National Blood Transfusion Service - Sri Lanka Dr. Ayesha Abeywardane Consultant Transfusion Physician National Blood Transfusion Service Sri Lanka 1
Sri Lanka Sri Lanka is an island Situated in the Indian Ocean Location : Northern latitudes 5 55 and 9 50 Eastern longitudes 79 42 and 81 52 Area of 65610 km 2 2
Sri Lanka Multi ethnic and Multi religious country with a population of 20.675 million. Population Density is 330 people per sq km Life Expectancy at birth 74.9 ( Male 71.4,Females 76.4) Literacy Rate 92.5 (Male 93.5 Female 91.6) Per capita GDP $3625 Human Development Index 0.750 3
Health Sector in Sri Lanka Sri Lankan government provides comprehensive health care service free of charge The health system of Sri Lanka is a good example for a low economic model with exceptionally good health indicators for relatively low per capita health expenditure Per capita health expenditure was $102.50 in 2013 4
National Blood Transfusion Service (NBTS) of Sri Lanka is a government organization functions under the Ministry of Health NBTS is a centrally coordinated island wide disseminated service 5
NBTS Sri Lanka National Blood Centre (NBC) is the administrative and technical headquarters of the NBTS Director NBTS is the head of the organization and the service There are 95 hospital based blood banks Grouped in to 18 clusters manned by 21 Specialist Transfusion Physicians 6
Blood Collection Annual Collection of blood is 380000 units 100% from VNRBDs 90% form mobile blood donation camps 10% in-house collection Blood donation Rate - 18WBD/1000 pop 7
Blood Safety Tested for HIV, Hep B, Hep C, Syphilis and Malaria Very low prevalence of TTI High-income countries Middle-income countries Low-income countries HIV HBV HCV 0.002% 0.02% 0.02% 0.12% 0.64% 0.37% 0.85% 3.59% 1.07% Sri Lanka 0.007% (con +ve) 0.10% (RR) 0.17% (RR) Prevalence of TTIs in blood donations - 2014 WHO Blood safety Fact sheet N 279 - June 2015 Revision
Component preparation 100% of the collected blood utilized for component preparation. All the specialized blood products are provided by NBTS for all state sector hospitals and most of the private sector hospitals PDMP are imported and managed by the Medical Supplies Division of MoH. 9
Quality assurance of NBTS A well established quality assurance system based on WHO, GMP and ISO standards. QC lab Quality monitoring of blood products and reagents. NBC participates in national and international EQAS to bench mark its performances with other parallel institutions. 10
NBTS - EQA Participation EQA Program TTI Marker(s) Years No. of cycles per year Participated centers NRL - Australia HIV/HBV 2000-2004 3 Up to 2009 10 Centers (NBC, HIV, HBV, HCV 2004-2012 3 AN, JA, KU, KP, KA, BA, SP, RA, AM) Multimarker 2013 3 HIV 2014 onwards 2 From 2010 NBC only Thailand WHO SEARO HIV 2006-2008 2 NBC Only National STD / AIDS Program HIV Syphylis From 2004 onwards 2 12 Centers (NBC, KA,AM,AN,KP,BA,KU,PE,CIM, SP,CN) Thailand AATM HIV,HBV,HCV 2015 2 NBC only
EQAS programmes conducted by NBC. NBC conducts; 1. Sri Lanka National External Quality Assessment Scheme in Blood Group Serology (SL NEQAS in BGS) 2. Sri Lanka National External Quality Assessment Scheme in Transfusion Transmitted infections(sl NEQAS in TTI) 12
Haemovigilance Nationally coordinated haemovigilance system is available to monitor the donor, process and recipient adverse events Over the phone consultation is available 24/7 for transfusion related emergencies islandwide. Biannual haemovigilance reviews are conducted Annual haemovigilance report is published 13
Teaching and Training NBC and Regional Centre Kandy - teaching and training centres in transfusion medicine at local and international level NBTS functions as an international training centre for AATM fellowship programme. NBTS provides training for; medical under graduates and postgraduate trainees. Basic and post basic training for nursing officers and MLTs. in-service training for medical officers, and other relevant staff of the Blood Banks 14
Policy and legislative frame work Parliament approved National Blood Policy is the governing policy document of NBTS Revised National Blood transfusion Act is awaiting Cabinet approval 15
Achievements National Health Excellency Award Large Campaigns (Gold) -2009 Provincial productivity award(commendation Award) -2009 ISO 15189 accreditation for the laboratories in National Blood Centre-2011 National Green award in Health care categories 2011(Silver award) Merit award in Sri Lanka National Quality award under medium scale healthcare category 2011 16
Achievements. ISBT(International Society of Blood Transfusion) best developing country award in 2012 Hosted World Blood Donor Day 2014 Global Event. 17
Strengths of NBTS Strong political commitment to provide quality and safe blood and blood products Socio cultural background of the country and all ethnic and religious groups contribute for the VNRBD Well established postgraduate training programme in Transfusion medicine. 18
Way forward Two main NBTS development projects are being conducted to acquire the latest technology in transfusion medicine Project 1: Construction and upgrading of peripheral blood banks under the NBTS Construction of 19 new buildings Upgrading the selected peripheral blood banks with modern equipments 19
Way forward Project 2: Upgrade the with state of the art technology I. Cord blood banking II. Stem cell collection and processing III. Frozen red cell processing storage and issuing IV. NAT testing for transfusion transmissible infections V. Improvement of HLA testing by molecular methods VI. Introduction of a computerized network linking all the blood banks 20
Acknowledgement His Excellency the President of the Democratic Socialist Republic of Sri Lanka Honorable Minister of Health and Officers of the Ministry of Health WHO, ISBT and AATM for their technical support NBTS staff for their devoted service Stake holders in NBTS People of Sri Lanka for their continuous support for the advancement of NBTS 21
Beautiful Sri Lanka 22
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