self sustainability plan is needed.

  • Meeting the country’s blood needs: KNBTS unable to achieve this

due to:

  • inadequate staffing
  • inadequate funding
  • inadequate blood storage facilities at the hospitals.
  • inadequate advocacy and public education.
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Challenges

  • Lack of legal framework

WHO Guidelines requires the establishment of a stand alone BTS. WHO 28th World Health Assembly, Geneva 13-30 May 1975 WHA28.72 Utilization and Supply of Human and Blood Products urges member states to:

  • 1. promote the development of national blood services based on

voluntary non-remunerated donation of blood

  • 2. enact effective legislation governing the operation of blood services

and to take other actions necessary to protect and promote the health of blood donors and of recipients of blood and blood products

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THANK YOU