The Hindu Business Line : Blood collection lags demand by bagfuls

BLOOD transfusion services constitute a crucial part of any healthcare delivery system and judging by the state of affairs obtaining today, India would need to opt for the surgeon's knife to ensure adequate flows.

The country requires about five million units of blood every year but annual blood collection is only 3.5 million units. This presents a paradoxical situation given the massive population base of not less than a billion, say researchers at surgical major Mr Terumo Penpol.

Adequate and safe supply of blood and blood components is essential to enable the conduct of a wide range of critical care procedures in hospitals. The gaping shortfall in the supply can be addressed only by increasing the number of voluntary blood donors getting into the act on a regular basis, the researchers said in the run-up to observation of National Blood Donation Day on October 1.

Experience in other countries shows that the single most important factor in assuring safe blood supply is the availability of adequate number of regular voluntary donors, they added.

As an essential component of the healthcare system, supply of safe blood must ensured, wherever and whenever required. The primary objective is to make sure the safety, adequacy and accessibility of blood in an efficient, cost-effective and coordinated manner.

The responsibility for fully discharging the role of coordinating, supporting, mobilising and facilitating safe blood transfusion services lies with the Government.

That said Governments couldn't be expected to do everything on their own. The need for forging partnerships is of relevance, especially in view of the need to ensure safety of blood. The public and private sectors, including the national and State Governments, academia and the industry can bring into focus their complementary skills and perspectives to facilitate this.

Since the Supreme Court has declared illegal professional blood donation, almost 80 per cent of donation has come to be labelled as replacement, and the rest as voluntary. The only exception to this is West Bengal with its excellent record in voluntary donation - and in respect of which the respective percentage figures are reversed.

Except for a few States such as Maharashtra, which have or one or two blood banks at the taluk-level, the services are located in the district towns, mostly in public sector hospitals. As for Kerala, blood banks are mostly based in the bigger cities or metropolitan areas. Blood banking services are extremely rudimentary or non-existent in the rural areas. Not surprisingly, nursing homes operating along the highways often face problems in dealing with accident cases.

Standards applying to the blood transfusion service also vary from State to State and also within a State. Blood banks with dubious quality and standards have been mushrooming all over the place.

Despite clearly specified legal requirements, the mandatory tests for blood safety are seldom enforced. In cities, many large hospitals and nursing homes function without blood banks.

According to the researchers, it would be better to develop centralised blood banking services at the district level. The concept of first referral unit is gaining ground, in which hospitals at the block or taluk level would have to have facilities to store blood.