Urgent Calls for Regulation as Clinicians Under Scrutiny for Blood Transfusion Practices

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Amidst global concerns over blood shortages and wastage, the spotlight has intensified on clinicians' practices surrounding blood transfusions. A recent gathering of medical experts at the 11th Africa Society for Blood Conference, held in Kampala, shed light on alarming trends in blood management, prompting urgent calls for regulatory measures.

Shortfalls and Misuse

Uganda, like many African nations, grapples with a significant deficit in blood supply, collecting just a fraction of the required units annually. Shockingly, only 320,000 units out of the necessary 450,000 are collected, leaving a gaping hole in the nation's healthcare infrastructure. Moreover, a staggering 38 African countries collectively recorded a shortfall of 3 million units in 2020, highlighting a continent-wide crisis.

Compounding the issue is the misuse of the limited blood supply. Reports indicate that a sizable portion of collected blood is administered without proper consideration for alternatives, such as iron tablets, leading to unnecessary transfusions. Clinicians have come under fire for neglecting pre-tests before transfusions, raising concerns about patient safety and exacerbating blood wastage.

Director Uganda blood transfusion services, Dr Dorothy says, "If you measure the BP and all a patient requires is just one unit of blood, then that patient can be treated without infusing blood"

The minister for health Jane Ruth Achieng equally notes, "A lot of blood is collected, yet a lot of blood is wasted"

Addressing the Challenges

In response to these pressing challenges, health authorities are advocating for a paradigm shift towards Patient Blood Management (PBM) models. PBM emphasizes optimizing the use of blood products while minimizing risks and conserving resources. The approach advocates for judicious transfusion practices, ensuring that blood is reserved for cases where it is truly necessary.

Dr Aggrey Banghi an infusion physician at the Ministry of Health challenged members of the public to take to be at the centre of patient blood management

He noted some patients are fond of neglecting medications that would otherwise prevent the infusion. "For example the pregnant mothers, if you are given iron tablets take them," he says

Health Minister Jane Ruth Acheng has underscored the importance of enacting legislation to regulate blood donation and transfusion processes. She emphasized the need for a legal framework to support national blood systems, aligning with World Health Organization (WHO) recommendations for standardized policies and legislative frameworks.

Global Disparities

Disparities in blood donation rates between low and high-income countries further exacerbate the crisis. Low-income nations struggle with a donation rate of 6.6 per 1000 people, significantly lower than the 31.5 per 1000 rate observed in high-income counterparts. These discrepancies underscore the urgent need for coordinated efforts to bridge the gap and ensure equitable access to life-saving blood products.

Looking Ahead

As discussions intensify and calls for action grow louder, stakeholders are urged to prioritize the establishment of robust blood management systems. With only a fraction of African countries equipped with comprehensive national blood policies and legislative frameworks, there is a clear need for concerted efforts to enact regulatory measures and safeguard the integrity of blood transfusion practices.

In the face of mounting challenges, the imperative for decisive action has never been clearer. The future of healthcare depends on our ability to address blood shortages, curb wastage, and uphold the highest standards of patient care.

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