Poor handling of donated blood puts Kenyans at risk
Kenyans are facing a serious risk of getting transfused with contaminated blood due to poor storage and transportation, a new report shows.
The performance audit report on the management of blood transfusion services compiled by the Office of the Auditor General shows that some counties had stocked expired and unscreened blood while in others blood was transported and stored in cartons in other centres, the staff opted to use public transport mostly tuk-tuks to transport collected blood.
The report tabled in the National Assembly on Tuesday by the leader of Majority Kimani Ichung’wa also revealed that in a number of counties, there are no air conditioners to maintain ideal temperatures for blood storage, as well as no cold rooms to store blood samples.
In Kisii and Machakos counties, for example, the report shows that they had stocked expired blood while in another unnamed county unscreened blood had been stocked yet there are nil stocks of screened blood in Bungoma county.
In Kenya, at least 1,100 patients need blood or blood components each day with 60 per cent of the donated blood being used by expectant women and children due to birth-related complications which include antepartum haemorrhage and post-partum haemorrhage as well as due to caesarean sections which are on the rise as they account for half the births in both private and public hospitals.
“Lack of an efficient inventory system does not only affect the availability of blood and blood products and when required for efficient service delivery, but may also result in wastage due to expiry of blood and blood components due to lack of adequate stocking systems,” reads the report.
In Nyeri county, for instance, the report stated that interviews with staff from the satellite centre revealed that during transportation, the centre packed blood samples in cartoons instead of cool boxes adding that there were also delays in the delivery of blood samples to the testing centre by the courier company thus compromising the safety and usefulness of the blood.
In Mombasa county, the auditors found a faulty cold room, thirteen air conditioners were not working, the freezer was not working, the generator was not working as servicing, the battery and changeover switch needed replacement, the refrigerator double door was not working as it needs a fan and gas while refrigerated centrifuge was not working as the motherboard is yet to be replaced.
In Eldoret, Thika and Embu counties, there was no automatic power backup plan as well as no air conditioners to maintain ideal temperatures.
In Kisii and Bungoma counties, the cold boxes did not have temperature monitors to ensure that blood is transported within the appropriate temperature range while in Nakuru Regional Blood Transfusion Center (RBTC) a standby generator installed in 2002 had been non-functional for a year and in the event of a power outage the centre’s cold storage facilities could only maintain the required temperatures for two hours.
Freezer not operational
“In Embu RBTC, one of the freezers had not been in operation since 2014, a period of about six years. The regional centre relied on a freezer provided by the county government,” reads the report.
The report fingers the Kenya National Blood Transfusion Services (KNBTS) for what she said was a lack of sufficient storage facilities in the blood cold chain management process as most of the equipment was broken down.
The blood chain is a system for storing and transporting blood and blood products within the required temperature range and condition from the point of collection from donors to the point of transfusion to patients.
The report also shows that there were equipment gaps in the blood cold chain as well as inadequacies in routine preventative maintenance of the available equipment.
“Lack of proper maintenance of cold chain equipment resulted in inefficiencies in the cold chain process, especially in maintaining the required temperatures at the requisite levels. Lapses at any point in the blood cold chain result in the collapse of the chain” reads the report.
Insufficient storage space
It adds, “Deviations from the specified temperatures ranges and conditions during storage and transportation of blood and blood products seriously affects the viability of the constituents of blood, thus leading to reduced clinical benefits.”
The auditors regretted that the institution does not have sufficient storage facilities and that even if the institution were to collect ideal amounts of blood units, there would be no sufficient storage space.
They reported that the institution does not have stock management for blood and blood products for hospital blood banks and thus health facilities make orders as and when blood is needed since there are no established limits of re-order levels for efficient blood transfusion services. The failure by hospitals to access blood when needed she said, is a major risk, considering blood is administered for treatment of patients with critical illness especially in life-threatening conditions like antepartum and postpartum haemorrhages which contribute to high mortality rates in maternal deaths or cases of emergencies like accident victims who require an immediate blood transfusion.
