Blood Transfusion Country Status Report Nepal

1
Blood Transfusion Country Status Report (Nepal)
Dr Manita Rajkarnikar Director Nepal Red Cross
Society Central blood transfusion Service
2
Country Introduction

• Nepal
• Total Land area 147,181 sq Km
• Total Population 23.1 million
• Literacy rate 54.1 (M 65.5, F 42.8)
• No of Hospitals 89
• No of Primary Health Centers 180
• Per - capita income 260 USD

3
History
4
Structure of Blood Transfusion Service
Blood Transfusion Service Central Management
Committee
BTS Centre Chief
Technical Section (Officer)
Administrative Section (Officer)
Public Relation Section (Officer)
Public Relation Officer
Lab. Unit (Lab Incharge)
Bleeding Unit (Bleeding Incharge)
Logistic
Store
Finance
Grouping / Screening / Component / Cross match
Mobile Blood Collection / BTS Blood Collection
Regional BTC
District BTC
Emergency BTC
Hospital (BTC) Unit
Total Staffs 43
5
Blood Transfusion Centres(58 centres in 41
districts)
6
National Blood Policy

• In 1991 Government declared Blood Policy -  
• NRCS as a sole authority to conduct Blood
  Programmes Nationwide. 
• Appropriate safe blood and blood products at no
  cost and only reasonable material / Service
  charges
• Collect blood only from healthy Voluntary
  non-remunerated blood donors. 
• Sale / purchase of blood - totally banned

7
Blood Transfusion Service Activities

• Motivation and recruitment and retention of blood
  donors
• Blood collection
• Transportation of blood and blood products
• Laboratory processing
• Storage and Supply of blood and blood products
• Collection of report and reporting to the
  different wings eg. GOs, NGOs, UN agencies and to
  all BTS

8
TTIs Testing

• 100 of collected blood is tested for HIV, Hep B,
  Hep C, and VDRL
• All above tests are National mandatory test and
  WHO recommended for BTS
• Screening methods are Rapid test, Particle Ag,
  Elisa and RPR, TPHA for Syphilis
• Confirmatory test done by the referal system to
  the Government sector Elisa and Western blot
• All donors are reported screening positive -
  Confidential

9
3 Years Comparative Study

• 2003/04 2004/05 2005/06
• BLOOD COLLECTION (in units)
• Nation-wide Collection-76,647/ 82,677/ 103,067
• Nation-wide Supply-96,000/ 124,142/ 136,630
• Central- 30,054/ 31,293/ 35347
• PREVALENCE OF TTIS IN PERCENTAGE (nation-wide)
• HIV-0.37/ 0.24/ 0.4
• HBsAg- 0.88/ 0.85/ 0.8
• HCV-0.42/ 0.49/ 0.6
• VDRL-0.14/ 0.17/ 0.2

10
Blood Group Distribution Nationwide
11
Blood Donors by Sex
12
Component Preparation

• About 10 of whole blood units processed into
  components
• Type of blood components Packed red cells,
  Plasma, Platelets, Cryo, WBC etc
• 87 of total collection used as whole blood in
  clinical use
• Only one center is having Apheresis blood
  collection and 4 centers having component
  separation facilities Nation-wide

13
STRENGTH /Opportunities

• An organised national BTS under the NRCS
• Volunteer donor organisations are highly
  successful and motivated, functioning entirely on
  voluntary effort and funds.
• Center is potential, one time fund raising
  program is easy and districts are capable to run
  own self
• Concept of voluntary blood donation well
  established across country
• WHO, UNDP, SSMP, DFID, UNICEF and other partners-
  supporting for the quality development, capacity
  building and institutional development
• NQAS and EQAS program
• Prevalence of infections relatively low.

14
WEAKNESS

• Lack of defined annual financial support to NBTS
• Deficient manpower particularly medical and
  technical, BTS run basically by technical staff.
  No monitoring of blood request from the concerned
  field inadequate infrastructure old equipment.
• Limitation of component facilities in the
  district level.
• No NRCS reference center for the positive cases
  for confirmation
• No uniformity for testing and material charge
  nationwide
• No Academic development in Transfusion Medicine
  eg. Diploma, MD in Transfusion Medicine

15
Challenges

• Needs felt to upgrade and strengthen existing
  procedures, infrastructural facilities and HR,
  management system for self blood, training and
  quality assurance
• To meet above challenges felt to develop 10 year
  master plan for blood programme

16
BTS STRATEGIES

• Policy and SOP Revision
• To develop Master plan for 10 years for blood
  program
• Assurance/Quality Control
• Donor Recruitment
• Club 25- young donor group
• Supervision and Monitoring
• Research
• Donor follow up and donor care system

17
BTS Participation in the Exhibition
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Blood Donation by Volunteers
19
Staffs at work in the Laboratory
20
Interaction Program on the Occasion of World
Blood Donor Day
21
BTS Anniversary
22
BTS Anniversary
23
Interviewing by Media People
24
Intercountry Training 6-16 July, 2004 Kathmandu,
Nepal
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Intercountry Training
26
South Asian Association of Transfusion Medicine
Conference 2005 Kathmandu, Nepal