Technical Assistance at four Cameroon Hospital Blood Banks Annual report of implementation of a Quality Management System using AfSBT Standards as a framework March 2017

After a Blood Safety Assessment and a GAP analysis of five blood services in Cameroon during 2013 the SBFA started to support four Hospital Blood Banks (HBB) in Cameroon in a Technical Assistance process towards Africa Society for Blood Transfusion (AfSBT) Step-wise Accreditation.

The system is based on an initial self-assessment as a critical step in preparation for certification and the SBFA was requested to conduct a third party assessment of four selected HBBs using the AfSBT Self-Assessment tool.  This tool encompasses eleven sections covering the AfSBT Standards of which nine sections are relevant to the current operations in the Cameroon HBBs.  The assessments were conducted in February 2016 and based on the results of these assessments.  The Safe Blood for Africa Foundation started a mentorship programme in July 2016 to assist the HBBs to meet the requirements of the World Health Organization (WHO) for Blood Safety and the Standards of AfSBT Stepwise Accreditation Programme focusing on Step 1 Certification.  For the mentorship programme the five mentors appointed in Cameroon were selected based on their education and professional experience in Blood Safety, Quality Management Systems (QMS) and mentorship.  They were trained for two days on principles of mentorship and AfSBT standards prior to their posting to the four designated hospitals.  Mentorship support and side-by-side practical demonstrations are essential to ensure progress towards AfSBT accreditation and refinement of the knowledge, skills and competency acquired during the previous training conducted in the Hospital Blood Banks since 2012.  The SBFA mentorship programme is a one-year programme, renewable depending on availability of funds after March 2017.  Trimester reports have been prepared and shared with stakeholders.  A follow-up assessment was conducted in February 2017 (one year later) to measure progresses made by the four facilities.

Huge efforts have been made by all four facilities supported by the Hospital Directors, Head of Blood Banks and all the Blood Service staff.  The Minister of Public Health personally encourages implementation of quality systems in blood services by providing official authorization to SBFA and by visiting the facilities.  Great improvements have been noticed in the organization of the service with appointment of Quality Managers, development of quality documents, refining of work environment, etc.  Significant changes are also noticed in blood donor recruitment and management, blood donation screening, processing and storage and staff training.  From February 2016 to February 2017 the level of compliance with standards for AfSBT Step 1 certification increased on average from 30% (range 17 to 25%) to 57% (range 41 to 70%) at the four blood banks, Bamenda Regional HBB, Buea Regional HBB, Douala Laquintinie HBB and Yaoundé Central HBB.

Despite these achievements and progress, challenges are still numerous for a full implementation of a sustainable Quality System.  Staff at all four sites will require further Technical Assistance, mentoring and training so they better understand the principles of evidence-based self-improvement and the importance of a functioning Quality Management System that supports on-going accreditation and self-improvement.  Advocacy is essential to maintain the commitment and engagement of Hospitals Directors and the MoPH through the National Blood Transfusion Programme.

Planning the assessment visit with the Director and Head of the Blood Bank at Yaoundé Central Hospital	Observing the preparation of a mobile blood drive in the Central Market in Yaoundé
Correctly labelled equipment awaiting repair at Douala Laquintinie Blood Bank	Screened blood in Bamenda
Discussions on corrective actions for improvements at Buea Regional Hospital Blood Bank	Safe Blood and reagents are correctly stored and labelled at all faculties after successful mentoring a Technical Assistance
Where rapid tests are used these are done to a standard SOP and in a Quality Assured manner at all facilities after mentoring	Blood inventory is checked regularly at all facilities after implementation of AfSBT standards