BACKGROUND

The Kenya National Blood Transfusion Service (KNBTS) was established in 2000 and functions as a department within the Ministry of Health (MoH). Its mandate is to collect, test, process, and distribute blood and blood products to all transfusing hospitals in Kenya. Over the last few years, the blood supply chain in Kenya has experienced several challenges, including incomplete systems for managing blood supply across the country, outdated policies, and limited access through the supply chain to the commodities required for collecting and testing blood. As part of its work to improve access to blood for transfusion and transplant centres, and the patients who need them, the KNBTS is working with key stakeholders to create a more robust blood supply chain across the country.

ARC’s ROLE

In February 2021, the director of the KNBTS invited the Africa Resource Centre (ARC) to review and develop guidelines and manuals to help improve the effectiveness of the blood supply chain in Kenya. The standards and policies needed to be developed first to direct the guidelines and manuals and inform the other activities and work of the blood service.

ARC’s initial assignment included reviewing the existing documentation governing the blood supply chain, some of which hadn’t been reviewed or updated since 2009. ARC then worked with the KNBTS and significant stakeholders to develop additional standards, manuals and guidelines to address the gaps identified in the existing documentation.

In particular, three important policies were developed: the Kenya Policy on Human Derived Medical Products Donations, Transfusion and Transplant (which the cabinet has endorsed); Blood Transfusion Standards in Kenya, which provide minimum standards for blood services; and standards for setting up blood establishments in Kenya.

Once the initial outlines for the policy and the standards had been created, they were reviewed by key
stakeholders. ARC intentionally used an integrated and participatory approach for the review process as giving space for feedback and input will accelerate the buy-in process once the standards have been finalised. These stakeholders included a range of medical doctor specialities, regulatory bodies, laboratories, and experts in pathology and haematology. Input from faith-based organisations and private hospitals was also sought because they have significant social capital in Kenya and county governments, which are a vital part of the health supply chain in the country.

To obtain final validation, ARC provided technical support in a four-day workshop to validate and finalise the documents. These documents were also submitted to other interested stakeholders in the East Africa region for peer review, including Uganda, Senegal, Ghana, Botswana and Rwanda.

The final stage of the process will be to submit the standards to the Director-General of the MoH and subsequently to the MoH cabinet secretary for gazetting as per the local legal and policy guidelines.

Developing policies and standards can be a lengthy, drawn-out process. However, because of the
inclusive approach supported by ARC, these two high-level blood supply chain policies and standards
were consolidated within a year. The political goodwill from the government and the MoH supporting the process and the support from influential community groups, such as the faith-based organisations and the private hospitals, also helped accelerate the process

OUTCOMES AND IMPACT

ARC’s support to ministries of health focuses on strengthening six supply chain elements. The work with the KNBTS in Kenya will strengthen five of these six areas: strategy, improvement roadmap, governance,
policies and research, and solutions proposals.

SUPPORTING THE KNBTS’ STRATEGIC DIRECTION

Key elements: strategy and improvement roadmap

The process of developing the policies, standards, guidelines, and manuals for the blood supply chain in Kenya will contribute to the KNBTS’ evolution into a semi-autonomous institution that oversees all transition and transplant services in Kenya.

CAPABILITY TRANSFER TO INTERNAL TEAMS

Key element: governance

Many of the meetings during the review process were held with internal stakeholders at the KNBTS and the MoH to ensure they could give input and take ownership of policies. In partnership with Kenyatta National Hospital, ARC also held six learning sessions with key leaders and technical personnel from
the MoH.

KNOWLEDGE SHARING ACROSS AFRICA

Key element: policies and research and solutions proposals

ARC and the KNBTS have intentionally shared the standards with other African countries and welcomed their input. This has expanded the benefit of the policies to the broader African blood supply chain.