SUMMARY:

The South African National Blood Service (SANBS) program aims to ensure an adequate supply of safe

blood. This includes expanding the Safe Blood Donor Base by donor education and selection, training donor

and technical staff, logistics management, and appropriate information systems. The major areas of activity

are donor and blood user education and strengthening the technical and information systems infrastructure.

The target population is potential blood donors.

BACKGROUND:

SANBS collects 750,000 units of blood per annum providing blood to eight of the nine provinces. The other

service, Western Province Blood Transfusion Service (WPBTS) collects 120,000 units per year serving the

Western Cape Province. SANBS is a leader of blood transfusion in Africa and supports by training and

technically the blood services of the Southern African Development Community (SADC). The National

Health Act requires a single national blood transfusion service. SANBS, WPBTS and the Department of

Health are discussing how best to comply with legislation. SANBS, utilizing PEPFAR, has shared

educational material with WPBTS, standardized the self-exclusion donor questionnaire, supported the

continuing professional development of staff and developed the PEPFAR indicator tool as a national

measuring system. FY 2008 funding to SANBS will support the merger by strengthening the bonds between

the services in the fields of blood safety, staff training and donor education.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Expanding the Donor Base

The focus of this activity is to expand the donor base by including younger and more demographically

representative population groups. Blood safety is achieved by donor education and self-exclusion of those

at risk of HIV exposure. This activity will consist of several sections: (a) The donor education and

communication materials have been revised and included in the donor educator and recruiter training

materials. These materials will be made culture-specific and translated into the indigenous languages to

facilitate the expansion and demographic diversity of the donor base. (b) A donor education guideline for the

Muslim community has been approved by an Islamic fatwa. This will be implemented in FY 2008. (c) A key

program focuses on educating and recruiting young donors. Prospective donors will be exposed to a special

scholar donor education program approved and in harmony with those of the Departments of Education and

Health, and the HIV and AIDS Directorate. Scholars at selected pilot schools will be educated on lifestyle

and HIV transmission, including the role of Abstinence and Be Faithful (AB), and the impact of lifestyle on

blood safety. Education also addresses the importance of blood donation, and the use and need of safe

blood. The Club 25 project was started in FY 2006 and is continually being refined and evaluated. In FY

2007 the program was expanded to other African countries. The model is based on education of particularly

scholars and their commitment to remaining regular safe blood donors (donate 20 units before the age of

25). The results of laboratory screening tests will be disclosed to them and the message of safe lifestyle,

and the benefits of being a donor reinforced. This is optimized by one-on-one interviews by trained nursing

sister counselors. Trained donor educators offer course by lectures supported by pamphlets, information

leaflets and booklets. In FY 2008 the program will be institutionalized in as many schools as possible. A

further 50,000 scholars in FY 2008 will be exposed to the Club 25 program. (d) A donor deferral guideline

has been developed for training of and use by the 100 tele-recruiters allowing them to professionally inform

blood donors. (e) A pilot project to expand the SANBS donor base aims at entering into partnerships with

private companies. SANBS has formed a successful partnership with Daimler Chrysler SA. This initiative

will be expanded and new partnerships fostered in FY 2008. (f) SANBS will continue to refer HIV-infected

donors to PEPFAR-supported ARV sites. SANBS will link with PEPFAR AB partners to optimize the

education of the youth on safe lifestyles. (g) FY 2008 activities will include donor recruitment and

educational programs at the four clinics established in 2007 in black communities. The donor programs will

focus on safe lifestyle and the relationship to safe blood, and the need for blood donors. The results of

laboratory screening tests will be used to reinforce the message of safe lifestyle, the role of AB in avoiding

sexually transmitted infections, and the importance of blood and donors.

ACTIVITY 2: Training

This program focuses on developing training courses and materials for SANBS and WPBTS staff. These

materials will be offered in the seven operational zones of SANBS, and WPBTS. Training focuses on

human capacity development and addressing skills shortages. The 40 technicians enrolled in the program

to qualify as technologists at a tertiary institution will continue in FY 2008. Training programs for technicians,

technologists, and donor education and recruitment staff will be continued. Sixty trainee phlebotomists will

be trained and registered with the Health Professionals Council of SA as Phlebotomy Technicians. Fifteen

trainers from all provinces will be trained in the train-the-trainer program The distance learning material

developed in FY2005-2007 will facilitate in FY 2008 the training of SANBS and WPBTS staff. The distance

learning program is strengthened by the videoconferencing equipment purchased in FY 2007. The national

and regional Training Center commenced in FY 2007 will be fully established in FY 2008 and all aspects of

the program assessed and overseen by a professional educator. SANBS and WPBTS staff will continue to

host seminars, workshops, symposia and lectures in the discipline of transfusion to internal staff and

external health practitioners. As part of the AABB PEPFAR Technical Assistance program, two SANBS staff

members, one each from the donor and technical areas will attend a specialist high-level training course at

Emory University. SANBS in FY 2007 assisted in the development of a certified course in clinical

transfusion medicine at the University of the Free State. SANBS will in FY 2008 participate in the delivery of

the theoretical and practical course material. The course content is suitable for students of other African

countries. Central to staff development is job satisfaction leading to better retention of staff. The staff

development program is complemented by performance management and reward with clear career paths.

ACTIVITY 3: Regional Reference Center and Plasma Repository

SANBS annually screens more than 700,000 blood donations for HIV, HCV and HBV. In FY 2007 a plasma

repository of viral positive plasma has been established in a facility funded by SANBS. This will in FY

2008/9 be expanded to a regional reference laboratory. This facility will satisfy the needs of the Southern

African region for an external quality assessment program. The plasma repository will be fully characterized,

Activity Narrative: and aliquots distributed to participants in an African External Quality Assurance System. Analysis of

performance of blood services will enhance national blood safety. The plasma repository is a unique

resource for African transfusion services and could be used to assess blood screening systems, investigate

the sensitivity and specificity of tests and their impact on the window period, and the identification of new

infectious agents. The technologist who will lead this program in August-October 2007 will be trained at the

Blood Research Institute in San Francisco.

ACTIVITY 4: Data Warehouse

The SANBS data warehouse will be fully operational by end FY 2008. It is an essential component of the

information system and will be used for the management and evaluation of all components of the blood

system. In FY 2008 the data warehouse will include the data of WPBTS. This will make it possible to utilize

the PEPFAR indicator tool to assess and improve the blood system of South Africa.

ACTIVITY 5: Western Province Blood Transfusion Service (WPBTS)

FY 2008 COP activities will be expanded to focus on the merger of SANBS and the WPBTS. Activities will

be implemented for a step-wise incorporation of WPBTS into the SANBS PEPFAR program focusing on

training and personnel development, establishment of a training centre, and by developing appropriate

information technology systems for the collection of national data as an indicator of the status of blood

transfusion in South Africa. WPBTS will also utilize PEPFAR funding to expand their base of safe donors by

establishing more mobile clinics. This will be facilitated by acquiring a specially fitted vehicle. WPBTS will

play a key role in the development of the web-based training system and the WPBTS will be incorporated

into the SANBS staff capacity building, on-site training and continuing professional development programs.