A total of 12,044 blood units collected from donors by the Kenya National Blood Transfusion Service (KNBTS) are being discarded for containing Transfusion Transmittable Infections (TTIs), an audit report has revealed.
The report tabled in Parliament indicates that 62 per cent of the blood has TTIs. Another 5,685 units, representing 29 per cent, were discarded after being found to have been collected from people who are either underweight or overweight.
According to Auditor General Nancy Gathungu, a further 382 blood units, representing two per cent, were discarded after expiry.
The audit team examined the operations of KNBTS in five out of its six regional centres and in 10 out of 18 satellite centres with regard to donor recruitment and notification, and blood collection, processing, banking and distribution.
The period covered is five financial years from 2016/17 to 2020/21. The audit reveals that blood expires because of fewer staff at KNBTS centres who handle a pool of donors, a move which results in inadequate elaborate pre-donation talks as well as inadequate blood monitoring during sessions.
“This contributes significantly to the collection of blood from unsuitable donors, including those who are TTI-positive. Further, some blood units develop blood clots due to inadequate monitoring of blood flow rate during blood collection which increased the number of discards,” reads the report.
Ms Gathungu pointed out that KNBTS did not have its own infrastructure and was mainly hosted by hospitals with limited space for donor services. The arrangement, according to the report, affects the delivery of blood transfusion services as the facilities are not ideal.
Some donated blood expired because of logistical challenges experienced by KNBTS. The report notes that the situation is so dire in collection centres that KNBTS sometimes opt to use public vehicles to transport blood. “As a result of logistical support, there were instances where centres opted to use public transport, mostly ‘tuk tuk’ for blood collection sessions, which are not ideal as blood is a sensitive commodity.”
The report added that most blood expires because of delays in repairing processing equipment and lack of reagents. Routine blood testing and grouping should take 24 hours, while emergency testing and grouping should take six hours.
The report however notes that in Embu and Naivasha centres, it takes four to 17 days for the centres to receive results from Nairobi for TTI screening.
“Delays in blood processing not only affect the timely availability of blood but also blood may expire while awaiting test results,” reads the report.
The report noted that there were a number of inadequacies which could compromise the quality and safety of blood transfused to patients such as lack of a centralized system for blood collection and processing, inadequate regular donors, lapses in the cold blood chain among others
“KNBTS has inefficiencies in blood collection, testing, processing and transfusion which may affect the quality and safety of blood. Further, KNBTS is not leveraging modern technology to maximize utilization of the available blood units,” reads the report.
In Kenya, at least 1,100 patients need blood or blood components each day. Sixty per cent of the donated blood is used by expectant women and children due to the birth-related complications.
KNBTS is vested with the reasonability of ensuring the supply of adequate and safe blood products to transfusing hospitals for the transfusion needs of all patients in hospitals.
During the period under review, the report revealed that KNBTS did not supply 46 per cent of the blood requested in 27 hospitals sampled.
“This not only poses a risk currently but also on the future of availability of blood for patients, considering that blood requests during the period increased by about 6,000 units each year,” reads the report.
The report notes that KNBTS has not only failed to set its blood collection targets as per the WHO requirements but also failed to meet its blood collection targets.
“Out of the total average collection targets of 201, 667 units during the period under review, KNBTS failed to collect about 40, 922 units of blood or an average of 20 per cent of the set targets annually.
Ms Gathungu says the performance audit was motivated by many issues including a Sh500 million that was budgeted to procure equipment meant to improve blood services at KNBTS between financial years 2015/2016 and 2019/2020 hence it was important to assess the impact made on blood service delivery in the country.
Performance audits are conducted to examine compliance with policies, obligations, laws, regulations, standards and to determine whether resources are managed in a sustainable manner.
They also examine the economy, efficiency and effectiveness with which public resources have been expended BY DAILY NATION