Before the Maternal and Newborn Health Improvement (MANI) project started in 2015, Bungoma county generated only 50% of the county’s annual target of blood per year. In 2017, with support from MANI and other partners, this increased to 61% of the year’s target. Data from the county’s maternal and perinatal death surveillance and response system revealed that half of maternal deaths were due to post-partum haemorrhage and in some cases, were directly linked to blood shortages. A number of methods have been carried out to help tackle blood shortages, by improving blood safety and reducing barriers of access to services.
In 2014, a satellite blood bank was set up helping to respond to and improve the availability and the safety of blood. The satellite now supplies to over 14 transfusing facilities in Bungoma including government, faith based and private facilities in the county.
Melda Wafula, a County Medical Laboratory Coordinator said, "I used to work in facilities and saw the challenges before we had a satellite clinic in Bungoma. We wasted a lot of resources traveling to Eldoret [100km from Bungoma] to get blood, but often returned empty handed. We had to watch children dying every day because of no blood being available. We collected blood, but we had no control over it. Setting up a satellite changed all of this. If we could become some regional hub, things could improve even more."
Over the last two years, with the help of the satellite blood bank, MANI has been able to set up monthly blood drives, undertaking a total of 127 blood drives and reaching willing volunteers aged 16-20 at schools, colleges and universities over the county.
Blood donors at Kamusinga Girls High School said, "I feel happy to be giving to the ones who need blood…I know there is someone somewhere who needs blood, and one day I may need blood too."
MANI has also helped improve blood safety through effective procurement and distribution of equipment at facilities, including blood bank refrigerators and cooler boxes. This has increased the cold blood storage capacity of the County satellite blood bank and Webuye Sub-County Hospital. Similarly, the programme also helped renovate Bungoma’s satellite blood bank, by donating blood drive chairs and a tent. This enabled the satellite staff to offer both in-house and blood outreach services with ease.
MANI has supported the set-up of hospital transfusing committees at five high volume hospitals. The committees meet quarterly and oversee the collection, safe storage, and distribution of blood. This enables blood transfusing facilities to learn, benchmark and share experiences more easily. Alongside this, the programme has designed a new data management tool so that facilities are better able to identify which areas in the county are highest consumers of blood and are therefore, in most need of services.
"The data collection tool has been an eye opener and has been useful in engaging transfusing facilities to know who are being transfused, and which major departments and diseases are major consumers of blood transfusion." Gossage Okumu, Bungoma Blood Satellite.
In addition to this, the setting up of a WhatsApp group with health workers, facility members, county satellites and regional blood banks, has enabled service providers to quickly and effectively communicate emergency blood requests. This has proved to be invaluable at creating unnecessary delays and ultimately saving lives.
Barriers of access for blood services have been reduced through removing fees for blood transfusions. Blood donors and recipients were frequently complaining that blood was donated for free, yet clients were being charged a fee to receive blood transfusions. All transfusion services charges have now been dropped and this has made blood accessible to all clients.
"I was not charged any fees for blood transfusion, and my family was not asked to donate blood. The hospital had blood available and ready for my transfusion. If the blood was not available, I would have died." Lydia Nanjala, Blood Transfusion Survivor, Lugulu Hospital
Overall, with the support of the MANI programme, blood transfusion services in Bungoma county have steadily increased since 2016. Services have been strengthened by increasing availability of donated blood, improving functionality of transfusing facilities, increasing access to services and using evidence to support service needs. Interventions are now focused on expanding blood transfusion services to neighbouring counties, increasing visibility through advocacy campaigns and increasing the numbers of trained staff to support at blood drives.