No Woman Should Die During Childbirth: Blood Safety and Maternal Health Issues in Sub-Saharan Africa
and Kaushal Shah, Head of Health Strategy, Africa Health Business
Blood transfusion is an essential component of the healthcare system of every country.
In 2013, the most recent year for which global data are available, an estimated 112.5 million blood units were donated worldwide. Of these, 5.6 million blood units were collected in 46 African countries, accounting for only 4% of global donations, although these countries are inhabited by approximately 13% of the global population .
Of all maternal deaths, over 90% occur in low-resourced countries and the leading cause of death is PPH. Worldwide, an estimated 800 women die every day from preventable causes related to pregnancy or childbirth, among which untreated haemorrhage is a major contributor.
Health Economic Value of Blood in Kenya, Ghana and Ivory Coast: The Case of Maternal Bleeding
Although the link between the blood supply and morbidity and mortality within a country is well understood, to date, there is not enough data regarding the impact of increased blood supply on healthcare performance in countries in Africa. More specifically, only a few studies in the African region have evaluated predictors of survival of patients requiring acute massive transfusion (e.g. due to maternal bleeding) or regular transfusion (e.g. due to chronic anaemia). To address this data gap, a review was conducted to understand the impact of blood availability on the health outcomes of patients in three African countries: Kenya, Ghana and Ivory Coast .
Failure throughout the entire blood supply chain
Blood shortage: The case of maternal bleeding and lives lost in numbers
• Nearly 30% of deaths are attributable to the blood shortage.
• Up to approximately 40% of maternal mortality could be attributed to severe PPH.
• Of the maternal deaths attributed to PPH, more than 85% are potentially avoidable with blood transfusions.
Partnerships are key
In 2019, Terumo Blood and Cell Technologies led a series of high-level discussions on the sidelines of the United Nations General Assembly to explore solutions to blood safety and maternal health issues in sub-Saharan Africa (SSA). One outcome was the formation of a working group to drive the agenda for adequate, safe, sustainable blood in SSA now referred to as the Coalition of Blood for Africa (CoBA). CoBA was launched in 2020 with the goal of finding solutions to the perennial challenges of blood in the continent. The coalition brings together an unprecedented array of health experts, including public-sector research institutes, ministries of health, academia, not-for-profit research and development organisations, NGOs, international organizations and private sector organisations all committed to one goal: access to safe, sustainable blood in Africa.
Specifically, partnerships can focus on :
• Infrastructure development: to ensure adequate and suitable facilities for blood collection, testing, processing, storage and distribution.
• National data collection and information management system: to ensure the traceability of donors, donated blood and transfusion recipients.
• Strengthening of blood donor programs: to increase the total number of donations by voluntary blood donors, reduce family and paid donation and implement strict criteria for assessing the suitability of donors.
• Testing and processing: centralized/regionalized testing of all donated blood in accordance with quality standards.
• Quality systems: in blood transfusion services and at the clinical interface.
• Training: of all staff in blood transfusion services and hospital staff involved in the clinical transfusion process.
• Blood utilization: prescribing of blood in accordance with national transfusion guidelines and the safe clinical transfusion procedures.
• Monitoring and evaluation: of all activities related to blood transfusion to assess progress, monitor trends and impact, and replan, as necessary.
 Owusu-Ofori SPO, Sekongo YM, Rajab JA, Asamoah-Akuoko L, Magutu V, Lamotte M, Bah A, Dierick K. Health Economic Value of Blood in Sub-Saharan Africa: The Case of Maternal Bleeding. Value in Health. 22. S773. 10.1016/j.jval.2019.09.1964.
 Making Safe Blood Available in Africa. Committee on International Relations, Subcommittee on Africa, Global Human Rights and International Operations, U.S. House of Representatives. 27 June 2006
About Terumo Blood and Cell Technologies
Terumo Blood and Cell Technologies is a medical technology company. The company’s products, software and services enable customers to collect and prepare blood and cells to help treat challenging diseases and conditions. Terumo Blood and Cell Technologies customers include blood centres, hospitals, therapeutic apheresis clinics, cell collection and processing organizations, researchers and private medical practices. The company’s customers are based in over 130 countries. Terumo Blood and Cell Technologies is a subsidiary of Terumo Corporation, a global leader in medical technology.
Learn more at: www.terumobct.com
About Africa Health Business
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About AHBS- Africa Women’s Health: The Role of the Private Sector in Advancing Women’s Health in Africa
AHB curated the Africa Health Business Symposium (AHBS) under the theme: The role of the private sector in advancing women’s health in Africa with the objective to prioritise, explore and strengthen the role of the private sector in advancing women’s health on the continent.
Learn more at: www.africahealthbusiness.com