Nyashadzaishe Mafirakureva1,2, Herbert Nyoni3, Sisodwa Z Nkomo2, Jeffrey S Jacob4, Radhi Chikwereti2, Zamile Musekiwa2, Star Khoza5, David A Mvere2, Jean C Emmanuel2, Maarten J Postma1,6,7, Marinus van Hulst1,8. 1. Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, Groningen, the Netherlands. 2. National Blood Service Zimbabwe. 3. School of Pharmacy. 4. New York Blood Center, New York, New York. 5. Department of Clinical Pharmacology, University of Zimbabwe, Harare, Zimbabwe. 6. Institute of Science in Healthy Aging & healthCare (SHARE). 7. Department of Epidemiology, University Medical Center Groningen (UMCG). 8. Department of Clinical Pharmacy and Toxicology, Martini Hospital, Groningen, the Netherlands.
Abstract
BACKGROUND: There is lack of published data on the costs of blood and blood transfusion in sub-Saharan Africa. This study aimed to assess the unit costs of producing blood in Zimbabwe using an activity-based costing (ABC) method. STUDY DESIGN AND METHODS: A management accounting approach, based on the ABC method, was used to develop a cost model for blood. The production of blood was broken down into recruitment, collection, testing, processing, and storage plus distribution. Data for the year 2013 were collected retrospectively from budgets, financial and expenditure reports, databases, and interviews with transfusion personnel and managers. All direct and indirect costs, in 2013 US$, were allocated, accordingly, to the activities of blood acquisition. RESULTS: The total cost of producing safe blood in Zimbabwe for the year 2013 was US$8.6 million. Variable costs accounted for 51.2% of the total cost of production. The unit production costs for red blood cells (RBCs) were US$15.94 for recruitment, US$34.62 for collection, US$17.88 for testing, US$11.49 for processing, and US$3.06 for storage plus distribution. The overall cost of production of one unit of whole blood was US$118.42 and RBCs was US$130.94 constituting 12.4 and 13.7% of the country's annual GDP per capita. CONCLUSIONS: The high unit cost of producing blood relative to the annual GDP per capita demonstrates that acquiring safe blood is a burden on the health care sector in Zimbabwe. Introducing additional safety measures, such as nucleic acid amplification testing and pathogen reduction technology, although desirable, will further increase this burden.
BACKGROUND: There is lack of published data on the costs of blood and blood transfusion in sub-Saharan Africa. This study aimed to assess the unit costs of producing blood in Zimbabwe using an activity-based costing (ABC) method. STUDY DESIGN AND METHODS: A management accounting approach, based on the ABC method, was used to develop a cost model for blood. The production of blood was broken down into recruitment, collection, testing, processing, and storage plus distribution. Data for the year 2013 were collected retrospectively from budgets, financial and expenditure reports, databases, and interviews with transfusion personnel and managers. All direct and indirect costs, in 2013 US$, were allocated, accordingly, to the activities of blood acquisition. RESULTS: The total cost of producing safe blood in Zimbabwe for the year 2013 was US$8.6 million. Variable costs accounted for 51.2% of the total cost of production. The unit production costs for red blood cells (RBCs) were US$15.94 for recruitment, US$34.62 for collection, US$17.88 for testing, US$11.49 for processing, and US$3.06 for storage plus distribution. The overall cost of production of one unit of whole blood was US$118.42 and RBCs was US$130.94 constituting 12.4 and 13.7% of the country's annual GDP per capita. CONCLUSIONS: The high unit cost of producing blood relative to the annual GDP per capita demonstrates that acquiring safe blood is a burden on the health care sector in Zimbabwe. Introducing additional safety measures, such as nucleic acid amplification testing and pathogen reduction technology, although desirable, will further increase this burden.
Authors: Elizabeth C George; Sophie Uyoga; Bridon M'baya; Dorothy Kyeyune Byabazair; Sarah Kiguli; Peter Olupot-Olupot; Robert O Opoka; George Chagaluka; Florence Alaroker; Thomas N Williams; Imelda Bates; Dora Mbanya; Diana M Gibb; A Sarah Walker; Kathryn Maitland Journal: Lancet Glob Health Date: 2022-03 Impact factor: 38.927