A Report on the “Assessment of Blood Banks in Uttar Pradesh, India”
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A Report on the “Assessment of Blood Banks in Uttar Pradesh, India” National AIDS Control Organization (NACO) and National Blood Transfusion Council (NBTC), Ministry of Health and Family Welfare, Government of India in collaboration with U.S Centers for Disease Control and Prevention (HHS/CDC) Division of Global HIV and TB (DGHT), India Christian Medical College, Vellore & Christian Medical Association of India (CMAI), New Delhi ii Abbreviations BB - Blood Bank BCSU - Blood Component Separation Units BTS - Blood Transfusion Service CDSCO - Central Drug Standard Control Organisation CHEMI - Chemiluminescence DAT - Direct Antiglobulin Test DCT - Direct Coombs Test ELISA - Enzyme Linked Immuno Sorbent Assay EQAS - External Quality Assessment Scheme FFP - Fresh Frozen Plasma HIV - Human Immunodeficiency Virus HBV - Hepatitis B virus HCV - Hepatitis C virus HVPI - Haemovigilance Program of India IAT - Indirect Antiglobulin Test ICT - Indirect Coombs Test IH - Immunohematology IQC - Internal Quality Control IQR - Interquartile Range MoHFW - Ministry of Health and Family Welfare NACO - National AIDS Control Organisation NAT - Nucleic Acid Testing NBTC - National Blood Transfusion Council NGO - Non Governmental Organisation NHP - National Health Portal PSU - Public Sector Undertaking QC - Quality Control QM - Quality Manager QMS - Quality Management Systems RPR - Rapid Plasma Reagin SACS - State AIDS Control Societies SBTC - State Blood Transfusion Council SD - Standard Deviation SIMS - Strategic Information Management System SOPs - Standard Operating Procedures TTI - Transfusion Transmitted Infection TM - Technical Manager TPHA - Treponema Pallidum Hemagglutination Assay VNRBD - Voluntary, Non-Remunerated Blood Donation VBD - Voluntary Blood Donor/Donation WHO - World Health Organization iii iv Table of Contents Executive Summary ............................................................................................................................ ix 1. Background.............................................................................................................................. 1 2. Objectives ................................................................................................................................ 4 3. Methodology............................................................................................................................ 4 4. Key Findings ........................................................................................................................... 7 4.1 Basic details of blood banks (n=247) .................................................................................... 10 4.1.1 Category of Blood Banks .............................................................................................. 10 4.1.2 Ownership ..................................................................................................................... 11 4.1.3 Organizational Attachment ........................................................................................... 13 4.1.4 License details of blood banks ...................................................................................... 13 4.2 Annual Blood Collection and Voluntary Blood Donation .................................................... 15 4.2.1 Annual Collection of Blood .......................................................................................... 15 4.2.2 Voluntary blood donation ............................................................................................. 21 4.3 Transfusion Transmitted Infections(TTIs) ............................................................................ 25 4.3.1 Transfusion Transmitted Infections by Category of blood banks ................................. 25 4.4 Component Separation .......................................................................................................... 31 4.5 Quality Management Systems .............................................................................................. 34 4.6. Reporting and Documentation .............................................................................................. 36 4.6.1 Compliance to NBTC guidelines ................................................................................. 36 4.6.2 Reporting requirements ................................................................................................ 36 4.7. Human Resources ................................................................................................................. 36 4.7.1. Availability of staff ...................................................................................................... 36 4.8. Training of Blood Bank Personnel ........................................................................................ 37 4.9. Equipment and Supplies........................................................................................................ 38 4.9.1. Regular supply kits/supplies ........................................................................................ 38 4.9.2. Equipment Availability (working condition) ............................................................... 39 4.10. The current status of blood banks based on the assessment .................................................. 40 4.10.1 Assessment score by Category of blood banks ............................................................ 45 4.10.2 Assessment score by Ownership .................................................................................. 46 4.10.3 Assessment score of Private Sector Blood Banks ........................................................ 47 4.10.4 Assessment score by Annual Collection ...................................................................... 47 4.10.5 Assessment score by Voluntary Blood Donation ......................................................... 47 4.10.6 Assessment score by participation in External Quality Assessment Scheme .............. 48 4.10.7 Assessment score by Accreditation status.................................................................... 49 5. Conclusion ............................................................................................................................. 53 6. Reference ............................................................................................................................... 55 7. Annexures .............................................................................................................................. 56 7.1 Individual Blood Banks Summary ........................................................................................ 56 7.2 NACO/NBTC – Questionnaire for Blood Banks .................................................................. 66 7.3 Scoring sheet ......................................................................................................................... 78 v Tables and Figures Tables Table 1 - Details of technical areas included in the assessment 5 Table 2 - Scoring details and weight 6 Table 3 - District wise description of blood banks 7 Table 4 - Basic details of blood banks 10 Table 5 - District wise list of blood banks by Ownership 11 Table 6 - Average Annual collection-District 16 Table 7 - Annual Blood Collection and percentage of VBD 18 Table 8 - Transfusion Transmitted Infections 25 Table 9 - Transfusion Transmitted Infections by category of blood banks 26 Table 10 - Total annual collection by BCSU’s and percentage of component separation 31 Table 11 - Availability and adherence to quality parameters in blood banks 35 Table 12 - Blood Banks Having Equipment in working condition 39 Table 13 - Mean assessment score 40 Table 14 - Mean assessment score - (NACO supported Vs. Non-NACO) 42 Table 15 - Number of blood banks scored <=35 44 Table 16 - Number of blood banks scored above 70 45 Table 17 - Mean assessment score by Category of blood banks 45 Table 18 - Mean assessment score by Ownership 46 Table 19 - Mean assessment score (Categories) by Ownership 46 Table 20 -Mean assessment score by annual collection 47 Table 21 - Mean assessment score by Voluntary Blood Donation 48 Table 22 - Mean assessment score by EQAS enrolment 48 Table 23 - Mean assessment score by Accreditation 49 Table 24 - Distribution of Blood banks by districts and mean assessment score categories 49 Table 25 - Distribution of Blood banks by districts and mean assessment score categories 51 vi Figures Fig 1 (a) - Availability of BBs per 1,000,000 (1 million) population 9 Fig 1 (b) - Availability of BBs per 1,000,000 (1 million) population 10 Fig 2 - License status 14 Fig 3 - Annual collection and Voluntary donation 15 Fig 4 - Type of blood donation (Voluntary vs. Replacement donation %) 15 Fig 5 (a) - Annual collection per 100 population - District wise 20 Fig 5 (b) - Annual collection per 100 population - District wise 20 Fig 6 (a) - Annual collection per 100 population vs. BB’s per 1 million- District wise 21 Fig 6 (b) - Annual collection per 100 population vs. BB’s per 1 million- District wise 21 Fig 7 (a) - Percentage of Voluntary Blood Donation by District (Overall) - VBD%>50 22 Fig 7 (b) - Percentage of Voluntary Blood Donation by District (Overall) - VBD%<=50 22 Fig 8 (a) - Percentage of Voluntary Blood Donation by District (NACO supported) 23 Fig 8 (b) - Percentage of Voluntary Blood Donation by District (NACO supported) 23 Fig 9 - Percentage of Voluntary Blood Donation by District (Non-NACO) 24 Fig 10 -Transfusion Transmitted Infections (%) Jan-Dec 2015 25 Fig 11