Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2013 2014 2015

Details for Mechanism ID: 12256
Country/Region: Cambodia
Year: 2010
Main Partner: Not Available
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $0

This is a new activity.

Goals and Objectives This TBD partnership with the USG will improve the availability and access to safe blood in Cambodia, reducing the risk of HIV transmission through transfusion. Our USG sponsored activities will strengthen the capacity of the Ministry of Health's (MoH) National Blood Transfusion Services (NBTS) to lead and manage the national blood program and will enhance laboratory quality for blood safety. Through ongoing USG technical support to NBTS, projects funded from other sources, such as the Global Fund's (GFTAM) activities to increase volunteer donation and improve rational use of blood, will be strengthened.

In FY10, USG support will: a) provide technical mentorship and training programs to improve management, monitoring and planning at NBTS and other blood banks; b) strengthen quality assurance and quality control practices; c) increase post donation counseling and referral; d) support infrastructure improvement through ensuring proper maintenance of laboratory equipment and assisting with equipment upgrades; e) provide technical support to NBTS for GFTAM Round 5 (and 9 if successful) activities; and f) assist NBTS to operationalize the Hospital Transfusion Committees (HTC) and develop a forum for sharing best practices from institutions and blood banks across Cambodia.

Target Populations

Through this mechanism, blood supply and safety will be improved for the population requiring blood or donating blood throughout Cambodia. All blood collected will be screened for HIV and 4000 prospective donors with transfusion transmitted infections (TTI) will have access to improved counseling and referral. The capacity of 75 blood bank personnel and 500 clinicians prescribing blood or blood products in the 22 national and provincial blood banks will be strengthened.

Geographic Coverage

Blood safety activities will have nation-wide coverage and take place in Phnom Penh and in the areas served by the 21 provincial blood transfusion services (PBTS).

Key Contributions to Health Systems Strengthening

The NBTS is responsible for ensuring access to safe blood for all Cambodians. This requires a quality system and adequate supply of blood or blood product when and where it is needed. A strengthened NBTS will help prevent mortality and morbidity associated with lack of blood and will help prevent adverse transfusion reactions from improper use of blood. For example, fewer women will die during childbirth as a result of obstetrical hemorrhage. By making safe blood and blood products more available in all geographic areas and supporting capacity building of health care providers for rationale use of blood, the risk of transfusion related transmission of other TTI's besides HIV (syphilis, malaria, and Hepatitis B and C) will also be reduced

Enhancing Sustainability

This mechanism will assist the NBTS to become more cost efficient over time as a result of improved management capacity, more effective tracking of inventory, more rational use of blood, and limiting blood manufacturing and distribution in the private sector.

Through regular review of data and better forecasting of blood supply and equipment inventory needs, costly emergency purchases which are common today can be avoided. NBTS managers will be trained to adopt new, cost-efficient ways of forecasting supply needs for the whole year and organizing a staggered delivery of test reagents and consumables. Procurement under this mechanism will take into account and complement procurement by the GFTAM and the MoH. Communication at NBTS will be enhanced through regular staff meetings.

USG will encourage NBTS to organize regular blood bank and blood depot network meetings to review program activities and to share 'best practices'. Coordination between hospitals and health providers and NBTS will be strengthened by supporting the Hospital Transfusion Committees established under the National Blood Strategy (2007). USG will advocate with NBTS, Bureau of Medical Laboratory, and the sub- sub technical working group for blood safety in the MoH to ensure that the committee meetings are functional.

Cambodia does not have a formal system to regulate the use and safety of blood and blood products in the private sector. To minimize the expansion of unsafe practices in the private sector, some PTBS have begun offering blood products to private hospitals and clinics for a small fee. NBTS also provides training to clinicians in both the public and private sectors. This IM will support NBTS to establish additional systems and strategies for a safe blood supply in the private sector.

Monitoring and Evaluation Plans

Activities in this mechanism will be monitored using data from the existing information system established with funding from GFTAM Round 5. Site visits will be carried out to directly observe quality control practices and infrastructure strengthening results activities. USG will convene regular meetings with NBTS senior management and TBD to review results reports, identify issues, track progress and review budgets and work plans.

Funding for Biomedical Prevention: Blood Safety (HMBL): $0

This is a new activity.

Basic approaches TBD will provide a blood safety expert to be based at National Blood Transfusion Services (NBTS) to support the implementation of quality management plans and provide technical support to the NBTS. TBD will assist NBTS to strategically manage and maximize USG and GFTAM resources.

Coverage and scope of activities TBD will organize training for the staff in 22 provinces on transfusion transmitted infections, immuno-hematology, quality assurance, and laboratory auditing. TBD will procure quality control materials for the PBTS in the CDC focus provinces and for NBTS, a re-agent grade water system and other essential equipment. NBTS will increase component manufacturing so that patients with specific transfusion requirements can be treated accordingly. The NBTS and PBTS in these focus provinces will be enrolled in international EQA.

TBD will assist NBTS to improve information management and re-organize quality assurance documents for easier access. To trace donors and increase post-donation counseling the use of national ID and the verification of donor's contact information will be reinforced. TBD will support NBTS in the implementation of GFATM-supported activities. For example, designing creative mobile blood drives using innovative technologies has proved to be successful in the past, and is a good model for future programming.

Integration with other HIV/AIDS services HIV-positive prospective donors will be referred to VCCT for counseling and follow-up. NBTS will continue to collaborate with NIPH in the national quality assurance program.

Fostering Sustainability Strengthening the organization and management of blood transfusion services, building capacity for quality assurance and better forecasting will lead to cost reductions and more sustainable systems. USG will work the Ministry of Health and participate in the Technical Working Group for Blood Safety to support the development of regulatory framework.

Health Care Worker Salary Report: Please estimate the number of health care workers (your agency and sub-partner staffs, and community workers/volunteers) who received salary support from PEPFAR (HIV fund) for the following categories: (Please see the definition and instruction in the COP guidance)