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Title: The strengths and weaknesses of blood services in Kumasi, Ghana
Author: Sharma, Veena
ISNI:       0000 0004 7428 5344
Awarding Body: University of Liverpool
Current Institution: University of Liverpool
Date of Award: 2017
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Limited research has been conducted in the area of blood transfusion policy in Africa. Prior to this study, it was unclear how many countries had a national blood policy in place, if they differed from other policies and if so to what extent. The aim of this study was, therefore, to better understand the Ghanaian national blood policy in an African context, identify its strengths and weaknesses and make appropriate policy recommendations. Following a literature review, WHO policy documents and African national policies were obtained via a web search in French and English, and by contacting representatives of national blood services. Policy documents were analysed qualitatively, and a list of commonly accepted policies was generated and compared with the evidence. Guidelines relating to blood donation, blood screening, blood grouping and component usage were common to more than half of the national blood policies reviewed. The common recommendations listed above were compared to current blood transfusion service practices at the Komfo Anokye Teaching Hospital, and areas of policy requiring further research, to improve policy implementation and better meet the local population's needs, were identified. As a result, the following sub-objectives were identified: 1) Determine the most common reasons for donor deferral 2) Determine what information donors are interested in receiving during pre and post-donation counselling to improve donor satisfaction and potentially increase blood supply; 3) Better understand component demand and usage and its influencing factors as well as determine whether current component production rates are appropriate; 4) Understand the patient experience in obtaining a blood transfusion and securing a replacement donor. Results from this study showed that blood donors were most commonly deferred due to a low haemoglobin level or hepatitis B infection. Blood donors seek more information regarding their health and whether their blood is found to have any infections. In addition, they would like to know more about the blood donation process ahead of time, such as what steps are involved, if donating will be painful and how long the entire process will take. Based on interviews with clinicians and data obtained from the blood bank, while component production was found to be increasing at KATH, there were still instances when demand of blood components exceeded supply. In spite of this, patients did not find it difficult to obtain blood for their transfusion, but some expressed interest in learning more about the risks and benefits of transfusion. Clinicians and policy makers should therefore work together to determine whether certain biological criteria currently implemented can safely be adjusted to be more inclusive and maximise the number of blood units donated. Future donor counselling sessions should aim to better communicate with donors the blood donation process and reassure blood donors of their health status. Component production should continue to increase at KATH given its demand, but only providing the blood bank has the resources to maintain production without affecting supply and patient outcomes. Finally, clinicians should increase their efforts to maintain good communication with their patients regarding transfusions, their risks and benefits, and ensure consent is always sought.
Supervisor: Bates, Imelda ; Hassall, Oliver ; Owusu-Ofori, Alex Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral