Challenges

In Guyana, the National Blood Transfusion Services (NBTS) faced challenges that impacted the management of services for people needing blood transfusion. This was due to the rapid staff turnover and the subsequent loss of experienced personnel. This was aggravated by poor procurement systems, lack of quality governance structures such as blood transfusion committees, and lack of transfusion guidelines. There was also a lack of knowledge on the use of blood components at hospital facilities and low availability of reagents for antibodies testing. All this compromised quality assurance and led to low confidence in the system. 

Toward a Solution

This South-South bilateral collaboration between Argentina and Guyana aimed at strengthening the blood transfusion system in Guyana between 2015 and 2018. Its objective was to strengthen the knowledge base on blood management and the professional skills of key staff working in the blood transfusion system in Guyana in order to strengthen the NBTS. 

The collaboration aimed to enable the country to have a reliable blood transfusion service that would ensure the timely availability of a lifesaving health care input such as blood and its components in all health facilities that may require it. This directly contributes to the achievement of Sustainable Development Goal (SDG) 3, targets 3.1 (on the reduction in maternal mortality) and 3.8 (on universal access to quality health services).   

Senior staff from Guyana’s NBTS including its quality manager and director teamed up with experts and senior staff from the Hemotherapy Center of the Garrahan Pediatric Hospital in Buenos Aires, Argentina. The latter is the largest paediatric hospital in Argentina and the national referral paediatric centre for intensive care, with an average of 10,000 paediatric surgeries annually.  

The collaboration ensured the systemic, cross-country transfer of knowledge by adopting a four–phase process that ensured the participation of the key stakeholders from both countries. In phase one, an expert from Argentina visited the NBTS in Guyana to undertake an audit to understand the gaps that needed to be addressed, which included donor recruitment, blood donor’s support and guidance, blood component processing, as well as blood distribution. The audit was instrumental in transferring new knowledge to Guyanese professionals, and served to prepare a programme of work to strengthen blood services in Guyana as several opportunities for improvement were identified and lessons learned were drawn.  

In the second phase, an Argentinean expert visited the same centre for two weeks in order to conduct a hands-on training in donor management procedures, serology and blood components processes and management. Several recommendations to improve management and quality were also made, which led to the adoption of an improvement plan that was implemented in a two-year process with specific timelines and milestones. 

In phase three of the collaboration, a senior staff member from the NBTS from Guyana visited the Garrahan Pediatric Hospital in Buenos Aires in June 2018 and participated in an intensive hands–on–training programme at the hemotherapy centre. The training focused on knowledge transfer in the areas of donor recruitment practices, quality assurance, immunohematology and blood collection. This phase later allowed for the dissemination of this new knowledge to Guyanese staff, thus ensuring the sustainably of the initiative. 

In the final stage, an expert from the blood bank at the Garrahan Pediatric Hospital in Argentina visited Guyana for a final audit of the NBTS and provided final recommendations for the optimal operation of the service. In a final meeting with the Junior Minister at the Ministry of Public Health of Guyana, the expert provided recommendations for the consolidation of blood transfusion services and guidance to ensure the sustainability of the improvements achieved in Guyana. 

Since the last visit of the Argentina experts, the NBTS has improved its operations in donor recruitment, blood processing and distribution. Although some aspects of the improvement process of these services require long-term implementation, Guyana took full advantage of this opportunity. Indeed, this South-South cooperation initiative was innovative because it brought new knowledge that enabled the beginning of a long-term process of structural improvement and innovation.  

These innovations included the adoption of a strategic plan, the establishment of a new national blood policy, the creation of transfusion committees in the most important hospitals in the country, as well as the gradual improvement of quality. The collaboration also highlighted the need for blood derivatives including plasma, plaques, hemoderivates, etc. at public and private health facilities that are currently in place in most of them. The collaboration was instrumental to the Government of Guyana to create a specialized immunohematology laboratory with capacity for platelets pooling and the adoption of standard of procedures (SOPs) for all stages of the blood transfusion cycle. 

As a result of the collaboration, the Government of Guyana, in a firm commitment to ensure the sustainability of the progress attained, has embarked in a long-term process to improve the quality of its national blood system. This is an area that requires a considerable amount of human and financial resources that the Government has committed to invest. The next goal of the country towards ensuring the sustainability of results is to improve quality to an even greater extent and obtain the accreditation of its NBTS according to international standards. Since the Garrahan Pediatric Hospital’s Hemotherapy Center is an internationally renowned blood bank, the plan is to upscale this collaboration.