TITLE: AABB Consulting in Rapid Strengthening of Blood Safety in Tanzania

NEED and COMPARATIVE ADVANTAGE: AABB has extensive experience assisting in blood safety

initiatives. Using a systems approach, AABB will provide technical assistance to improve quality systems

and to develop human and organizational capacity. Strengthening the infrastructure in this manner will

provide the Ministry of Health and Social Welfare (MOHSW)'s National Blood Transfusion Service (NBTS)

with the quality processes and systems to provide safe blood and blood products for transfusion

consistently.

ACCOMPLISHMENTS: AABB provided technical assistance to the NBTS for development of blood safety

policy documents, blood collection training, systems development, and expansion of a quality management

plan (records and documents, training, validation, and error management). In addition, development of

information technology documents, blood bank computer system implementation, and a strategy for

enhancing component production has also been achieved.

ACTIVITIES: AABB will provide technical assistance to the NBTS to continue development of the quality

management plan in addition to ensuring implementation of quality systems programs throughout all

operations of the NBTS. AABB will assist with designing documents and developing training to support

implementation of new and revised processes. AABB will also initiate the design of a Training of Trainers

(TOT) program for various aspects of the blood transfusion service, allowing for the training of trainers,

executive management, and zonal managers. AABB will provide technical assistance in the planning,

implementation, validation, and post-implementation monitoring of blood bank computer system software.

The NBTS team will implement a protocol, which will address all critical elements at the department level in

order to ensure compliance with the quality management plan. This will provide control mechanisms for

every step of the blood donation process from donor solicitation to the release of blood products for

transfusion, with each step having been documented using a computer system.

AABB will provide TA in development and implementation of a monitoring and evaluation (M&E) program

throughout the NBTS. The M&E program will include electronic tools and paper-based materials depending

on capability at each site. In order to accomplish this, AABB will do the following; perform a gap analysis on

existing M&E activities; develop and implement M&E procedures and training throughout operational areas;

assist in reviewing current M&E data integrity; and assist in post-implementation monitoring of M&E

program. In combination with quality systems and the M&E program, the NBTS can monitor quality,

efficiency, and effectiveness while controlling critical aspects of blood transfusion service, blood collection,

transportation, safety, storage and component production..

In order to develop a sustainable plan of action, AABB will provide technical assistance to strengthen the

capacity of the NBTS to effectively manage blood transfusion activities in Tanzania, including developing

and implementing a process to determine actual costs of blood and blood products and services provided

by the NBTS. The AABB will collaborate with the NBTS to develop and conduct formalized, scientific

processes to obtain actual transfusion activities in NBTS serviced hospitals, prepare reports, and ensure

buy-in from management staff. By utilizing the obtained information, the NBTS can begin planning a cost-

recovery program.

For optimum utilization of the NBTS services offered, AABB will design and assist hospital and laboratory

education sessions regarding NBTS blood products and services. This will include development of

educational materials, and implementation of regional education sessions. Hospitals receiving blood

products from the NBTS will be equipped to make informed decisions about blood products requested for

patient transfusion. The education sessions will target hospital-based transfusion committees, and

clinicians. By involving hospital-based transfusion service committees, hospitals will have the capability to

monitor critical elements in their regions while providing a mechanism for transfusion medicine oversight.

This process will facilitate a linkage between hospitals and blood centers resulting in effective

communication and synergy.

LINKAGES: AABB will provide technical assistance to the NBTS and link hospital programs in the areas of

counseling, testing, prevention, and medical injection safety along with collaboration between Haukeland

University Hospital (HUH) from Norway and the NBTS. The primary focus would center on areas of blood

donor collection and counseling, testing, storage, and distribution of blood products. In addition, AABB will

collaborate with HUH and the NBTS in planning and implementing of blood bank computer system software.

CHECK BOXES: AABB will support the NBTS by providing technical assistance in designing a self-

sufficient blood supply using non-renumerated, volunteer blood donors. The blood donor program targets

the general population of Tanzania. Technical assistance will be provided in a systems-based approach to

include development of a NBTS quality management plan and quality systems, creation, and

implementation of a NBTS M&E program. Local policies, international guidelines, and best practices will all

contribute to the development of operational processes.

M&E: AABB will collaborate with the NBTS and its partners, to ensure that the M&E program

encompasses all areas of operations. In order to identify potential opportunities for enhancement, a gap

analysis will be conducted, and subsequently, a model will be developed incorporating existing NBTS

procedures and desired best practices stemming from existing industry M&E data. The M&E model will

reflect processes ensuring accuracy of data and flexibility as critical elements. As demands on the blood

center/blood program increase, the NBTS M&E program will adjust to accommodate the workload.

SUSTAINAIBLITY: AABB will provide technical assistance to the NBTS in the area of sustainability with

specific focus on two activities: cost recovery and actual hospital transfusion activity. AABB will assist the

NBTS toward cost recovery planning by completing a formalized process to determine actual costs of blood

products and services both for current and future operations. This planning process is targeted for

completion no later than December 2007. Secondly, AABB will collaborate with the NBTS to complete a

formalized timeline that will allow determination of actual NBTS hospital transfusion activities targeted to

start by October 2007. Information yielded from both activities is critical elements in planning a cost

recovery system directly affecting sustainability.