By: Elizabeth Obar
There are 231 health facilities supported by GIS. 105 of them are transfusing facilities however only
38 are directly supported by GIS on Blood Safety activities.
Western Kenya has 1 Regional Blood Transfusion Centre in Kisumu and a few Blood Satellite Centres
namely Bungoma, Busia, Migori, Homabay and Siaya (both upcoming) and Kakamega Counties as far
as blood safety support is concerned. Migori county has 5 facilities, Homabay 6, Kisumu 7, Vihiga 1,
Kakamega 6, Bungoma and Busia both have 5 each, a total of 38 transfusing facilities under GIS
support.
Entry to Facilities and Capacity Building (Mentorship)
GIS managed to sensitize the senior Health Management teams of the counties thus paving the way
for smooth entry into the facilities with the support of the Lab Managers and mentors (GIS) who
were already working in those facilities. So in collaboration with NBTS GIS has held 4 trainings on Blood
Safety ensuring that all the important topics were covered during the period e.g. Appropriate Use
Blood and Blood Products, Recognizing and Managing blood Transfusion Reactions, Blood Cold
Chain, Blood Inventory Management and Setting/ Monitoring of blood transfusion. A total of 114
Health Care Workers were trained plus 41 others who came from other transfusing facilities which
are not directly supported by GIS but are within the region.
Three officers from each of the 38 transfusing facilities comprising of a nurse, a lab technician and
a clinician were trained as blood safety champions. This enhanced the dissemination of information
to the rest of the staffs through CME activities and as a result 790 HCWs were sensitized and have
knowledge on Blood Safety and Haemovigilance. This interaction has improved and strengthened the
lab- clinic interface that had earlier derailed and left the 2 entities more of enemies than colleagues.
There is better interaction and communication between the clinical area and the laboratory
department staffs and more so with the realization that the issue of safe blood transfusion is not a
lab issue as many thought, but rather it is the responsibility of all the stakeholders.
Hospital Transfusion Committee (HTC)
After the training of the officers again it became easier to establish and/or revive the Hospital
Transfusion Committees. At the beginning of July 2016 just when GIS was entering the facilities
there were 13 facilities that had HTCs and only 3 of them were active. So we set on a mission to
establish, revive and form these committees depending on the state on the ground. Indeed this was
and still is an uphill task as there are many challenges that have been experienced. However, 35 HTCs
have been formed and established. 29 are active and report of having regular meetings, 6 are
dormant and inactive because they do not meet as required but they have a clear-cut number of
members identified by their respective Health Management Teams. 3 are in the process of being
formed and soon will be announcing their committee members and the dates when they will hold
their first meeting. All these HTCs have appointed a Haemovigilance Officer except the 3 facilities,
which are yet to identify theirs. I must say with all honesty that it was made easier with the support of
the GIS resident mentors who have done a tremendous job in doing mentorship to laboratory staffs
who in turn have ensured that the HTCs have remained active despite the challenges.
Support Supervision
GIS, in cooperation with RBTC and the satellite heads within their areas of jurisdiction have
embarked on doing supportive supervisions to the transfusing facilities. A total of 19 facilities have
so far benefited from these visits that are quite comprehensive. On the other hand this has
improved the ownership of the programme because of the involvement of RBTC/NBTS and because
of the linkage between the transfusing facilities and RBTC as a source collection centre for blood.
It has created a networking system whereby facilities are interlinked one with another in the venture
of looking for blood in times of emergency without any boundaries courtesy of RBTC/ Satellite. This
has shown impact and seriousness in the programme because RBTC representing the National has
always emphasised with authority the need to have safe blood, which is its sole mandate, and so
facilities have no option but to adhere to the policy guidelines set by the National Blood Transfusion
Centre. It has therefore erased the notion that it is the partners’ pushing for their own benefit.
Light Lifting
The other area is the light lifting whereby GIS has come in fully to support some of the transfusing
facilities by buying fridge guards for the blood bank refrigerators, internal thermometers for
monitoring fridge temperatures and plans are underway for acquiring cool boxes for transporting
blood and blood products from the blood transfusion units to the wards.
This is basically to ensure that blood cold chain is maintained and the practice upheld in high
standards by all the stakeholders involved in the transfusion process. It is ongoing and in the financial
year, more facilities are set to benefit especially the lab as the main custodian of this delicate
commodity (blood).
GIS has done printing of some of the Haemovigilance tools and distributed them to various facilities
for use through the Mentors again. The Blood Requisition Forms, the Blood Transfusion Monitoring
Charts and the Haemovigilance Reporting Tool are among the tools that we have worked on to enable
dissemination to the facilities for use. This was because the supply from the National was not
adequate and we had already embarked on sensitization of the tools to the staffs in the facilities. We
still expect a lot of support from KNBTS in this area to enable sustainability and continuity of reliable
processes and information.
Advocacy
We have reaped good results following serious advocacy for equipment to be used in safe blood
transfusion. Facilities have managed to acquire better blood bank fridges and especially most Faith
Based Hospitals responded positively to this.
Other facilities bought themselves cooler boxes for carrying blood within the facilities and did away
with the practice of carrying blood in a box or in the pocket as was the norm there before. Others
were even lucky when Care and Treatment Partners offered to purchase for them the ideal fridges
following advocacy and in support for safe blood transfusion to mothers and children as was the case
in Bungoma County.