Detailed Mechanism Funding and Narrative

Years of mechanism: 2012 2013 2014 2015

Details for Mechanism ID: 13971
Country/Region: Central Asia Region
Year: 2013
Main Partner: Ministry of Health - Kazakhstan
Main Partner Program: NA
Organizational Type: Host Country Government Agency
Funding Agency: HHS/CDC
Total Funding: $30,000

This mechanism supports CARs PEPFAR Strategy Objectives 2 and 3. The primary goals are to increase the capacity of the Republican Blood Center in Kazakhstan (recently re-organized as the Almaty Oblast Blood Center) to improve their blood safety program, ensure an adequate blood supply, perform accurate and appropriate blood screening for the KZ population, and to sustain these program improvements over time. Challenges in blood safety in KZ include lack of voluntary donors, inappropriate clinical use of blood, lack of capacity and high staff turnover, and insufficient quality management systems (QMS). Under this award, TA will be provided to the KZ RBC to improve these deficiencies and to build a QMS covering all stages of the transfusion process. A key element for the QMS will be supported by integrating the International Standards for Blood Transfusions (ISBT) 128 and the blood centers Excel-based M&E data into the existing health information management software. These improvements will allow the KZ blood centers to improve their efficiency over time. The project will implement a national M&E system for blood service indicators, which will include number of donors served, number of donors tested, number of donors positive for Transfusion Transmissible Infections, and number of trained people over time. Indicators will be monitored by review with a standardized checklist during regularly scheduled site visits. Sustainability of the program and country ownership will be fostered through training and capacity building of RBC staff, and enhanced quality and utility of the electronic databases for both QMS and M&E, which will allow the RBC to monitor and improve the quality and efficiency of their activities.

Funding for Biomedical Prevention: Blood Safety (HMBL): $30,000

This ongoing Cooperative Agreement supports CARs PEPFAR Strategy Objectives 2 and 3.

In 2007, CDC re-screened 7500 samples from blood donors in CAR, confirming that contaminated blood is being administered in health facilities. Transfusion of HIV-infected blood is 100 times more efficient for transmitting HIV infection than intravenous injection with a contaminated syringe. An adequate supply of safe blood and the appropriate clinical use of blood are important components of the PEPFAR CAR prevention strategy, as well as a priority for the Government of Kazakhstan.

The goals for this activity are to: (1) improve the KZ national strategy for voluntary blood donorship using international expertise and results from a KAP survey; (2) help establish a quality management system (QMS) for blood banking, with screening for Transfusion Transmitted Infection (TTI), blood compatibility and typing; (3) reduce non-evidence-based clinical use of blood products; (4) establish national norms, standards and organizational structures for a national blood service; (5) improve information systems and standardize databases for tracking blood donors and donated blood units; and (6) strengthen professional development of blood services staff.

The RBC has developed its own Access-based data management software to track blood donors and blood units, and an Excel-based M&E system for tracking blood service indicators, both of which have limited utility. Technical assistance will be provided to integrate the two databases and improve the softwares analytical capacity; assist with the integration of the ISBT 128 standard into existing software; scale up a sustainable electronic database to track blood donations from vein to vein; conduct on-site training workshops on the database; implement and scale up a bar code system and to the Oblast level. These activities address the 1st (Policy), 5th (Training), 6th (Monitoring and Evaluation) and 7th (Sustainability) key elements identified by the Medical Transmission TWG.

The KAP surveys will inform a national strategy on voluntary donorship, including IEC campaigns for recruitment of donors. Trainings and recruitment materials will be developed for donor recruiters on republican, oblast and rayon levels, who will also collect basic donor information. These activities are related to the 1st, 2nd and 5th and 7th elements of the TWG.

Technical Assistance will be provided to assist with the establishment of facility-based transfusion committees (ongoing activity using prior year funds) as well as a national transfusion committee (new activity using FY12 funds). Technical Assistance activities to assist the committees include guideline development, protocols, SOPs and data collection tools. To improve data quality, on-site trainings will be conducted. These activities are related to the 1st, 3rd-7th elements identified by the TWG.

These activities will be conducted in the context of a QMS, currently being developed by the MOH, spanning the entire chain of blood services. They will be integrated with other HIV/AIDS related services, as potential donors who test positive for TTIs will be referred to the KZ AIDS Center for further counseling, testing and treatment. Sustainability of the program and country ownership will be fostered through capacity building (training the Government of Kazakhstan to improve their blood safety program) and technology transfer (the electronic database).

Cross Cutting Budget Categories and Known Amounts Total: $15,000
Human Resources for Health $15,000