Kenya tests emergency blood donation system for remote hospitals
Researchers are piloting a community-based blood donation scheme at a rural Kenyan hospital to address critical shortages in regions with no access to blood banks. The study could reshape emergency care delivery in low-resource settings where hemorrhage remains a leading cause of preventable death.
Originaltitel: Implementation and evaluation of a community walking blood bank for haemorrhagic shock when banked blood is unavailable: protocol for a mixed-methods, effectiveness-implementation study - phase 2 of the Local Initiative for emergency blood (LIFE-Blood) study.
# Mobil blodbank kan lösa försörjningskris på landsbygden Miljontals dödsfall från blödningar uteblir där blodtransfusioner är omöjliga att tillhandahålla. Harvard Medical School testar en lågkostnadsmodell — en mobil civilblodbank (CWBB) — vid Lodwar sjukhus i Nordvästra Kenya, ett område helt utan blodförsörjning. Studien mäter effektiviteten under ett år genom att jämföra blodbeställningsmönster före och efter implementering av en nödblodtransfusionsprotokoll. Forskarna förväntar cirka 140 ouppfyllda transfusionsbehov månatligen, varav 40 är akuta. Genom intervjuer med personal och samhälle kartläggs också acceptans och möjligheten att överföra modellen till andra resurssvaga miljöer. För samhällsplanerare är detta relevant för global hälsopolitik och utvecklingssamarbete. Resultaten kan påverka donationsstrategi och akutvårdsstandard i länder med bristande blodtillgångar, samt visa vägen för snabb anpassning av medicinsk infrastruktur i kritsituationer.
INTRODUCTION: Trauma, obstetric haemorrhage and severe anaemia lead to millions of deaths every year. Many of these deaths occur in regions known as 'blood deserts' where there is virtually no access to blood transfusions. A community or civilian walking blood bank (CWBB) is a low-resource strategy that can provide just-in-time, point-of-care tested blood transfusions in blood deserts when banked blood is not readily available and the alternative is almost-certain death. This protocol is designed to evaluate the effectiveness and implementation of a CWBB at Lodwar County Referral Hospital located in a blood desert in rural north-west Kenya. METHODS AND ANALYSIS: We will use a mixed-methods approach relying on an implementation science design to evaluate effectiveness, acceptability, applicability and impact of a CWBB. The study will be conducted over 1 year in two parts: pre-emergency and post-emergency transfusion protocol (ETP) implementation. First, a previously developed ETP will be validated and finalised by key hospital stakeholders. Effectiveness will be assessed quantitatively and qualitatively. Prospective laboratory-based data collection will measure changes in blood ordering practices. We expect a sample size of approximately 140 (20/month) unmet blood transfusion requests, with 40 (5/month) of those being emergent (requiring blood in less than 2 hours). These cohorts will be compared pre-implementation and post implementation. Qualitatively, key informant interviews of hospital staff and the community will explore clinical blood demand and general understanding and perceptions about blood donation and transfusion. Lastly, we will determine the adaptability and scalability of a CWBB to other low-resource settings with in-depth interviews and a modified Delphi approach to achieve consensus regarding key components of a CWBB and its transferability to other settings. ETHICS AND DISSEMINATION: Ethical approval was granted by the Strathmore University Institutional Scientific and Ethics Review Committee (SU-ISERC2234/24) and the Mass General Brigham (MGB) Hospital's Institutional Review Board (#2024P001878; #2024P001879; #2024P001885; #2024P001887). The study team also secured a research licence from the National Commission for Science, Technology and Innovation (#168094) before initiating the study. Interviews will be voluntary and consent will be obtained prior to participation. Blood transfusion consent will be collected as per standard hospital process. The findings will be disseminated through academic publications, conference presentations and workshops, contributing valuable insights into emergency blood transfusion protocols. These findings will also be conveyed to Lodwar County Referral Hospital in order to facilitate quality improvement.