Blood Safety seeks to reduce the medical transmission of HIV through technical support from the American Association of Blood Banks (AABB) provides technical assistance to the National Center for Blood Transfusion (CNTS) to ensure for the provision of adequate supplies of safe blood to all health care facilities in Rwanda. Through twinning, AABB institutional partners will provide expert guidance and technical assistance to the CNTS, resulting in better practices in donor recruitment, blood collection, laboratory quality assurance, blood bank management and transfusion practice. This support will include training, monitoring, guidance, oversight and mentoring through site visits and performance evaluation. This linkage will strengthen the CNTS and improve institutional capacity for effective program management. Furthermore, it will result in enhanced sustainability and safety of the blood supply through human resource capacity building for current and future CNTS staff members. This will be accomplished through the development of a comprehensive, job-specific training plan designed to build confidence and didactic knowledge of blood safety activities. The AABB gap analysis performed in 2009 provided information which, together with follow-up discussions, will be used to form an action plan for further activities for 2010 and beyond.

The activities planned for this period are based on the priorities as identified in the gap analysis. The first activity will center on donor qualification and screening. Currently, the CNTS does not utilize a standardized donor history questionnaire to screen the donor population. The activity planned to address this deficiency will incorporate a design, training and implementation phases in which where expert consultants will assist the CNTS in designing an adequate donor questionnaire to screen out potential high-risk donors. In addition, this workshop will focus on the appropriate transfer of knowledge and skills necessary to equip the CNTS staff in utilizing this tool. The final phase of this activity will involve AABB oversight of the implementation of this tool out in the field. AABB expert consultants will be on hand to assist as the tool is incorporated into daily practice. This overall strengthening of donor screening will also include training and implementation on donor hemoglobin screening using copper sulfate

methodology and donor temperatures. The appropriate procedures and forms will be developed in collaboration with CNTS staff and implemented simultaneously with the donor history questionnaire. Workshop participants will include donor services personnel (phlebotomists, recruiters, counselors, data clerks) as well as the quality assurance officer.

Another priority activity that which will be carried out during this time-frame involves the elaboration of a strategy to perform donor notification of positive HIV test results. Currently, no partnership exists between the CNTS and the HIV counseling and testing (VCT) clinics for the handling of those donors who test positive for HIV. This workshop activity will assist the CNTS in defining the policy and approach to notifying donors. A feasibility study will be carried out to assist the CNTS in defining the appropriate human resources necessary to undertake this responsibility as well as additional equipment needed (e.g., vehicles for donor notification purposes). Due to Because of infrastructure limitations with the national postal service, donor notification is best carried out in person by qualified and trained CNTS staff members. Because this is a new function, the requisite training in counseling will need to be provided to CNTS staff members charged with this duty. In addition, new educational material will need to be developed to provide both staff member and donor with the knowledge to refer/seek treatment options at locally available VCT clinics.

An absolute prerequisite to donor notification is the identification of a suitable partner for the CNTS to perform confirmatory testing prior to notification. The appropriate partnership will need to be developed in terms of test methodology, sample requirements, testing schedules, and policy development. Due to the fact that this partnership involves other Ministry of Health departments, close communication will need to be maintained at the highest levels to ensure this priority is addressed. This e above workshop activity will incorporate an create an opportunity to elaborate on the necessary policy and forms required for confirmatory testing.

Another priority area to be addressed during this time period is the appropriate management of equipment. An area that was discovered in dire need of corrective action pertains to the proper validation of equipment used in the collection, testing, processing and storage of blood components is an issue in dire need of corrective action, as is the. An additional area of need was identified in the ongoing preventive maintenance of such equipment. An extensive workshop will be planned to target both the quality assurance officer, biomedical engineer, managers of laboratories and chief technologists in the importance of proper installation, operational and performance qualification,; as well as ongoing preventive maintenance. This workshop will provide basic knowledge and understanding on designing and documenting equipment validation studies. An additional focus of this workshop will be the twinning of the CNTS biomedical engineer with the AABB consultant engineer to train on equipment maintenance and testing.

Twinning has also been identified as an important area to focus on for the development and enhancement of knowledge for CNTS Staff. In particular, AABB will help to identify an appropriate partner to facilitate the twinning experience. Furthermore, in collaboration with the twinning partner, AABB will help develop in collaboration with the twinning partner the appropriate twinning curriculum, objectives, outcome measures and evaluation tools. The twinning program will focus on the transfer of knowledge for implementing quality systems and as such the first identified participants will be the Quality Assurance Officer. It will be expectation that the twinning participants will bring back the knowledge gained and begin training others and implementing quality systems within the CNTS.

A workshop activity focusing on standard operating procedure (SOP) writing skills and incorporating best practices will be carried out with key CNTS personnel to facilitate the strengthening of SOPs. Many of these revisions will focus on improving the process control of the CNTS over its products and services. Didactic knowledge of change control and document control will be provided to the workshop participants.

The American Association of Blood Banks (AABB) provides technical assistance to the National Blood Transfusion Center (CNTS) to ensure the provision of adequate supplies of safe blood to all health care facilities in Rwanda. Through twinning, AABB partners will provide expert guidance and technical

assistance to CNTS, resulting in better practices in donor recruitment, blood collection, laboratory quality assurance, blood bank management and transfusion practice. This support will include training, monitoring, guidance, oversight and mentoring through site visits and performance evaluation. This linkage will strengthen CNTS and improve institutional capacity for effective program management. Furthermore, it will result in enhanced sustainability and safety of the blood supply through human resource capacity building for current and future CNTS staff members. This will be accomplished through the development of a comprehensive, job-specific training plan designed to build confidence and knowledge of blood safety activities. The AABB gap analysis performed in 2009 provided information which, together with follow-up discussions, will be used to form an action plan for further activities for 2010 and beyond.

The activities planned for this period are based on the priorities as identified in the gap analysis. The first activity will center on donor qualification and screening. Currently, CNTS does not utilize a standardized donor history questionnaire to screen the donor population. The activity planned to address this deficiency will incorporate design, training and implementation phases in which expert consultants will assist CNTS in designing an adequate donor questionnaire to screen out potential high-risk donors. In addition, this workshop will focus on the appropriate transfer of knowledge and skills necessary to equip CNTS staff in utilizing this tool. The final phase of this activity will involve AABB oversight of the implementation of this tool in the field. AABB expert consultants will be on hand to assist as the tool is incorporated into daily use. This overall strengthening of donor screening will also include training and implementation on donor hemoglobin screening using copper sulfate methodology and donor temperatures. The appropriate procedures and forms will be developed in collaboration with CNTS staff and implemented simultaneously with the donor history questionnaire. Workshop participants will include donor services personnel (phlebotomists, recruiters, counselors, data clerks) as well as the quality assurance officer.

Another priority activity which will be carried out during FY 2010 involves the elaboration of a strategy to perform donor notification of positive HIV test results. Currently no partnership exists between CNTS and HIV counseling and testing (VCT) clinics regarding the handling of those donors who test positive for HIV. This workshop will assist CNTS in defining the policy and approach to notifying donors. A feasibility study will be carried out to assist CNTS in defining the appropriate human resources necessary to undertake this responsibility as well as additional equipment needed (e.g., vehicles for donor notification purposes). Due to limitations with the national postal service, donor notification is best carried out in person by qualified and trained CNTS staff members. Because this is a new function, the requisite training in counseling will need to be provided to CNTS staff members charged with this duty. In addition, new educational material will need to be developed to provide both staff member and donor with the knowledge to refer/seek treatment options at locally available VCT clinics.

An absolute prerequisite to donor notification is the identification of a suitable partner for CNTS to perform confirmatory testing prior to notification. The appropriate partnership will need to be developed in terms of test methodology, sample requirements, testing schedules, and policy development. Due to the fact that this partnership involves other MOH departments, close communication will need to be maintained at the highest levels to ensure this issue is addressed. This activity will create an opportunity to elaborate on the necessary policy and forms required for confirmatory testing.

Another priority area to be addressed during this time period is the appropriate management of equipment. The proper validation of equipment used in the collection, testing, processing and storage of blood components is an issue in dire need of corrective action, as is the ongoing preventive maintenance of such equipment. An extensive workshop will be planned to target the quality assurance officer, biomedical engineer, managers of laboratories and chief technologists in the importance of proper installation, operational and performance qualification, as well as ongoing preventive maintenance. This workshop will provide basic knowledge and understanding on designing and documenting equipment validation studies. An additional focus of this workshop will be the twinning of the CNTS biomedical engineer with the AABB consultant engineer to train on equipment maintenance and testing.

Twinning has also been identified as an important area to focus on for the development and enhancement of knowledge for CNTS Staff. In particular, AABB will help to identify an appropriate partner to facilitate the twinning experience. Furthermore, in collaboration with the twinning partner, AABB will help develop the appropriate twinning curriculum, objectives, outcome measures and evaluation tools. The twinning program will focus on the transfer of knowledge for implementing quality systems and as such the first identified participants will be the Quality Assurance Officer. It will be expectation that the twinning participants will bring back the knowledge gained and begin training others and implementing quality systems within CNTS.

A workshop focusing on standard operating procedure (SOP) writing skills and incorporating best practices will be carried out with key CNTS personnel to facilitate the strengthening of SOPs. Many of these revisions will focus on improving the process control of CNTS over its products and services. Didactic knowledge of change control and document control will be provided to the workshop participants.