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Thiruvananthapuram , Dec. 23

A STUDY of the blood donor programme in the State has recommended that the State blood policy must stipulate the commitment and support from the Government to the national blood programme, and should have the required legislative or regulatory support to achieve listed milestones.

The study, spearheaded by the All Kerala Blood Donors Society (KEBS) and Terumo Penpol, said authority must be delegated suitably to enforce national guidelines in the State even as adequate funding is made available for the purpose.

The policy must provide for the appointment of a full-time Transfusion Director with the specific responsibility for institutionalising the Kerala Blood Transfusion Service and implementing the blood policy. The person appointed must have the authority to organise, manage and coordinate the development and implementation of the blood policy. The policy should seek to ensure that blood is collected from voluntary non-remunerated donors from lowest risk groups. The donated blood and blood products must be appropriately screened before transfusion. Safe blood and blood products must be made available for transfusion to all in need.

Within the framework of the national blood policy, the State blood programme should aim at developing and maintaining all services required to provide safe and adequate supply of blood and blood products by providing, among others, appropriate buildings and equipment, adequate organisational and financial infrastructure and qualified staff.

The act of donation must be encouraged from voluntary non-remunerated low risk donors who are regulars. It is acknowledged that this will take time to be developed fully and needs to be started with as soon as possible.

Donor education/deferral procedures, counselling and referral for follow-up should be administered wherever necessary.

All donated blood should be screened for infectious agents while ensuring donor confidentiality at all times. Good laboratory practices and quality assurance must be followed in the laboratory screening of donations for blood grouping and crossmatching.

This should be the norm in the collection, preparation of components, storage and distribution of blood and blood products. Good clinical practice must be ensured in the appropriate use of blood and blood products and the subsequent monitoring of transfusion recipients.

All procedures would need to undergo continual monitoring and evaluation with a comprehensive quality assurance programme. The staff must be trained in all areas of work relating to blood transfusion service.

Staff at the district hospitals with multi disciplinary laboratory responsibilities would also need to be trained. Cost effective management and use of resources should be prioritised and development of strong community-based links promoted to ensure support for the blood transfusion service. Costing and budget control systems would need to be well planned to ensure a sustainable programme.

Adequate funding in the following key areas of the blood programme is essential: (i) organisation and management (ii) promoting appropriate use of blood and the use of blood substitutes to the prescribers of blood products (iv) training and continual staff development programmes, and (v) total quality management programme.

The weak areas of the existing systems are decentralisation of blood banks, lack of professionalism and consequent commercialisation of blood banking services. Inadequate motivational programmes to collect safe blood go to further magnify these weaknesses.

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