THIS IS AN ONGOING ACTIVITY.

The major changes to the program since approval in the 2007 COP are:

A prevention component has been integrated that is separately budgeted and described under HMBL

activities through Community Housing Foundation, Hope Worldwide, TBD/Donor Notification and TBD/Club

25 and includes the following elements:

+ Messages for prevention of HIV through sexual abstinence and faithfulness to single partner will be given

during blood donor mobilization. Up to 480,000 people will be reached by these messages.

+ At least 80,000 blood donors will be informed of their test results for HIV, hepatitis B and c and syphilis.

+ Hospital transfusion committees in 20 hospitals will be supported to meet regularly, institute appropriate

blood use, and submit reports to the NBTS.

+ Youth clubs in 60 schools will be supported to foster positive life styles for HIV prevention and regular

blood donation.

1. LIST OF RELATED ACTIVITIES

This activity relates to the prevention of medical transmission of HIV through mobilization of low-risk

volunteer blood donors by the National blood Transfusion Service (NBTS) supported by Kenya Red Cross

society (KRCS), Hope Worldwide Kenya, (HWWK) and Bloodlink Foundation (BLF), under the umbrella

organization CHF. Internews will help promote voluntary blood donation by training radio and TV journalists.

USAID APHIA II Health Communication and Marketing will develop IEC material for blood donor

mobilization and appropriate blood use. Supply Chain Management Systems (SCMS) will procure

equipment and reagents to facilitate centralized blood testing, preparation of blood components and

maintenance of the blood storage cold chain.

2. ACTIVITY DESCRIPTION

This activity relates to reduction of medical transmission of HIV through blood transfusion by the provision of

adequate supplies of safe blood to all health care facilities in Kenya. Fear of HIV/AIDS and weakened

health infrastructure led to a 50% drop in blood donation in Kenya over the last 20 years. A national survey

in 1994 demonstrated a 2% risk of HIV transmission in all transfusions due to inadequate testing and poor

quality control. A study in 2001 found that 83% of blood was obtained from family replacement donors.

Kenya is estimated to require 250,000 units of blood for transfusion. Currently only about 120,000 units are

collected annually. The foregoing observations indicated that Kenya's blood supply was neither sufficient

nor safe. Following the bombing of the US Embassy in Nairobi in 1998, USG supported the Kenya

Government in developing a nationally coordinated blood program through establishment of the National

Blood Transfusion Service (NBTS). USG assistance has contributed to development of Policy Guidelines on

Blood Transfusion, National Strategy on Blood Donor Mobilization, Clinical Guidelines for Appropriate Use

of Blood and Blood Products and National Standards for Blood Transfusion Services. While the government

of Kenya policy on blood transfusion has outlined the structure of the NBTS, there is still a lack of legislative

authority for it to become a semi-autonomous agency of the Ministry of Health. Blood safety receives limited

financial support from government resources. In FY05 the NBTS received a PEPFAR grant to support the

recruitment of volunteer blood donors, procurement of supplies and equipment for blood testing and

processing and to support the training and supervision of staff. This facilitated invigoration of blood donor

recruitment drives with a corollary increase in blood collections of over 100% between 2005 and 2006. The

NBTS has procured equipment and hired additional staff including nurses, donor recruiters and data

personnel, to support blood collection and processing. Contracts with sub partners (HWWK and KRCS ) for

donor mobilization have continued to operate smoothly. It is estimated that less than 0.5% of Kenyans are

blood donors and that 70% of Kenya's blood supply is currently obtained from students. The World Health

Organization (WHO) suggests that a country cannot be self- sufficient in blood unless about 2% of the

population is donates blood regularly. This funding will expand the partnership between the NBTS and the

sub-partners who will recruit for low-risk non-remunerated volunteer blood donors in work places, training

institutions, out-of-school youth and among faith and community based organizations. FY07 funding will be

used to scale up blood donor recruitment to increase blood collections by 40,000 units while reducing the

prevalence of HIV to below 2%. Repeat donations will be increased by 20 %. This funding will be utilized to

increase the number of health care facilities that obtain at least 80% of their blood supply from the NBTS

from 162 in FY07 to 180 in FY08. Training in donor recruitment, data management, Quality Standards and

blood processing will be organized nationally. Regional blood transfusion centres in collaboration with Africa

society for Blood Transfusion- Kenya Chapter (AfSBT- K) will organize training for user hospitals in

appropriate blood use. The national Blood transfusion Strategic plan and annual operational plan will be

developed. Blood bank staff training at the Kenya Medical Training College will be supported. The

curriculum for Higher Diploma in Blood Transfusion Services was recently revised with support from AABB.

The distance-learning diploma course in blood banking will be discontinued. Y08 funding will enable two

NBTS staff to acquire advanced education in Blood Bank Management and Quality Management Systems

at institutions to be identified. As blood collections increased manual and semi-automated testing were

identified as a bottlenecks within the blood bank. This was addressed in Y07 by increased automation and

centralization of testing. Testing reagents will continue to be procured. This funding will also support

contractual staff hired for the NBTS head office to facilitate administrative, financial and IT support as the

final moves towards semi-autonomy are taken. It has been estimated that $15 is required to collect and

screen a single unit of blood. This excludes salaries and overheads. A business plan will be developed to

ensure continuity and growth of the blood safety program in later years. Other donors contributing to a safe

blood supply include the Japanese International Cooperation Agency (JICA), which has trained laboratory

staff, conducted a national assessment of blood safety and improved laboratory infrastructure. There is

excellent donor coordination through a national committee chaired by the NBTS.

3. CONTRIBUTIONS TO OVERALL PROGRAM AREA

This activity aims at collecting 180,000 units of blood from low-risk volunteer blood donors. This would meet

the current blood consumption in the country and contribute to the prevention of 4,200 cases of HIV. At

least 105 health care workers will be trained in blood safety.

4. LINKS TO OTHER ACTIVITIES

AABB (American Association of Blood Banks) (#6840) gives technical support to NBTS through provision of

training in BDR, blood processing and banking preparation of policy guidelines, protocols for quality

assurance schemes, standard operating procedures and blood bank management. Bloodlink Foundation

mobilizes blood donors from corporate organizations to broaden the donor base and increase private-public

partnership in Blood safety.

Activity Narrative:

5. POPULATIONS BEING TARGETED

NBTS: activities target health care workers within the NBTS who mobilize and recruit, blood donors, test

and process blood, counsel donors and manage blood banks as well as health care workers in hospitals

and nursing homes who prescribe blood and blood products, group and cross match blood and monitor

transfusions. These activities will benefit the general population including people living with HIV/AIDS.

6. EMPHASIS AREAS COVERED

This activity includes major emphasis on HIV prevention through the provision of safe blood. There is minor

emphasis on local organization capacity development (NBTS), procurement of specialized equipment,

reagents and lab consumables to ensure safe blood under the PEPFAR program.