Safe blood transfusion Pakistan
Title: Safe blood transfusion Pakistan (all provinces, territories and Azad Jammu & Kashmir)
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Lead executing agency: The Federal Ministry of Health, and health ministries of all provinces, territories and Azad Jammu & Kashmir
Overall term: 2009 to 2015
A properly functioning blood transfusion service is one of the essential components of health care and can save a considerable number of lives. Half of all people require a blood transfusion at some time in their lives. Particular beneficiaries of an improved blood transfusion service include women with high-risk pregnancies, as well as anaemia and trauma patients.
The blood transfusion service in Pakistan is neither organised nor consistently regulated. Blood and blood products are only produced and stored by isolated blood banks, which are operated by both state and private providers. The blood banks are subject to unsystematic state quality controls and they do not always meet the necessary standards for patient care. The level of training among staff entrusted with blood transfusion varies considerably between the various transfusion services. Blood products are often not used appropriately. As a result of these deficiencies, the blood products administered are of inadequate quality, and in some cases are even contaminated. This increases the risk of transmitting infectious diseases, including HIV/AIDS, but especially hepatitis B and C, which are passed on in the blood. In Pakistan there is as yet no systematic approach for providing the population with safe blood transfusions (core problem).
The population has access to safe blood transfusion services and blood products. Specifically, there are more registered and licensed state blood banks, and more voluntary blood donors; the amount of properly screened blood at the blood banks has increased, and a greater number of patients receive blood components of WHO-compatible quality.
The programme provides advice on shaping the legal framework for safe blood transfusion services and the practical implementation of those services in the provinces. In the management field business plans are being drawn up, and a harmonised information system is being developed to record relevant data for the blood transfusion service. The programme is helping to develop and deliver training for health workers, and is also examining possible approaches for setting up a blood bank system based on voluntary donations (outputs).
Results achieved so far
The National Blood Transfusion Service (NBTS) has established a National Strategic Framework 2008–2012 for blood transfusion services in Pakistan, which was officially approved in March 2009. Based on that framework, the NBTS has drafted and subsequently promulgated the Federal Blood Transfusion Law to guide legislative reforms at provincial level. It has also established a National Steering Committee and completed an inventory of existing teaching and training facilities. In one district, it has conducted a survey of knowledge, attitudes and practices related to blood donation, while at the federal level it has carried out an instructors’ training course for quality management trainers. The first quality management courses have already been delivered in Sindh and Punjab. Most recently, the NBTS has developed a functional brief for creating regional blood centres, and it has taken the necessary steps toward establishing a national platform for voluntary non-remunerative blood donation.