The Government of Pakistan through support from the Government of Germany initiated the process of restructuring the blood transfusion system by following a centralized model. The Safe Blood Transfusion Programme was established which created a high visibility environment to promote a modern national blood transfusion system as part of its health services. Required resources for national and provincial safe blood transfusion programmes were defined and approved in PC-1s (project documents), while national and provincial commitment was enhanced by the German support through technical advisory services (GIZ) and the establishment of a network of fully equipped regional blood centres in strategic areas throughout the country (KfW).
The project design conceived in 2008 anticipated the forthcoming 18th amendment and the devolution of the subject of health to the provinces. It was, therefore, the policy decision of the Health Ministry to develop separate PC-1s for federal and provincial programmes. The devolution process in 2011 resulted in a shift from national to provincial level, however, keeping the National Coordination role through the Safe Blood Transfusion Programme. The SBT Programme has continued to scale up visibility through a series of strategy and training workshops on all aspects of blood safety.
Since its establishment in 2010, the SBTP has been able to deliver a series of outputs which have significantly contributed to improvement in blood safety standards and establish strong bonds among the national stakeholders. The close collaboration with the assorted stakeholders has deepened the Programme’s understanding of the existing ´diversity´ in terms of structures, technology, human resource capacity and overall organization. Working groups and task forces, comprising of eminent local experts, have been formed to develop key policy and operational documents including Model SOPs, National Standards and Guidelines, National CUB Guidelines, Business Plan, Functional Brief for MIS, Functional Brief for BTA, Functional Brief for RBC and HBB, Inventory of BDO and BT Laws, etc. The inclusive approach has enhanced local ownership and integration of experience and evidence, thus increasing local users’ expertise and capacity. The SBTP is also implementing a capacity building plan aimed at creating a suitably qualified workforce, well equipped to adequately operate both in the new system and in the current reality.
Recently, the SBTP under the supervision of Ministry of National Health Services adopted a systematic and participatory approach to revise the National Blood Policy & Strategic Framework (2014-20) to ensure a sustainable planning base for the future. The overarching priorities regarding blood transfusion services that are addressed in this framework include: equity; the development of leadership, planning and management capacity; quality of care and monitoring and evaluation.
The first phase (2010-15) of the project is nearing successful completion. The Agreement of the second phase has been submitted by the German government and is being processed in the Economic Affairs Division and the Agreement is expected to be signed very soon now. The Phase II proposes expansion of the scope and coverage of the Phase I concept in the light of the experience gained and lessons learned.
The Safe Blood Transfusion Programme remains high on the priority of the present Government. The honorable Prime Minister of Pakistan recently granted special exemption on all kind of taxes for this project. And the continued commitment to this vital public health project will again be reiterated soon with the signing of the second phase of the project with the German partners.
The SBTP publishes a monthly e-newsletter regularly in which all the programme and related activities are documented. The newsletter is shared with an ever increasing number of stakeholders in the country and abroad. The feedback received from the partners especially the international partners is very encouraging and supportive. The global blood transfusion fraternity takes a very keen interest in the development and progress of the national blood transfusion service in Pakistan.
Despite many challenges, the Programme continued to strengthen and scale up the implementation process by engagement of committed resources and the conduction of strategic system and regulatory reform efforts under the National Blood Policy and Strategic Framework. Apart from creating a conducive environment for sustainable blood programmes within their health systems, efforts are made to strengthen the capacity of system governance and safe blood transfusion practices through institutional and regulatory reforms.