Assessment of structural and process readiness for postpartum haemorrhage care in Uganda and Ghana: A mixed methods study

Objective To determine structural and process readiness for postpartum haemorrhage (PPH) care at referral-level facilities in Ghana and Uganda to identify opportunities for strengthening. Design Mixed-methods cross-sectional study. Setting Three districts in Ghana and two in Uganda. Population or Sample Nine hospitals in Ghana and seven in Uganda; all hospitals had theoretical capacity for caesarean section and blood transfusion. Methods We deployed a modular quantitative health facility assessment to explore structural readiness (drugs, equipment, staff) complemented by in-depth interviews with maternity health service providers to understand process readiness (knowledge, attitudes, and practices as related to World Health Organization [WHO] guidance on PPH care). Main Outcome Measures Availability of essential structural components needed to support key PPH processes of care. Results In both countries, there was generally good structural readiness for PPH care. However, key common gaps included inade

Application of Information Technology by Blood Banking and Transfusion Facilities in Ghana

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Health Economic Value of Blood in Kenya, Ghana and Ivory Coast: The Case of Maternal Bleeding

Background: In sub-Saharan Africa, severe bleeding accounts for up to 44% of maternal deaths, and the need for blood products far outstrips supply.Aims and objectives: We aimed to map the causes and consequences of blood shortage in Kenya, Ghana and Ivory Coast and estimate the health economic impact of overcoming blood shortages resulting in maternal bleeding.Methods: We conducted a targeted literature review to evaluate the impact of blood shortage on maternal mortality rates due to post-partum haemorrhage (PPH). Clinical experts from the selected countries were included as an additional source of information. Using a de novo budget impact model, costs associated with severe maternal bleeding were compared with investment costs to adequately manage maternal bleeding.Results: Of the estimated 4 000 941 births/year, 118 428 will be confronted with severe PPH requiring blood transfusion. The estimated total yearly value of life years lost for the three countries combined would be 57 104 042 USD. The total cost to provide adequate blood supply (13 units/patient) was 33 781 945 USD, meaning that blood transfusion in PPH results in 23 322 097 USD saved with savings starting from the first year onwards in Kenya and Ghana, and from the second year onwards in Ivory Coast.Conclusion: In Kenya, Ghana and Ivory Coast, an increased investment in blood supply would likely provide large cost savings in less than two years. French title: Valeur économique du sang pour la santé au Kenya, au Ghana et en Côte d'Ivoire : le cas de l'hémorragie maternelle Contexte : En Afrique subsaharienne, les hémorragies sévères représentent jusqu'à 44 % des décès maternels, et le besoin en produits sanguins dépasse de loin l'offre.Buts et objectifs : Nous avons cherché à cartographier les causes et les conséquences des pénuries de sang au Kenya, au Ghana et en Côte d'Ivoire et à estimer l'impact économique sur la santé de la résolution des pénuries de sang entraînant des saignements maternels.Méthodes : Nous avons effectué une revue ciblée de la littérature pour évaluer l'impact de la pénurie de sang sur les taux de mortalité maternelle due à l'hémorragie du post-partum (HPP). Des experts cliniques des pays sélectionnés ont été inclus comme source d'information supplémentaire. À l'aide d'un modèle d'impact budgétaire de novo, les coûts associés aux saignements maternels graves ont été comparés aux coûts d'investissement pour gérer correctement les saignements maternels.Résultats : Sur les 4 000 941 naissances/an estimées, 118 428 seront confrontées à une HPP sévère nécessitant une transfusion sanguine. La valeur annuelle totale estimée des années de vie perdues pour les trois pays combinés serait de 57 104 042 USD. Le coût total pour fournir un approvisionnement en sang adéquat (13 unités/patient) était de 33 781 945 USD, ce qui signifie que la transfusion sanguine dans l'HPP permet d'économiser 23 322 097 USD avec des économies à partir de la première année au Kenya et au Ghana, et à partir de la seconde à partir d'un an en Côte d'Ivoire.Conclusion : Au Kenya, au Ghana et en Côte d'Ivoire, un investissement accru dans l'approvisionnement en sang permettrait  probablement de réaliser d'importantes économies en moins de deux ans. &nbsp

How can 'Blood' collection agencies facilitate first time plasmapaheresis donation?

Background: Blood mobilization and collection agencies worldwide are challenged with blood donor recruitment and retention. When the demand for blood exceeds collection, there is inadequacy of supply and safety of the blood is also compromised. This challenge varies in severity between developed and developing countries. The median blood donation rates per 1000 population are 36.4 in high-income countries, 11.6 in middle-income countries and 2.8 in low-income countries. The World Health organization (WHO) African Regional Strategy, adopted in 2001, focuses on recruitment of low risk regular voluntary donors. But, even though blood from Voluntary Non-Remunerated Blood Donors (VNRBD) is safer than Family Replacement Donors (FRD), there is evidence that blood from first time VNRBD is not safer than FRD, and that only repeat donations provide improved blood safety. Therefore in developing models to increase repeat blood donations from existing donors, it is important to understand what will encourage the first time donor, whether VNRBD or FRD, to donate again, and the repeat donor to continue donating