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Improving blood availability in a district hospital, Bo, Sierra Leone. The Bo PMM Team
P Sengeh1, O Samai, S K Sidique
1Division of Planning, Monitoring and Evaluation, Ministry of Gender and Children's Affairs, Freetown, Sierra Leone.
Preliminary Studies:
A situation analysis of Bo Government Hospital found there was no functioning blood bank. Focus group discussions revealed negative perceptions of community members regarding donation and transfusion of blood.
Interventions:
In late 1992, the hospital laboratory was refurbished: a refrigerator, freezer, reagents and other equipment and supplies were provided and technicians were trained. Consequently, small quantities of blood could be stored and rapidly transfused. Other improvements to obstetric services in the hospital were undertaken at the same time. Afterwards, community education to encourage blood donation was done.
Results:
The number of units of blood drawn increased from 304 to 501 (65%) from 1992 to 1993 (the first intervention year); the number actually transfused increased from 296 to 452 (53%). By the third intervention year (1995), the annual numbers of units drawn and transfused were 469 and 422, respectively. Case fatality rates for major obstetric complications were lower in all post-intervention years (10% in 1993, 7% in 1994, 10% in 1995) as compared to 1992 (13%).
Costs:
Cost of improvements to blood services in the hospital was nearly US $10,000, of which 77% was used to purchase supplies and equipment.
Conclusions:
Even in settings with irregular electrical supply, storage of small quantities of blood is possible. Ready availability of blood may contribute to improved quality of obstetric care and improved survival among patients.