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National Baseline Survey for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan SBTP-WHO
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WORKSHOP REPORT
NATIONAL BASELINE SURVEY FOR ASSESSMENT, MONITORING AND EVALUATION OF BLOOD
SCREENING SYSTEMS IN PAKISTAN
Islamabad, July 02, 2013
SAFE BLOOD TRANSFUSION PROGRAMME WORLD HEALTH ORGANIZATION
National Baseline Survey for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan SBTP-WHO
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Table of Contents 1. Introduction ...................................................................................................................... 3
2. Workshop Proceedings .................................................................................................... 4
3. Working Group Results .................................................................................................... 9
ANNEXES ............................................................................................................................. 10
A: List of Participants ...................................................................................................... 10
B: Workshop Programme ............................................................................................... 11
C: Group Photograph ...................................................................................................... 12
D: Newspaper Clipping .................................................................................................... 13
National Baseline Survey for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan SBTP-WHO
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1. Introduction The ‘National Baseline Survey for Assessment, Evaluation and Monitoring of Blood
Screening System in Pakistan’ was conducted by the Safe Blood Transfusion Programme
from September 2012 to April 2013. The survey was supported through WHO/OFID Joint
Project (OPEC Fund for International Development) on Prevention of Transfusion
Transmitted HIV/AIDS and Hepatitis Infections. For data collection, the Provincial Blood
Transfusion Programmes and the private sector Blood Centres extended full cooperation to the
Programme and their support is very much appreciated. A total of 170 blood banks were
covered in the survey. The findings and recommendations of the survey have provided the
stakeholders an excellent evidence to base their future course of action on. The survey also
helps the SBT Programme, policy makers and other key stakeholders to take necessary
corrective actions which will prove beneficial to reduce the burden of the risk of transmission
of infections through transfusions in Pakistan.
The subject workshop was conducted to share the results of the survey and to plan a way
forward in the light of the recommendations. The participants included key stakeholders for
the transfusion sector; policy makers, transfusion experts, haematologists and researches.
The Programme is very grateful to the WHO and OFID for supporting the survey and looks
forward to deriving maximum benefit from the evidence generated through this excercise.
Prof. Hasan Abbas Zaheer, PhD Incharge, Blood Transfusion Services Project Director Pakistan Institute of Medical Sciences Safe Blood Transfusion Programme Islamabad, Pakistan Government of Pakistan Ph: 0092 51 926 12 72 Ph: 0092 51 926 32 36 Email: [email protected] URL: http://www.sbtp.gov.pk
National Baseline Survey for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan SBTP-WHO
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2. Workshop Proceedings
The Safe Blood Transfusion Programme in collaboration with the World Health Organization
conducted a 1-day workshop on ‘National Baseline Survey for Assessment, Monitoring and
Evaluation of Blood Screening Systems in Pakistan’ on July 2, 2013, in Islamabad. The
objective of the workshop was to share the result and findings of the national baseline
survey on assessment, monitoring and evaluation of blood screening systems in Pakistan.
The survey and the workshop were supported by the WHO/OFID Joint Project.
The programme started with opening remarks by the Programme Officer WHO, Dr. Quaid
Saeed who introduced the WHO/OFID Joint Project for the prevention of TTIs. He also shed
light on the National Baseline Survey on Assessment, Evaluation and Monitoring of Blood
Screening Systems in Pakistan which was conducted between September 2012, and April
2013, as part of a WHO/OFID Joint Programme in collaboration with the Safe Blood
Transfusion Programme (SBTP). The survey tools were based on WHO evaluation
framework for assessment, monitoring and evaluation of blood screening systems adapted
for application in Pakistan in 2011. He said the purpose of the survey was to encompass all
aspects of the blood screening process. The findings of the survey provide a comprehensive
situation analysis of the state of the blood screening process in the country.
PUNJAB BTA PRESENTATION
Dr. Jafar Saleem, Secretary
Blood Transfusion Authority
Punjab, made a special
presentation on the progress of
the regulatory authority in
Punjab with special reference to
prevention of TTIs. PBTA is a
regulatory body responsible for
Prof. HA Zaheer Dr. Quaid Saeed Dr. Jafar Saleem Dr. Farrukh Hasan Mr. Usman Waheed
National Baseline Survey for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan SBTP-WHO
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regulating both the public and private sector blood banks. It is involved in registration of
blood banks, issuance of licenses and provision of quality blood. Dr. Saleem gave a brief
history of the Punjab BTA which was notified in 1999, under the Punjab Safe Blood
Transfusion Act on the directives of
the Chief Minister. However, it
remained limited in its operations due
to inadequate financial,
administrative and logistic support. In
2012, the CM announce to re-notify
the BTA with an aim to check illegal
blood banks and business of
substandard and unscreened blood
and monitoring of blood banks to ensure that these banks are managed and run by qualified
professionals preferably having post graduate qualifications in blood transfusion. One of the
members’ provincial assembly Dr. Saeed Elahi, was elected as the Chairman BTA and the
first meeting was held on February 28, 2013 which took important decisions regarding the
registration of blood banks, issuance of licenses and provision of quality blood. The BTA is
doing efforts for resource mobilization and staff hiring to become fully active.
PRESENTATION ON SURVEY REPORT
Prof. Hasan Abbas Zaheer, Project Director SBTP, gave a detailed overview of the survey
findings. The survey documented quantitative (sample size 170 blood centres, both in public
and private sector in all the four provinces and AJK, GB, and FATA) and qualitative aspects
to the extent possible. The survey findings were analyzed under following headings:
Regulatory Framework: The findings of the survey indicate that the blood transfusion
regulatory framework is inconsistent in different provinces. Sindh is the only province that
has a functional blood transfusion authority.
National Baseline Survey for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan SBTP-WHO
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Physical Infrastructure: Almost all the blood centers surveyed had power and water supply
connections. Seventy five percent of the blood centers faced power cuts in the range of 5-12
hours daily. Backup generation facilities were available in 70 percent of the blood centers.
Management, Technical, & Financial Capacity: In the absence of MIS, both in the public
and private sector, data management is not accorded priority in almost half of the blood
centres surveyed. The survey findings indicate limited scale and scope of technical support
to blood centres.
Quality Assurance
System: Only 58 % of the
total blood centres
surveyed have a quality
assurance policy as
compared to 71 (42 %)
that had none. The
situation is worse in public
sector blood centres
where the majority (55%) of the blood centres lack an internal quality audit system.
Screening Processes: Operations and processes of blood centres including screening
strategies are; irregular, unsafe and unregulated in the majority of the blood centres. Almost
43 percent of the blood centres had no internal quality audit system and none of the blood
centres surveyed had any external quality control system.
Procurements: In the public sector blood centres, 95% of the equipment was purchased
centrally by the health departments in comparison to the private sector where 80% of the
equipment was procured locally. The procurement process involves little input of the
technical staff. Almost 92% of the blood centres surveyed (n=157) had a programme or
system for equipment maintenance.
Management Environment:
The survey findings indicate
the existence of a
fragmented blood transfusion
system in which blood
centres function in isolation
and with limited regulatory
control.
National Baseline Survey for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan SBTP-WHO
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The major findings of the study lead to the
several recommendations to improve the
overall blood transfusion services in the
country. Prof. Zaheer’s presentation was
followed by a detailed question and answer
session. The participants took keen interest in
the survey findings and gave useful
recommendations.
SAATM PRESENTATION
Taking advantage of the presence of Dr. Farrukh Hasan, Executive Council Member, South
Asian Association of Transfusion Medicine (SAATM), the recent collaborations with the
Association were discussed. Dr. Farrukh Hasan provided an update on SAATM and its roles
and objectives. SAATM is a regional organization promoting Transfusion Medicine in the
South Asian countries and working towards finding solutions for their common problems and
issues. The primary objective of the Association is to accelerate the scientific progress and
common standards in Blood Transfusion Services (BTS) in member states.
GROUP WORK
Mr. Usman Waheed, Technical Expert
SBTP gave a brief introduction to the
working groups which were task
oriented. He discussed the proposed
topics and possible deliverables from
each working group. All participants
were distributed in three groups and
each group was assigned a facilitator
and specific topic to discuss. Group 1, 2
and 3 were facilitated by Dr. Jafar
Saleem (BTA Secretary Punjab), Dr. Muhammad Tahir Khan (Project Director KPK SBT
Project) and Dr. Sarfraz H. Jaffri (Administrator Husaini Blood Bank, Karachi) respectively.
The topics discussed during the working group sessions were; Group 1: Improvements in
data management system in Blood Transfusion Services; Group 2: dissemination and
implementation plan of survey report and the possible road map for formulation of National
Blood Policy; and Group 3: Future Recommendations for the WHO/OFID project. The
presentations made by the working group were very well received and followed by a detailed
question and answer session.
National Baseline Survey for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan SBTP-WHO
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CONCLUDING REMARKS
Concluding remarks were given by Dr. Quaid Saeed who lauded the efforts of the SBT
Programme in conducting this survey and facilitating the workshop.
CERTIFICATE DISTRIBUTION Following the successful technical session and group work, certificates were distributed among the participants by Prof. Zaheer and Dr. Quaid.
National Baseline Survey for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan SBTP-WHO
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3. Working Group Results
Dr. Jaffer Saleem from Group I presented recommendations on “Data Management System Improvement’ which are summarized as below: Data management tools such as registers, donors and recipients forms should have
uniform information in all the hospitals. There should be training programs conducted for staff. Donors and recipients data should be collected and managed carefully and
effectively. Feedback system must be implemented from donors and recipients. Data manager must regulate data compilation, analysis, validation and report
generation. The topic of Group II was ‘Dissemination and Implementation plan of survey Report and screening strategies for Transfusion Transmissible Infections, National Blood Policy Mechanism’. Dr. Tahir Khan presented the following recommendations on behalf of Group II; According to them National Blood Policy already exists but expired in 2012 so all the
stakeholders should do amendments in the policy according to their requirements and regulatory coordination division should help to approve this policy.
Input or feedback must be obtained from end users from public and private sector blood centers.
There should be awareness programs among the technicians and public. Pressure from masses is also essential for the implementation of the policy.
Dr. Sarfaraz Jafri from Group III gave some recommendations on “Future strategy recommendations for the project” which are given below:
Regulatory body should be responsible to ensure functioning of an internal as well as external quality assurance systems.
There should be a communication through SMS for proper reporting systems. Pathologists and Hematologists should supervise the blood bank. If not then medical
officer should do this job. Procurements should be monitored by regulatory authority and standard operating
procedures (SOPs) must be provided to blood centers. It is very important to dispose of waste properly and for this purpose there should bea
waste management team in every blood bank.
National Baseline Survey for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan SBTP-WHO
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ANNEXES
A: List of Participants
S. No. Name Designation Hospital/Institute
1. Prof. Hasan A. Zaheer Project Director SBTP
2. Dr. Quaid Saeed Programme Officer WHO Pakistan
3. Dr. Saeed Ahmed Head/Consultant Husaini Blood Bank, Karachi
4. Prof. Tahir Shamsi Consultant Haematologist NIBD, Karachi
5. Prof. Syed Irfan Consultant Haematologist LNH, Karachi
6. Dr. Nisar Ahmed Associate Professor Children Hospital, Lahore
7. Dr. Ashraf Memon Senior Pathologist Sindh AIDS Control Programme
8. Dr. Shah Muhammad Deputy Program Manager Sindh Blood Transfusion Authority
9. Dr. Tahir Khan Project Director KPK SBT Project
10. Dr. Naveed Ahmed Programme Manager SBTP AJK
11. Dr. Farhat Abbas Infection Control Committee Benazir Bhutto Hospital, Rawalpindi
12. Dr. Naila William Infection Control Committee Benazir Bhutto Hospital, Rawalpindi
13. Dr. Sarfaraz H. Jaffri Administrator Husaini Blood Bank, Karachi
14. Mr. Zahid Mahmood Team Leader EPOS Health Management
15. Dr. Farrukh Hasan Vice President SAATM
16. Mr. Wasiq Paracha Vice President PWA, Karachi
17. Mr. Usman Waheed Technical Expert SBTP
18. Dr. Shahtaj Khan Assistant Professor HMC, Peshawar
19. Dr. Jafar Saleem Secretary Punjab Blood Transfusion Authority
20. Dr. Suryya Hashmi Public Health Specialist Institute of Public Health
21. Mr. Bilal Tareen Medical Technologist PIMS, Islamabad
22. Dr. M. Aamir Mirza Associate Professor Dow University of Health Sciences
23. Mr. Sajd Shah Admin Officer SBTP
24. Mr. Muhammad Fareed Managing Editor Medical Review
25. Ms. Tayyaba Komal Internee, BTS, PIMS Student, NUST Univ.
26. Ms. Isra Mahmood Internee, BTS, PIMS Student, NUST Univ.
27. Ms. Hafsa Inam Internee, BTS, PIMS Student, NUST Univ.
28. Ms. Kaenat Nasir Internee, BTS, PIMS Student, NUST Univ.
29. Ms. Ayesha Sajid Internee, BTS, PIMS Student, NUST Univ.
30. Ms. Fatima Darakhshan Internee, BTS, PIMS Student, NUST Univ.
31. Mr. Uzair Hashmi Internee, BTS, PIMS Student, NUST Univ.
32. Ms. Aqsa Abbasi Internee, BTS, PIMS Student, NUST Univ.
33. Ms. Sana Javed Internee, BTS, PIMS Student, NUST Univ.
National Baseline Survey for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan SBTP-WHO
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B: Workshop Programme
WORKSHOP ON
NATIONAL BASELINE SURVEY FOR ASSESSMENT, MONITORING AND EVALUATION OF BLOOD
SCREENING SYSTEMS IN PAKISTAN
Tuesday, July 02, 2013 Hotel Hill View, Islamabad
Time Subjects Format Actor
08:30 Registration Individual All participants
09:00 OPENING
09:05 Recitation from the Holy Quran
09:10-09:20 Introductory Remarks Speech Dr. Quaid Saeed
09:20-09:50 Punjab Blood Transfusion Authority Speech Dr. Jafar Salem
09:40-10:50 Survey Report Summary Presentation Prof. Hasan A. Zaheer
(30 min) Group Photograph and Tea Break
11:20-11:50 An Update on SAATM Presentation Dr. Farrukh Hasan
11.50-12.10 Questions / Answers Discussion Forum
12:10–12:20 Introduction to Working Groups Speech Mr. Usman Waheed
12:20-13:20
WORKING GROUP ACTIVITY 1. Data Management in BTS 2. Dissemination and Implementation and NBP 3. Plans for WHO/OFID Project
Group Work Group Work Group Work
Dr. Jafar Saleem
Dr. M. Tahir Khan
Dr. Sarfraz H. Jaffri
(40 minutes) Lunch/Prayer Break
14:00-15:00 Results from Working Groups Presentations/ Discussion
Forum
15.00-15.10 Questions / Answers Discussion Forum
15:10-15:20 Closing Remarks
Dr. Quaid Saeed
15:20-15:30 Certificates Distribution Prof. Hasan A. Zaheer / Dr. Quaid Saeed
National Baseline Survey for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan SBTP-WHO
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C: Group Photograph
National Baseline Survey for Assessment, Monitoring and Evaluation of Blood Screening Systems in Pakistan SBTP-WHO
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D: Newspaper Clipping