Blood-transfusion services are vital to maternal health because
haemorrhage and anaemia are major causes of maternal death in South
Asia. Unfortunately, due to continued governmental negligence,
blood-transfusion services in India are a highly-fragmented mix of
competing independent and hospital-based blood-banks, serving the needs
of urban populations. This paper aims to understand the existing
systems of blood-transfusion services in India focusing on Maharashtra
and Gujarat states. A mix of methodologies, including literature review
(including government documents), analysis of management information
system data, and interviews with key officials was used. Results of
analysis showed that there are many managerial challenges in
blood-transfusion services, which calls for strengthening the planning
and monitoring of these services. Maharashtra provides a good model for
improvement. Unless this is done, access to blood in rural areas may
remain poor