Blood transfusion services in Nepal: An overview

The Nepal Red Cross Society (NRCS) and hospital laboratory services operate blood transfusion services (BTSs) in Nepal. Currently, 121 blood centers in 76 districts of Nepal provide blood donation and transfusion services. The NRCS is involved in almost 90% of Nepal's blood transfusion-related services. The society has established 105 blood service center units in 76 districts and blood centers in 40 hospitals. The National Public Health Laboratory serves as both a governing body for blood safety and a reference laboratory for screening for BTS in transfusion-transmitted infections (TTIs). Different organizations, including government and nongovernment offices, education institutions, media houses, NRCS units (district chapters, sub-chapters, youth circles, and clubs), and other civil societies, support Central BTSs (CBTS) by regularly collecting blood. The country's demand for blood is rapidly increasing with the expansion of medical colleges, government and private hospitals, and nursing homes. In 2023, NRCS CBTS collected 262,439 units of whole blood nationwide and supplied 344,933 blood components to save lives. In Nepal, there is a lack of proper blood transfusion policy and guidelines. Although the national guideline for blood transfusion was developed and revised in 2015, it did not define a precise protocol for safe blood component administration procedures; instead, it focused primarily on the criteria for blood donation and donor selection. The licensing work is done by the National Bureau for BTS, which is governed by the National Public Health Laboratory and the Health Ministry of Nepal. While the drug controlling authority is not associated with legislation for blood centers, the draft policy for plasma fractionation is related to drug authorities and is under progress.