Social & Scientific Systems, Inc. (SSS) provides technical assistance (TA) to the National Blood Transfusion

Service of Côte d'Ivoire (NBTS) to support the rapid expansion of safe blood activities. These include

training in the configuration and use of Progesa, a blood tracking software; inventory management;

appropriate equipment selection; laboratory quality assurance (QA); guidance on infrastructure needs;

procedures for collecting, testing, and the preparation of blood and blood products; monitoring and

evaluation; and sustainable human resource development.

SSS objectives for FY08 are to provide TA to support the following NBTS activities:

1. The organization and management of the NBTS network of collection, testing, storage and distribution

units.

2. The roll-out of a national Quality Assurance plan.

3. The development and deployment of a national hemovigilance system to trace transfusion outcomes and

improve patient safety during transfusions.

4. Provide technical expertise in special study design and conception

5. Support IT integration among new centers and blood banks

6. Continue training and drafting of common policies, guidelines and procedures

Other core activities include the development of a laboratory automation strategy and the computerization of

data collection and management activities. Emphasis areas include capacity development and training,

needs assessment and targeted evaluations, and QA. Target audiences are host country government

workers and health care providers, located in Abidjan and the regional centers managed by the NBTS.

Activities carried out by SSS complement those initiated by the NBTS. TA provided by SSS and its sub-

partners (Belgian Red Cross-Francophone Blood Service and Paris-based Transfusion et Développement)

will assist the NBTS to implement international safety standards and target collection and production

activities that are adapted to the needs of donors and patients. TA is provided through a local SSS

coordinator, regular expert missions, and frequent e-mail and phone communications with senior

management and technical staff.

The NBTS production target for FY08 is to have 145,000 units of blood available for distribution.

As detailed in the Program Area Context, SSS successfully completed activities in the areas of Information

Systems, Quality Assurance and Sustainability in FY07.

These activities included:

• Evaluating and redesigning the configuration of several buildings identified as potential blood centers.

• Advising on the selection of 3 advanced collection sites.

• Advising the NBTS on logistics and cold chain needs.

• Reassessment of the blood center data management software PROGESA and identification of the need

for an upgrade in order to meet the NBTS capacity and international blood safety standards.

• Advising on the planning, development and research of new donor mobilization strategies and

partnerships to recruit new donors and increase the number of repeat donors. This activity led to the

installation of 40 new donor clubs in Abidjan on the heels of the 44 previously installed in Yamoussoukro

and Daloa at the end of 2006. SSS is also actively participating in the development of a KAP survey.

• Designing and implementing a quality control program, including organization and start-up of the quality

control laboratory activities, to help monitor the production of the NBTS. It is one of the key elements of the

hemovigilance system being developed.

• Developing a hemovigilance protocol focusing on the traceability of the blood products

• Advising on the development of Blood Transfusion Policies and Guidelines, which led to the validation of

the first National Guide on Blood Transfusion during the 1st Expert conference on the use of blood held in

Yamoussoukro in August 2006

• Advising and helping on the draft of an NBTS Reference manual.

• Training on the medical software PROGESA; stock management and logistics, monitoring and evaluation,

collection and preparation (for technicians); blood donors selection (for physicians), use of blood products

for prescribers, laboratory practices (lab technicians), and quality assurance.

• Strengthening and developing staff skills in the utilization of the blood center data management software

through training in data management for monitoring and evaluation. The medical software PROGESA

facilitated the accurate periodic evaluations of NBTS activities and helped produce a range of reports to

inform training as well as operational and quality assurance decisions. Quarterly, semi-annual and annual

activity reports were prepared and transmitted to the CDC.

Most program activities planned for FY08 will be a continuation of those undertaken in FY07.

Those activities are:

Activity 1: SSS will review renovation plans and provide technical assistance, where appropriate, to

complete the rehabilitation of the blood transfusion centers in Aboisso, San Pedro, Yamoussoukro, Abidjan,

Bouaké, Korhogo, Man, Abengourou, Bondoukou, and Odiénné. SSS will provide similar assistance to

NBTS as it plans, designs, and establishes 5 new blood collection sites, and renovates the patient reception

area at the NBTS headquarters. SSS support will advise NBTS on the type and quantity of equipment,

materials and supplies needed at all of these locations.

Activity 2: In association with JHUCCP, SSS will help NBTS develop marketing materials for donor

recruitment and public sensitization activities, particularly in low-risk communities. SSS will help NBTS to

maximize the findings expected from the Knowledge, Attitudes and Practices (KAP) survey NBTS is

undertaking in FY07. These findings will inform new strategies to recruit and retain low-risk blood donors

who are willing to give blood more than once a year. SSS TA will also help NBTS to collect and manage

indicator data required by PEPFAR, WHO and the Ministry of Health. SSS will actively participate in the

elaboration of new protocol agreements between NBTS and new partners. In addition, SSS will support the

public health evaluations detailed in the NBTS narrative.

Activity 3: SSS will continue its support for the diversification (operations, supplies, production) of blood

Activity Narrative: products based on the needs identified by the NBTS, the organization of an inter-laboratory quality control

system, and in-house quality control for all biological activities. SSS will also monitor the implementation of

hospital blood bank agreements with NBTS, and support the implementation of a tracking system of

transfused blood products (hemovigilance). Finally, SSS will assist with the development of:

1. Procedures for storage and labeling of specimens in the serum archive.

2. Management procedures for hospital blood banks, including standard operating procedures

3. Uniform hygiene and safety protocols for the NBTS

4. Strategies to encourage donors to return for test results and protocols to ensure that more donors are

linked to appropriate testing, care and treatment services.

Activity 4: SSS will support the drafting and dissemination of policies and guidelines on blood transfusion by

providing expertise for the training curriculum of 500 physicians, in collaboration with JHPIEGO. Technical

assistance will be provided for the elaboration of blood transfusion guides in anticipation of a third experts'

conference in FY08 to continue consensus-building on the use of blood in Côte d'Ivoire. SSS will continue

the development and roll-out of a blood products tracking system for the NBTS network of blood banks.

SSS will provide technical review and input to support the NBTS and MoH with new framework legislation to

strengthen NBTS autonomy and create a sustainable environment for safe blood activities.

Activity 5: SSS will provide training on the Progesa blood tracking software, stock management and

logistics, and M&E, and QA. Training will also be offered to collection, laboratory and preparation

technicians; physicians who conduct pre-donation interviews with donors; and prescribers and users of

blood products. In FY08, SSS training methodology will focus on complementing the ‘'class-room'' training

sessions, with "hands-on" skills training. Similar practical training will target Blood Bank Managers. SSS and

the TA sub-contractors (T&D and Belgian Red Cross) with work with NBTS to identify instructors to lead the

practical sessions and collaborate with classroom instructors. Specialized training in serology and

immunohematology will be organized for a limited number of NBTS technicians in Belgium. Approximately

150 NBTS staff will be trained in FY08.

Activity 6: Monitoring and evaluation (M&E). SSS TA will focus largely on training in the use and

maintenance of the Progesa blood tracking software system. Training will focus on data collection and

management, as well as analytical evaluations. At NBTS's request, SSS will assist with the periodic

evaluation of NBTS activities and assist with reporting requirements. Data from these evaluations will guide

NBTS programs, such as the recruitment of donors with rare blood types activities. These reports will also

support QA activities. QA activities for FY08 will focus on the roll-out of the quality system for the NBTS.

Activity 7: SSS will support the NBTS as it implements the recommendations from the sustainability working

group and expands the process to transfer skills from PEPFAR-funded blood safety experts on the Equipe

Projet to NBTS staff. SSS's work in these areas will include, where appropriate, mentoring for administrative

and technical staff, and targeted evaluations of systems and policies.

All TA provided by will be based on international norms, but tailored to meet local requirements.