Blood transfusion service critical in achieving universal health coverage

In Kenya, seven people require a blood transfusion every 10 minutes amid a shortage of supply, with only 16 per cent of the blood needed in the country collected in 2019. The World Health Organisation (WHO) says to meet the need Kenya requires at least a million units of blood yearly.

The Covid-19 pandemic exacerbated the shortage owing to a stark decrease in blood donations due to fears of infection at donation centres, cancelled blood donation drives and lockdown restrictions. This increased the risk to people needing blood as part of treatment for ailments and medical emergencies.

With schools closed, cancelled blood drives and mitigation measures against the pandemic, such as social distancing, blood donations were severely curtailed, resulting in a dire shortage of this essential commodity.

In the current model, availability of blood is strained and compounded by inadequate structures to support the blood management services value chain, including last-mile deliveries to the health facilities.

Satellite transfusion centres

The Kenya National Blood Transfusion Service (KNBTS) does not deliver blood all the way; they only do to regional satellite blood transfusion centres. It then becomes the responsibility of the county governments to deliver it to the health facilities, which becomes difficult due to the strained financial resources.

To achieve the ambitious universal health coverage (UHC) aspiration, there is a need for highly innovative health system strengthening solutions that are available, cost-effective, sustainable and scalable. It requires solutions that can be immediately deployed to bridge the huge gap in the blood ecosystem. It’s imperative to invest in the whole blood transfusion and management value chain—blood donation, storage, testing and distribution.

Blood donor drives and donations are important in addressing the shortage but it is critical to strengthen the other components within the ecosystem.

Cold chain systems ensure safe storage and ferrying of blood from its collection point to its final transfusion into a patient. Whole blood is warm on collection but must be chilled to 4°C and kept at this temperature until transfusion. Kenya has a storage capacity of only 50,000 pints of blood at its cold chain system, which is inadequate to sustain demands for blood and limits blood drives.

Must be safe

The blood to be transfused must be safe for administration to patients; it should be free from disease pathogens such as hepatitis B and C viruses, HIV and syphilis. It is, therefore, critical to invest and build capacity in quality laboratory testing systems in the counties with capabilities for blood typing, compatibility testing and diagnostic testing for infectious diseases.

The delivery and distribution of critical medical supplies, including blood, to healthcare centres is hugely critical with a direct impact on patients in need. In most emergency cases, the availability or lack thereof of these supplies often presents a life or death situation. In remote areas with poor roads and extreme weather conditions, the delivery time is often hampered. It’s therefore extremely important to adopt and innovative last-mile delivery solutions to save lives.

Amref Health Africa has partnered with the Health ministry in augmenting KNBTS’s efforts to increase access to safe blood. Innovative solutions to management of blood services can catalyse the attainment of UHC by ensuring access to timely supply of safe blood to the marginalised and vulnerable communities, particularly women and children.

Without the empowerment of the people-centred primary healthcare systems, UHC will take longer coming. The journey requires integration and, hence, partnership cultivation and development are crucial. We must develop and incubate innovative solutions that are geared towards supporting devolved governance, address the needs of vulnerable populations, especially women, children and the youth, and address the burden of infectious diseases, non-communicable diseases and maternal mortality.

Mr Waiganjo is venture development manager, Amref Health Africa in Kenya. [email protected]. @Pwaiganjo