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| Financial challenges faced in blood banks |
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Fatma Hussain Sajwani
Sharjah Blood Transfusion and Research Center, Emirates Health Services Establishment, P.O Box 1853 Dubai, United Arab Emirates
Click here for correspondence address and email
| Date of Submission | 15-Jul-2021 |
| Date of Decision | 08-Aug-2021 |
| Date of Acceptance | 29-Aug-2021 |
| Date of Web Publication | 04-Jun-2022 |
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Sir,
Blood transfusion is a life-saving intervention. Appropriate and timely transfusion of blood and its components is mandatory to insure maximum benefit to patients.[1]
Studies that attempted accurate estimation of blood transfusion expenses are limited in general, especially in this area of the world.[2] In most countries of the Eastern/Mediterranean region, blood banks financing comes as a fraction from the governmental budget allocated for the entire health system. Competing of different departments and health-care sectors to get a share in this budget is usually directed toward areas that give a higher profit in return to the service while blood banks that serve the community and save lives with the least profit in return, are managed by saving and budget constrain. Blood banks face many challenges that can be solved by proper financial support.
With the fast-growing countries in the region, maintaining an adequate blood supply to match the increased demand is a major challenge. Add to this, the diversity of the population, which sometimes mandates extra testing for screening the blood to insure its safety.
Increasing number of trauma centers and the adoption of massive transfusion protocols increased the burden on the blood banks to meet the requirement of blood supply to treat bleeding patients.
Emerging clinical guidelines recommending transfusion of specific components rather than whole blood has moved the trend in blood banks to process the majority of the whole blood collected from donors into components adding to the cost of the service. Apheresis collection techniques are preferred in certain disease conditions, a technique that does not come without a cost.
The well-known fact of transfusion-dependent hemoglobinopathies being common in the area, adds a special need of freshly collected packed red blood cells (PRBC) and RBC antigen-matched donor's blood is preferred to prevent RBC antibody development in such chronically transfused patients who might suffer from lack of matched RBC in future transfusions due to the development of irregular antibodies to unmatched antigens.
With the international recommendation of the WHO aiming for 100% voluntary blood donation, donor recruitment can be a major issue causing limited blood units, hence, limited supply to hospitals.[1] Marketing for such services requires proper infrastructure and resources. Recruitment of donors, especially of rare blood groups, needs a special sustainable plan that adds on to the financial requirement of any blood donation center.
The emergence of new transfusion-transmitted infections necessitates adding more tests to screen the blood and many agencies recommend nucleic acid testing to detect infections in early phases.[3] Higher public awareness puts a pressure on blood banks to increase safety measures and quality products by participating in quality assurance schemes and adding pathogen inactivation/reduction techniques, which markedly increases the health-care budget expenditure.
Blood banks need to be fully prepared financially in case of any emergency either local or global. This was faced with the severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic where most of the budget by the government was directed to provide treatment and vaccines.
All these challenges and many more can affect the blood supply and its safety mainly in low and medium income countries.[4]
The Department of Health and Human Services Advisory Committee on blood and tissue safety and availability-US recommends direct governmental support to the blood banks to insure adequate financial supply to maintain proper infrastructure and sustainable blood supply.[5]
In conclusion, blood banks should be financially supported and have a direct and separately assigned budget suitable to maintain safe and adequate supply of blood and its components to meet the growing need in the hospitals as well as in case of any emergency or disaster. Providing financial security to the blood banks being national or not can be achieved by involving vendors, investors, and stockholders to support the financial independence of blood banks from other health facilities. This can help blood banks to overcome some of the challenges faced.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
 References | |  |
| 1. | Jenny HE, Saluja S, Sood R, Raykar N, Kataria R, Tongaonkar R, et al. Access to safe blood in low-income and middle-income countries: Lessons from India. BMJ Glob Health 2017;2:e000167.  |
| 2. | Stokes EA, Wordsworth S, Staves J, Mundy N, Skelly J, Radford K, et al. Accurate costs of blood transfusion: A microcosting of administering blood products in the United Kingdom National Health Service. Transfusion 2018;58:846-53. |
| 3. | Roth WK. History and future of nucleic acid amplification technology blood donor testing. Transfus Med Hemother 2019;46:67-75. |
| 4. | Roberts DJ, Field S, Delaney M, Bates I. Problems and Approaches for Blood Transfusion in the Developing Countries. Hematol Oncol Clin North Am 2016;30:477-95. |
| 5. | Menitove JE. The U.S. blood system: Under pressure. In: The Hematologist. USA: American Society of Hematology; 2018. |
Correspondence Address:
Fatma Hussain Sajwani,
Sharjah Blood Transfusion and Research Center, Emirates Health Services Establishment, P.O Box 1853 Dubai
United Arab Emirates
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/ajts.ajts_100_21
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