Protocol: identifying policy, system, and environment change interventions to enhance availability of blood for transfusion in Kenya, a mixed-methods study
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Published:2023-09-07
Issue:1
Volume:23
Page:
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ISSN:1472-6963
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Container-title:BMC Health Services Research
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language:en
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Short-container-title:BMC Health Serv Res
Author:
Munoz-Valencia Alejandro, Aridi Jackline O., Barnes Linda S., Rudd Kristina E., Bidanda Bopaya, Epuu Tonny, Kamu Robert, Kivuli Tecla, Macleod Jana, Makanga Cindy M., Makin Jennifer, Mate Muthoni, Muiru Carolyne Njoki, Murithi Gatwiri, Musa Abdirahaman, Nyagol Hellen, Ochieng Kevin, Rajgopal Jayant, Raykar Nakul P., Tian Yiqi, Yazer Mark H., Zeng Bo, Olayo Bernard, Kumar PratapORCID, Puyana Juan Carlos
Abstract
Abstract
Background
Safe blood is essential for the care of patients with life-threatening anemia and hemorrhage. Low blood donation rates, inefficient testing procedures, and other supply chain disruptions in blood administration affect patients in low-resource settings across Sub-Saharan countries, including Kenya. Most efforts to improve access to transfusion have been unidimensional, usually focusing on only point along the blood system continuum, and have excluded community stakeholders from early stages of intervention development. Context-appropriate interventions to improve the availability of safe blood at the point of use in low-resource settings are of paramount importance. Thus, this protocol proposes a multifaceted approach to characterize the Kenyan blood supply chain through quantitative and qualitative analyses as well as an industrial engineering approach.
Methods
This study will use a mixed-methods approach in addition to engineering process mapping, modeling and simulation of blood availability in Kenya. It will be guided by a multidimensional three-by-three-by-three matrix: three socioeconomic settings, three components of the blood system continuum, and three levels of urgency of blood transfusion. Qualitative data collection includes one-on-one interviews and focus group discussions with stakeholders across the continuum to characterize ground-level deficits and potential policy, systems, and environment (PSE) interventions. Prospectively-collected quantitative data will be used to estimate blood collection and transfusion of blood. We will create a process map of the blood system continuum to model the response to PSE changes proposed by stakeholders. Lastly, we will identify those PSE changes that may have the greatest impact on blood transfusion availability, accounting for differences across socioeconomic settings and levels of urgency.
Discussion
Identifying and prioritizing community-driven interventions to improve blood supply in low-resource settings are of utmost importance. Varied constraints in blood collection, processing, delivery, and use make each socioeconomic setting unique. Using a multifaceted approach to understand the Kenyan blood supply and model the response to stakeholder-proposed PSE changes may lead to identification of contextually appropriate intervention targets to meet the transfusion needs of the population.
Funder
National Heart, Lung, and Blood Institute
Publisher
Springer Science and Business Media LLC
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