Strengthening blood programs in developing countries.

The lack of an adequate and safe blood supply is a major limitation to health care in the developing world. It is estimated that about 80% of the worlds' population has access to only 20% of the world's blood supply. When experts from the developed world attempt to provide assistance to blood programs in the developing world, this must be done with respect for the situation and the people who often work under difficult conditions. Important factors in the potential to strengthen blood availability and safety are government support, a national blood policy, the nature and leadership of the blood organization, transfusion medicine expertise, and hospital relations. A key first step is to carry out a needs assessment of the policies, governmental support, organizations, public attitudes about blood donation, and personnel and operations involved in providing the current blood supply. The important facets of the assessment are: the tool itself, the manner in which the assessment is conducted, and the presentation of the results. The assessment should provide recommendations for infrastructure, operations, standard procedures, testing strategies, training programs, types of donors and donor recruitment, budgeting, quality systems, and hospital relations. A sound assessment provides the groundwork and strategy for moving forward. Technical assistance from developed world experts to colleagues in the developing world can be extremely valuable in improving blood availability, safety, and the quality of blood services in the developing world.