Projects


IQM consulting involvement in international projects since 2001.

  1. WHO EMR – Preparation of the regional status report on blood safety and availability 2017 and report on 15-year analysis of trends on blood safety and availability in EMR
    Based on information collected annually through the survey lined to the Global Database on Blood Safety, WHO EMRO published the first regional status report on blood safety and availability 2016. This report was based on 2013 data. The report was produced in collaboration with Iranian Blood Transfusion Organization (IBTO), which is a WHO Collaborating Center for Research and Training on Blood Safety, and a senior international consultant in the field (IQM Consulting). Member States have already submitted 2014 and 2015 data and IBTO has started preparing the report for 2017. In addition, IBTO will also prepare a report on 15-year analysis of trends on blood safety and availability in EMR, also with the help of a senior international consultant (IQM Consulting). This document outlines the Terms of Reference for consultant contract for the above mentioned tasks, starting on 1 December 2018 to 28 February 2019. It became clear that the time frame is too short for the amount of work of the analysis over the years of reporting and executing a trend analysis for the EMR.

    Terms of Reference – Preparation of the regional status report on blood safety and availability 2017 and report on 15-year analysis of trends on blood safety and availability in EMR (2000-2015)

  • Provide guidance to IBTO and WHO EMRO in data entry, analysis and report writing.
  • Prepare manuscripts of the regional status report 2017 and 15-year analysis of trends on blood safety and availability in EMR.
  • Review comments and recommendations from reviewers to finalize the manuscripts.

  1. Mongolia – CSIH/ADB Mongolia Fifth Health Sector Development Project. Component 1 – Blood Safety.
    The final mission during the first week of May to finalize the component 1 of the project, has been completed successfully. The focus was on –
    1) the implementation of the Quality System and its management;
    2) support of the completion of the donor and clinical use part of component 1 (local consultants);
    It is expected that the ISO 9001:2015 audit and accreditation will happen October 2018.
    3) final preparations for international ISO9001:2015 accreditation.
  2. WHO EMR – Strategic Plan and Framework for Action 2016-2025 for Availability and Safety of Blood focused on countries with (protracted) humanitarian emergencies.
  3. WHO EMR – Preparation of the regional status report on blood safety and availability 2017 and report on 15-year analysis of trends on blood safety and availability in EMR
    Based on information collected annually through the survey lined to the Global Database on Blood Safety, WHO EMRO published the first regional status report on blood safety and availability 2016. This report was based on 2013 data. The report was produced in collaboration with Iranian Blood Transfusion Organization (IBTO), which is a WHO Collaborating Center for Research and Training on Blood Safety, and a senior international consultant in the field. Member States have already submitted 2014 and 2015 data and IBTO has started preparing the report for 2017. In addition, IBTO will also prepare a report on 15-year analysis of trends on blood safety and availability in EMR, also with the help of a senior international consultant.This document outlines the Terms of Reference for consultant contract for the above mentioned tasks, starting on 1 December 2018 to 28 February 2019.Terms of Reference -Preparation of the regional status report on blood safety and availability 2017 and report on 15-year analysis of trends on blood safety and availability in EMR

    • Provide guidance to IBTO and WHO EMRO in data entry, analysis and report writing.
    • Prepare manuscripts of the regional status report 2017 and 15-year analysis of trends on blood safety and availability in EMR.
    • Review comments and recommendations from reviewers to finalize the manuscripts.

  1. Mongolia – CSIH/ADB Mongolia Fifth Health Sector Development Project. Component 1 – Blood Safety.
    The mission planned for end May to complete the component 1 of the project, has been completed.
    However, ADB on request of the MoHS, the NCTM and CSIH decided to allow another (seventh) mission which will take place mid-October and will focus on continued support of
    1) the implementation of the Quality System and its management;
    2) a mid-term reporting on the situation (SWOT analysis);
    3) support completion the donor and clinical use part of component 1 (local consultants).
  2. WHO EMR – Strategic Plan and Framework for Action 2016-2025 for Availability and Safety of Blood focused on countries with (protracted) humanitarian emergencies.
    Cairo – Review of existing legislations and regulations in EMR and draft of a model legislation.
  3. GIZ SP-SPH/SBTP Blood Safety Pakistan. Short term project completed in November 2017 on education, quality management, rational use of blood and regulation and inspection. Activities took place in Islamabad, Peshawar, Quetta and Lahore.

  1. Mongolia – CSIH/ADB Mongolia Fifth Health Sector Development Project. Component 1 – Blood Safety.
    There were two missions – April/May and November 2016.
    Continuation of the project implementation focused on implementation of the Quality Management system and preparing for an International accreditation through an ISO 900:2015 audit. The reform of the blood supply structure through a consolidation of 21 small Aimag Blood Centers into 5 somewhat larger supra-Aimag centers for processing was put on hold by the MoHS in Mongolia.
    a) Mid-term evaluation; b) Training on implementation of the Quality and Quality Management System; c) Training of Trainers in Clinical Use of Blood; d) Training course on ISO 9001:2015
  2. WHO EMR – a) Technical support to prepare a Regional Report on Blood Safety in collaboration with IBTO, Iran;
    b) Regional consultation on the Availability and Safety of Bood Transfusion during Humanitarian Emergencies;
    c) Mission to Erbil, Iraq to assess the situation and advise on improvement of the blood supply in Iraq;
    d) Mission to Damascus, Syria to assess the situation and advise on improvement of the blood supply in Syria;
    e) Technical support to finalize the report of the survey on Availability and Safety of Blood Transfusion during Humanitarian Emergencies; literature review, draft final report and preparing a manuscript for publication.

  1. Pakistan – GIZ Health Sector Support Programme, Safe Blood Transfusion (HSSII). Lead Consultant to GIZ for the supervision and guidance of the Safe Blood Transfusion Project.
  2. Mongolia – CSIH/ADB Mongolia Fifth Health Sector Development Project. Component 1 – Blood Safety.
    Continuation of the project implementation focused on a reform of the blood supply structure through a consolidation of 21 small Aimag Blood Centers into 5 somewhat larger supra-Aimag centers for processing. a) Training on documentation and design of the Quality Manual with its four levels of interrelated documents; b) Preparation for a nation-wide KAP-survey to collect data on knowledge and attitudes of the Mongolian population about regular blood donation, to be used to design a medium to long term promotion campaign; c) design of a national clinical guideline, in-hospital documentation system and reporting.

  1. Montenegro – EU IPA funded projectImplementation of a European blood transfusion system in Montenegro’ Components 1 and 2; Project Technical Team Leader and International Expert Consultant on Quality Management.
    The project was completed successfully by May 2014.
  2. Pakistan – GIZ Health Sector Support Programme, ‘Safe Blood Transfusion’ (HSSII). Lead Consultant to GIZ for the supervision and guidance of the Safe Blood Transfusion Project. Evaluation of Phase I and development of a Road Map for Phase II (implementation); Completion of the third Strategic Framework 2014-2020.
  3. Mongolia – CSIH/ADB MongoliaFifth Health Sector Development Project’. Component 1 – Blood Safety. Expert consultant Blood Safety and Quality Management. Work in close cooperation with WHO consulting services and the working group under the MOH on safe blood supply, and:
    – Coordinate activities related to the implementation of quality management         procedures in the NCTM, the four model blood banks, and the aimag and soum blood banks;
    – Conduct monitoring and evaluation (assessment) on operations of blood banks at every level of health care of Mongolia and draw conclusions;-
    Revise and upgrade specialized training program on blood banks for staff;
    – Coordinate and monitor training activities in all project facilities;
    – Assist the NCTM to prepare for international accreditation;
    – Develop the quality management handbook (manual) on introduction of quality management system in the blood sector and monitor, counsel and assist the implementation of quality management procedures in all project blood banks;
    – Conduct mid-term evaluation on implementation of quality management system in organizations of the blood sector, develop recommendations and provide the organizations with recommendations;
    – Counsel and assist with implementation of recommendations from evaluation; and revise and finalize the list of medical equipment for blood banks that will be procured.

Two missions were undertaken in July and October to assess the current situation and start focused training in Quality Management at national level.

  1. Montenegro – EU IPA Project ‘Implementing the European Blood Transfusion System in Montenegro’. Grant agreement CRIS 2010/257260, implemented through WHO EURO Copenhagen.
    Assignment – Team Leader and Expert Consultant for Quality Management.
    Specific objective of the project – To secure sufficient quantities of safe blood and blood products to meet the needs of all patients, in regular and emergency situations, provided as a part of a sustainable and modern blood transfusion programme within the existing health care system in accordance with the EU standards for blood transfusion.
    Actions planned –
    Component 1 – legal and organizational framework
    a. Legal and regulatory framework harmonized with EU requirements and WHO recommendations;
    b. System of VNR blood donation extended;
    c. Quality management established and initiated.
    Component 2 – Capacity building
    d. Staff involved in the blood transfusion service and the clinical site adequately trained according to assessed needs..
    Component 3 – Physical infrastructure
    e. Construction/renovation of appropriate facilities;
    f. Needs assessment and specifications for equipment;
    g. Procurement of equipment and training of staff.The project started April 2012 with a Steering Committee and four local Work Groups, and was extended with one more year as off May 01, 2013.
    Work Group 1 – Legal and Regulatory framework harmonized;
    Work Group 2 – Voluntary Non-remunerated Donations extended;
    Work Group 3 – Quality System and Management;
    Work Group 4 – Human Capacity Building.
    There were 10 monthly mission during which interactive meetings with the Work Groups were organized to initiate the activities and monitor and evaluate the progress made, creating ownership of and commitment to the project.Major achievements over the year 2013 –
    Work Group 1 – Legal framework completed; regulations harmonized (EC 2004/33, 2005/61, 2005/62)
    Work Group 2 – KAP survey completed; Network for VNRBD promotion institutionalized; Communication plan and Public Awareness campaign initiated; International expert consultant assigned.
    Work Group 3 – Quality Manual and documentation system completed; Technical and Quality Standards (bylaws); Haemovigilance Requirements (bylaw); Clinical Use Task Force developed the in-hospital part of the quality system; Steps towards accreditation initiated; Local expert consultants completed respective process descriptions and SOP/EOPs for the primary and supportive processes.
    Work Group 4 – Needs assessment and capacity building framework completed; Occupational standard for medical technicians in blood transfusion completed; Quality Management Training courses completed; Training sessions initiated; Local expert consultants assigned.
  2. USA/HHS/CDC – programme ‘Technical Assistance Support for the Strengthening of Blood Transfusion Services in Selected Countries under the President’s Emergency Plan for AIDS Relief (PEPFAR)’, a 5 years TA effort focused on three Central Asian Republics (CAR) – Kyrgyzstan, Tajikistan and Uzbekistan.
    Assignment – Team Leader
    Team – composed of joint IQM Consulting and HEAPResearch bv expert consultants focused on the technical requirements (see objectives).
    The objectives of the project are –
    Key technical requirement #1: Infrastructure development-to improve the management, organization, and technical capability of the transfusion services;
    Key technical requirement #2:
    Blood collection-increase blood collection from voluntary non-remunerated blood donors from low risk populations & and improve donor counseling, voluntary non-remunerated donors (VNRD);
    Key technical requirement #3: Blood testing and production of components-improve safety by improving blood testing, processing of samples and cold chain management;
    Key technical requirement #4: Quality assurance, including monitoring & evaluation-establish a quality assurance system and introduce a national M & E program;
    Key technical requirement #5: Transfusion and blood utilization-improve clinical use of blood;
    Key technical requirement #6: Training-a cross-cutting issue to achieve the first five technical requirements.The project started February 2013 for Kyrgyzstan and Tajikistan –
    February – Field mission to Kyrgyzstan and Tajikistan.
    Tajikistan decided to discontinue.
    Kyrgyzstan – two day Round Table meeting to define the key priority areas:
    a) national reform [organization and (infra) structure];
    b) voluntary non-remunerated blood donation.
    Assessment of the Republican Blood Center operations and 3 hospitals.
    May – Field mission to Kyrgyzstan to organize the assessment trip and prepare for the development of the in-hospital transfusion chain. One day Round Table with interactive work groups to reach consensus on the strategies for both priority areas, and a consensus meeting on the major clinical problem areas.
    July – Assessment trip through the country, including 6 of the 7 Oblasts;
    The visit locations were selected and prepared in close collaboration with the Republican Blood Center, and comprised –
    1. Oblast Blood Centers: Osh, Batken, Jalal-Abad, Naryn and Issik-Kul (Karakol, serves the Oblast);
    2. Rayon Hospital Transfusion Units: Isfana, Kyzyk-Kya, Kara Kulta, Tash-Kumur, Toktokul, Kochkor, Cholpon-ata, Balykchy, Kara-Balta and Sokuluk.
    3. Rayon Hospital Transfusion Departments: Kemin
    4. Oblast Territorial Hospitals: Osh, Batken, Naryn, Karakol
    5. Rayon Hospitals: Leilek Rayon Territorial Hospital (Isfana), Kyzyl-Kya, Kemin, Kochkor Rayon Territorial Hospital, Issik-Kul Rayon Hospital (Cholpon-ata), Balykchy, Jarzyl Rayon Hospital (Kara-Balta) Solukul
    6. City Hospitals: Tash-Kumur, Toktokul.In Bishkek City, the following hospitals and their Transfusion Departments were visited:
    1. Cardiology and Transplant Institute (operates a TU);
    2. City Haematology Center;
    3. National Center of Oncology;
    4. City Perinatal Center;
    In Osh, the following hospitals and their transfusion departments were visited:
    1. Osh Inter-Oblast Children Hospital;
    2. Inter-Oblast Infectious Disease Hospital (pediatric);
    3. City Territorial Hospital (Maternity);
    4. Osh Inter-Oblast merged Clinical Hospital.
    Where possible and accessible the AIDS Centers and Laboratories (hospital) were visited and their operations on viral Transfusion Transmissible Infection (TTI) markers observed.
    At USA HHS and CDC Atlanta level decisions are being made on the continuation because of further central financial restriction.

Montenegro
EUI PA Project ‘Implementing the European Blood Transfusion System in Montenegro’ Grant agreement CRIS 2010/257260, implemented through WHO EURO Copenhagen.

Assignment
Team Leader and Expert Consultant for Quality Management. Specific objective of the project – To secure sufficient quantities of safe blood and blood products to meet the needs of all patients, in regular and emergency situations, provided as a part of a sustainable and modern blood transfusion programme within the existing health care system in accordance with the EU standards for blood transfusion.

Actions planned

  • Component 1 – legal and organizational framework
    • Legal and regulatory framework harmonized with EU requirements and WHO recommendations;
    • System of VNR blood donation extended;
    • Quality management established and initiated.
  • Component 2 – Capacity building
    • Staff involved in the blood transfusion service and the clinical site adequately trained according to assessed needs.
  • Component 3 – Physical infrastructure
    • Construction/renovation of appropriate facilities;
    • Needs assessment and specifications for equipment;
    • Procurement of equipment and training of staff.

The project started April 2012 with a Steering Committee and four local Work Groups.

  • Work Group 1 – Legal and Regulatory framework harmonized;
  • Work Group 2 – Voluntary Non-remunerated Blood Donations extended;
  • Work Group 3 – Quality System and Management;
  • Work Group 4 – Human Capacity Building.

There were 8 monthly mission during which interactive meetings with the Work Groups were organized to initiate the activities and monitor and evaluate the progress made, creating ownership of and commitment to the project.

Major achievements over the first 9 months:

  • Work Group 1 – gap analysis oh the current legal framework; regulations harmonized (EC 2004/33, 2005/61, 2005/62); rewriting of existing law initiated. Local expert consultant assigned.
  • Work Group 2 – preparations for a KAP survey, network for VNRBD promotion and Public Awareness campaign. International expert consultant assigned.
  • Work Group 3 – Quality Manual framework and documentation system completed. Technical and Quality Standards created and accepted. Haemovigilance Requirements created and accepted. Clinical Use Task Force initiated to develop the in-hospital part of the quality system. Local expert consultants assigned to draft the respective process descriptions and SOP/EOPs for the primary and supportive processes.
  • Work Group 4 – Needs assessment and capacity building framework completed. Occupational standard for medical technicians in blood transfusion completed. International expert consultant assigned.

USA HHS PEPFAR
HHS/CDC–programme ‘TechnicalAssistanceSupportforthe Strengthening of Blood Transfusion Services in Selected Countries under the President’s Emergency Plan for AIDS Relief (PEPFAR)‘, a 5 years TA effort focused on three Central Asian Republics (CAR) – Kyrgyzstan, Tajikistan and Uzbekistan.

Assignment – Team Leader
Team – composed of joint IQM Consulting and HEAPResearch bv expert consultants focused on the technical requirements (see objectives).

May 2012 a proposal for TA provision for the Asian Region, which includes Ukraine, three CARs, Cambodia and Papua New Guinea, was submitted by AIHA, Washington DC. In that project IQM Consulting together with HEAPResearch would provide the TA support for the CARs Kyrgyzstan, Tajikistan and Uzbekistan, with a possible extension to Kazakhstan. The grant was awarded end of August 2012 and the project would start by September 2012. Administrative and budget negotiations caused a delay in the actual start of a first field mission to assess the current situation in each of the countries. This will happen February 2013.

The objectives of the project are:

  • Key technical requirement #1: Infrastructure development-to improve the management, organization, and technical capability of the transfusion services;
  • Key technical requirement #2: Blood collection-increase blood collection from voluntary non-remunerated blood donors from low risk populations & and improve donor counseling, voluntary non-remunerated donors (VNRD);
  • Key technical requirement #3: Blood testing and production of components- improve safety by improving blood testing, processing of samples and cold chain management;
  • Key technical requirement #4: Quality assurance, including monitoring & evaluation-establish a quality assurance system and introduce a national M & E program;
  • Key technical requirement #5: Transfusion and blood utilization-improve clinical use of blood;
  • Key technical requirement #6: Training-a cross-cutting issue to achieve the first five technical requirements.

The project will start for one year and then evaluated for sustainability and continuation into the next years. The work plan for FY01 was discussed in December 2012 in Geneva in a synergetic meeting between CDC Atlanta, WHO HQ Blood Safety Department and AIHA.

Georgia
WB Project Id: P099808; Loan No. 4179-GE – Development of national blood policy and national blood transfusion services (BTS) Plan 2011-2015 in consortium with AIHA, Bethesda, MD, USA started November 2010. The Terms of Reference for this 4 months project are:

  • Conduct a current situation analysis related to the BTS which includes, inter alias, analyses of
    • legislation and regulatory framework of the BTS;
    • characteristics and issues of the current BTS and blood use in Georgia;
    • institutional, monitoring and quality assurance arrangements and capacities.
    • provide recommendation based on the analyses of current situation conducted.
  • Elaborate or develop of national quality system, including standards, guidelines, Standard Operational Procedures (SOP); Provide equipment list required for blood transfusion system in Georgia;
  • Definea National Blood Policy and a five-year Operational Plan for BTS including the National Blood Donation Plan. It should be also define national principals in relation to:
    • Quality systems and initial and ongoing training; (b) The selection of blood donors;
    • Screening for transfusion-transmissible infections; (d) Red cell serology testing;
    • The preparation of blood components and plasma derivatives; (f) The clinical use of blood;
    • Record and information system.
  • Ensure the inclusion of bloodtransfusion services in the national influenza contingency planning body; Particularly, develop a blood transfusion services contingency plan.
  • Ensure that the National Blood Policy and Plan is prepared consistent with internationally accepted requirements of the WHO, FAO and OIE.
  • Assess personnel trainingneed on donated units of blood at the national and regional level; Develop training program and train plans for personnel at the level of national and regional donated units of blood on national quality system, including standards, guidelines, Standard Operational Procedures (SOP).
  • Conduct two workshops on national level to ensure the enhancement oft he BTS involving not less than 50 key stakeholders.

The project was completed in April. As a result the Ministry of Labour, Health and Social Affairs has appointed a focal person. The Georgian CDC was assigned the responsibility to implement the reform recommendations.


Kazakhstan
WB project WB750-770/10, contract # KHSTTIRP-B4/CS-01
Kazakhstan Health Technology Transfer and Institutional Reform Project (KHTTIRP) sub-component B4 Twinning arrangement for Blood Services Reform is being implemented in consortium with HeapResearch BV, the Netherlands. The project has a 28 months length. A first orientation mission was organized to clarify the Terms of Reference, make a feasible work plan and prepare for signing the formal contract with WB In Kazakhstan. The objectives and scope of work are.

Objectives:

  • To create an effective and efficient Blood Transfusion Service in line with international best practices that can provide a sufficient and timely supply of safe blood and blood products to meet the needs of the population
  • To ensure evidence-based, rational and safe use of blood and blood products in routine medical practice as well as during mass emergencies, disasters and conflicts.

Tasks:

  • The twinning agency will provide technical assistance to the MOH and relevant institutions in, inter alia
  • Restructuring Kazakhstan’s current blood transfusion service into a well- organized, nationally coordinated system with a strong legal and regulatory base, in line with international best practices,
  • Developing an effective voluntary blood donor program,
  • Promoting the rational use of blood to reduce unnecessary transfusions and minimize the risks associated with transfusion, the use of alternatives to transfusion (where possible) and safe clinical transfusion procedures.
  • Introducing effective quality systems for blood and blood products, including quality management, the development and implementation of quality standards, effective documentation systems,
  • Capacity building in blood transfusion service and safe blood use for relevant staff (e.g. policy makers, managers, laboratory technicians, clinicians)

Scope of Work:

Under the twinning arrangement, the Consultant is expected to provide services to the MOH, Health Departments of Local Governments, the Blood Transfusion Service, as well as medical academic institutions in the following key areas:

  • To provide technical assistance in restructuring the blood transfusion service and build capacity its capacity:
  • To introduce an internal and external quality improvement system for blood safety with the aim for quality-assured screening of all donated blood for TTIs and to prepare laboratories for accreditation in compliance with international standards and norms.
  • To establish an effective national voluntary non-remunerated blood donor program
  • To promote rational and safe use of blood and blood products.

The expert team met in December to discuss terms of reference and the logistics of the project over the coming 2.25 years. Follow up meetings were held in May, September and November 2011.
Missions were carried out by various team members in March, April, May and June, July, August, September, October and November.


Iraq
The project is a joint WHO-EMRO/EU initiative, conducted from the WHO EMRO Iraq office in Amman, Jordan. A first mission was conducted in June in the North – Erbil and Sulaymania. The present Project for Upgrading and Strengthening Blood Services in Iraq has been developed to focus on the following components:

  • Support to the policy/strategy development and quality assurance system
  • Support to the existing NBTC in the areas of human resources development (training, and capacity building), training of staff on the use and in the maintenance of the newly received equipment, provision of reagent
  • Establishing three to four regional blood services centers (depending on funds available). The priority is as follow (1) Basra, (2) Al Najaf and (3) Ninewah (4) Erbil.
  • Capacity building aimed at strengthening the managerial and operational (functional) capacity of the new centers as well as to increase the ownership of the MOH and the community in close collaboration with the Ministry of Higher Education.

In collaboration with NBTS Iraq and WHO-Iraq the key elements of a national blood program in Iraq were promoted, including the development of a national blood policy and strategic plan consistent with the five year health strategy and plan for Iraq as well as structured blood transfusion service in Iraq in accordance with the current international recommendations and principles of blood transfusion, both for the procurement and for the clinical use (supportive hemotherapy).

To achieve the objective the following activities were carried out – Assessment of the current situation blood supply and clinical use in the Northern part of Iraq.

A consensus workshop was conducted to create awareness and ownership of the key issues (pillars) of the reform of the national blood transfusion program – policy, strategies, legal and regulatory framework, managerial and operational structure and related infrastructure (e.g. finances, human capacity, Quality Management, logistics and communication/ICT, education. Technical Revision of the Blood Transfusion SOPs and Technical Guidelines produced by MOH. A second mission to Baghdad planned for November had to be postponed for security reasons.

USA HHS PEPFAR
HHS/CDC – programme Rapid strengthening of Blood Transfusion Services in selected African and Caribbean countries under the President Bush’s Emergency Plan for AIDS Relief (PEPfAR) TA efforts focused on two African countries – Uganda and Zambia. Emphasis has been on sustainability through further capacity building as well as monitoring and evaluation, and on the development of the clinical interface through a series of clinical seminars spread
over the countries. The project was terminated by the end of March 2010.


Sudan
WHO EMRO – In collaboration with the Sudanese NBTS and WHO review existing quality management program and identify gaps to be addressed to strengthen the program.

  • Assist in the development of a draft national quality policy
  • Develop a plan for quality improvement including development of guidelines, SOPs, recording and reporting system and training in quality management 2010
  • Development of plan for quality improvement 3 weeks

The project was successfully completed – active National Steering Committee, National Sudanese Voluntary Blood Donor Association, draft National Quality Manual and Clinical Guidelines, draft National Blood Request Form.


Uzbekistan
The project focused on Component 3 (Build a Blood Safety Program ) and eventually started late 2009 under Contract # WCH/QCBS/02/06.

The assigned TA task is Blood Quality Management (code 3A1). The overall objective is to provide expertise and guidance in the Quality Assurance of the blood procurement and clinical use processes, and in formalizing an appropriate monitoring and evaluation system to assess the success of the reformed blood transfusion service (vein to vein).

  • Protocols and trainingprogram in Quality Management developed
  • Appropriate monitoring and evaluation systems for compliance with guidelines/protocols are specified and operational;
  • Specified monitoring and evaluation systems for assessment of overall project effectiveness (including cost effectiveness).

Detailed Tasks:

  • To review current progress of WCHD Component 3 (Blood Safety) and review documents and relevant regulations, aiming to develop/enhance blood safety system in Uzbekistan through providing guidance and recommendations on the necessary next steps;
  • To review the draft Decree, which is to be endorsed by the Cabinet of Ministers, regarding development of regional blood centres and structural changes in organization, human resource development and management, financing blood safety system and the development of a voluntary anonymous and regular blood donor system;
  • To conduct a first three two-day seminars on in-hospital quality management of blood transfusion, based on the Module 14 of the WHO QMT course;
  • To assist the Ministry of Health in incorporating estimated budgets and required financing mechanism into the National Blood Safety Policy, with the use of data which were earlier provided by the local financial management consultant based on a WHO recommended criteria;
  • To advocate with there levant authorities, including the Ministry of Finance, for the adoption of the National Blood Safety Policy which includes the budget and the information on required funding sources;
  • To review there habilitation work of the National Blood Transfusion Center, and provide recommendations on suitability and functionality of the National Blood Transfusion Center for its future operations.
  • To prepare for the pilot implementation of thetransition of hospital based blood banks into the Tashkent City and Oblast Regional Center operations.

During the year three missions were completed. By the end of the year ADB had decided to extend the project for another xx months into 2011.


Georgia
WB Project Id: P099808; Loan No. 4179-GE Development of national blood policy and national blood transfusion services (BTS) Plan 2011-2015 in consortium with AIHA, Bethesda, MD, USA started November 2010.

The Terms of Reference for this 4 months project are:

  • Conduct a current situation analysis related to the BTS which includes, inter alias, analyses of
    1. legislation and regulatory framework of the BTS;
    2. characteristics and issues of the current BTS and blood use in Georgia;
    3. institutional, monitoring and quality assurance arrangements and capacities.
    4. provide recommendation based on the analyses of current situation conducted.
  • Elaborate or develop of national quality system, including standards, guidelines, Standard Operational Procedures (SOP); Provide equipment list required for blood transfusion system in Georgia;
  • Define a National Blood Policy and a five-year Operational Plan for BTS including the National Blood Donation Plan.. It should be also define national principals in relation to:
    1. Quality systems and initial and ongoing training; (i) The selection of blood donors;
    2. Screening for transfusion-transmissible infections; (k) Red cell serology testing;
    3. The preparation of blood components and plasma derivatives; (m)The clinical use of blood;
    4. Record and information system. The Policy should:
      • be in line with the universal principles of blood safety as recommended by WHO;
      • be short, focused, easily readable and understandable by decision makers and stakeholders;
      • reflect the country’s specific situation;
      • present the evidence, define the key results, and identify – at a general level – the key interventions (the Policy should not go into details of the activities, which rather belong in operational plan);
      • specify agreed results to be achieved, with appropriate indicators and arrangements for monitoring program effectiveness and efficiency. This should include both program indicators and other indicators that relate to improved management of financial and human resources;
      • specify institutional arrangements to implement the Policy;
      • and identify changes in regulatory and legal frameworks that might be needed. The five-year Operational Plan should
      • clearly link activities to measurable results identified in the Policy;
      • specify roles and responsibilities of key actors;
      • provide clear outputs and expected outcomes;
      • include capacity building, technical support and M&E activities;
      • indicate accountabilities and responsibilities;
      • be prioritized;
      • be fully costed;
      • identify the activities for which funding is already available, and how much.
  • Ensure the inclusion of blood transfusion services in the national influenza contingency planning body; Particularly, develop a blood transfusion services contingency plan, which is reviewed constantly, regarding:
    1. Risk of transmission of influenza by blood transfusion;
    2. Temporary loss of blood donors resulting in a reduced supply of donated
      units of blood
    3. Temporary loss of staff
    4. Change in the clinical demand for blood and blood product
    5. Change in the equipment demand for blood transfusion system.
  • Ensure that the National Blood Policy and Plan is prepared consistent with internationally accepted requirements of the WHO, FAO and OIE.
  • Assess personnel training need on donated units of blood at the national and regional level; Develop training program and train plans for personnel at the level of national and regional donated units of blood on national quality system, including standards, guidelines, Standard Operational Procedures (SOP).
  • Conduct two workshops on national level to ensure the enhancement of the BTS involving not less than 50 key stakeholders.

A first mission was completed in November.


Kazakhstan
WB project WB750-770/10, contract # KHSTTIRP-B4/CS-01
Kazakhstan Health Technology Transfer and Institutional Reform Project (KHTTIRP) sub-component B4 Twinning arrangement for Blood Services Reform is being implemented in consortium with HeapResearch BV, the Netherlands. The project has a 28 months length. A first orientation mission was organized to clarify the Terms of Reference, make a feasible work plan and prepare for signing the formal contract with WB In Kazakhstan. The objectives and scope of work are.

Objectives:

  • To create an effective and efficient Blood Transfusion Service in line with international best practices that can provide a sufficient and timely supply of safe blood and blood products to meet the needs of the population
  • To ensure evidence-based, rational and safe use of blood and blood products in routine medical practice as well as during mass emergencies, disasters and conflicts.

Tasks:
The twinning agency will provide technical assistance to the MOH and relevant institutions in, inter alia

  • Restructuring Kazakhstan’s current blood transfusion service into a well- organized, nationally coordinated system with a strong legal and regulatory base, in line with international best practices,
  • Developing an effectiv evoluntary blood donor program,
  • Promoting the rational use of blood to reduce unnecessary transfusions and minimize the risks associated with transfusion, the use of alternatives to transfusion (where possible) and safe clinical transfusion procedures.
  • Introducing effective quality systems for blood and blood products, including quality management, the development and implementation of quality standards, effective documentation systems,
  • Capacity building in blood transfusion service and safe blood use for relevant staff (e.g. policy makers, managers, laboratory technicians, clinicians)

Scope of Work:
Under the twinning arrangement, the Consultant is expected to provide services to the MOH, Health Departments of Local Governments, the Blood Transfusion Service, as well as medical academic institutions in the following key areas:

  • To provide technical assistance in restructuring the blood transfusion service and build capacity its capacity:
  • To introduce an internal and external quality improvement system for blood safety with the aim for quality-assured screening of all donated blood for TTIs and to prepare laboratories for accreditation in compliance with international standards and norms.
  • To establish an effective national voluntary non-remunerated blood donor program
  • To promote rational and safe use of blood and blood products.

The expert team met in December to discuss terms of reference and the logistics of the project over the coming 2.25 years.

USA
HHS/CDC – programme Rapid strengthening of Blood Transfusion Services in selected African and Caribbean countries under the President Bush’s Emergency Plan for AIDS Relief (PEPfAR) TA efforts focused on two African countries Uganda and Zambia. Emphasis has been on sustainability through capacity building as well as monitoring and evaluation, and on the development of the clinical interface through a series of clinical seminars spread over the countries. Overall progress achieved in the respective countries by the end of 2009.


Sudan
WHO EMRO – In collaboration with the Sudanese NBTS and WHO review
existing quality management program and identify gaps to be addressed to strengthen the program. Assist in the development of a draft national quality policy and develop a plan for quality improvement including development of guidelines, SOPs, recording and reporting system and training in quality management.
A time line over 2009 and 2010 was agreed.

  • 2009: Review of existing quality management program and development of national quality policy
  • 2010: Development of plan for quality improvement

USA HSS PEPFAR
HHS/CDC – programme Rapid strengthening of Blood Transfusion Services in selected African and Caribbean countries under the President Bush’s Emergency Plan for AIDS Relief (PEPfAR) TA efforts focused on two African countries – Uganda and Zambia. Emphasis has been on sustainability through capacity building as well as monitoring and evaluation.

Overall progress achieved in the respective countries by the end of 2008.

USA HHS PEPFAR
HHS/CDC – The January 2004 submitted project application for the USA HHHS/CDC programme Rapid strengthening of Blood Transfusion Services in selected African and Caribbean countries under the President Bush’s Emergency Plan for AIDS Relief (PEPfAR) was awarded in July 2004.
In 2007 the TA efforts focused on two African countries –Uganda and Zambia. The second fiscal year (FY02) ended March 31, 2007 and the third fiscal year was started that will end by March 31 2008.
Overall progress achieved in the respective countries since the start of the project.


Uzbekistan
The project under the overall title Woman and Child Health
Development Project is supported by ADB. Component 3 will provide technical assistance aimed at rendering assistance to the Ministry of Health in the following three sub-components:

  • Establishing a National Level Comprehensive Blood Safety Program. 2.
  • Restructuring the regional Blood (Transfusion) Supply System
  • Encouraging Voluntary Blood Donors.

ADB launched a call for proposals to implement the project. Sofreco from France applied jointly with SCS, where the SCS input will focus on the quality system and quality management system implementation.

In anticipation of the project to be awarded working visits in September and November were carried out against the following objective – a comprehensive assessment and analysis of current status of blood service system in Uzbekistan.

This visit resulted in a National Consensus meeting chaired by the Deputy Minister of Health responsible for Blood Transfusion. The outcome now functions as the political guideline for the planned Reform of the blood supply in the country.

In November the Uzbekistan Ministry of Health requested also to include a baseline consultation on the public awareness and donor problems in the country. Therefore Mr. A.P.M. Los, medical sociologist and donor management expert, was advised to accompany and start the creation of a public awareness policy and related strategies in Uzbekistan. The Objective was to make a comprehensive assessment and Knowledge, Attitude, and Practice (KAP) analysis of current status of blood donorship in Uzbekistan. Based on the baseline KAP analysis, the consultant will make recommendations: (i) to develop a policy and strategy to promote voluntary and non-remunerated blood donation, and (ii) to develop a plan of activities to promote and sustain voluntary and non- remunerated blood donation involving all relevant parties.


Afghanistan
The joint collaborative project (EPOS,Germany) in Afghanistan, financed by the Agence Française de Developpement (AFD) was launched. The project focuses on the rehabilitation of the National Blood Transfusion System and Laboratories in Kabul. SCS contributes with a back stop operation and not necessarily needs to be present in Afghanistan.


Bangladesh
Ministry of Health and Family Welfare(MoHFW), and WorldBank (WB) requested a review consultation with the following objectives – to support the HAPP Supervision Mission in October 2007 by review of the national safe blood transfusion programme.

Because of the short notice and unavailability of time to commit to the request, Dr. Peter Campbell was asked to stand in, which he did in good communication and with applaudable success.

Uzbekistan
The project is supported by ADB under the overall title ‘Woman and Child Health Development Project’. Component 3 will provide technical assistance aimed at rendering assistance to the Ministry of Health in the following three sub- components:

  • Establishing a National Level Comprehensive Blood Safety Program.
  • Restructuring the regional Blood (Transfusion) Supply System
  • Encouraging Voluntary Blood Donors.

USA HHS PEPFAR
HHS/CDC – programme Rapid Strengthening of Blood Transfusion Services in selected African and Caribbean countries under the President Bush’s Emergency Plan for AIDS Relief (PEPfAR). The efforts were focused on the TA support of two countries: Uganda and Zambia. Overall progress achieved in the respective countries since the start of the project.


Cyprus
EU Twinning Light project nr CY/2003/IB/OT/02
TLwassuccessfully completed after the agreed period. Partner for this project was NSPOH, Amsterdam and the Dutch Ministry of Health, Welfare and Sport.

The prime objectives were:

  • To safeguard the safety, quality and adequacy of blood and blood components in compliance with the acquis communautaire.
  • To introduce a new organisational structure with a clear role definition of its various components so that a new National Blood Establishment is created to undertake, in an efficient and secure way, all aspects of blood transfusion in Cyprus including collection, processing, testing, storage and distribution of blood and blood components in compliance with the EU acquis.

Contribution focused on guidance and advice, transfer of knowledge, training and evaluation. The missions in 2006 contributed to the two major objectives being:

  1. The development of a National Blood Establishment – defining the role of the various components; the legal framework; the organizational, departmental and operational structure; logistical and communication structures; levels of personnel and JDs and a study visit.
  2. Development and upgrading of the hospital BTSs – advice on ICT for labeling, monitoring and traceability; advice on successful retention and motivation of donors; blood stock, clinical use and hemovigilance; effective blood distribution; flow charts for allocation of tasks and working areas; specifications of equipment; parameters for safety and hygiene; development of a quality system.

USA HSS PEPFAR
HHS/CDC – January 2004 a project application for the USA HHS-CDC programme Rapid Strengthening of Blood Transfusion Services in selected African and Caribbean countries under the President Bush’s Emergency Plan for AIDS Relief (PEPfAR).
The application focuses on four African countries – Uganda, Rwanda, Tanzania and Zambia. July 2004 the application was awarded conform the narrative under the cooperative agreement nr U62/CCU024045-01. During the calendar year 2005 the provision of technical advice to Tanzania was unexpectedly and unilaterally terminated, leaving SCS with the continuing support of three countries – Rwanda, Uganda and Zambia.


Estonia
Senter Matra/EVD Pre-accession project on Development of the Capacity of the Estonian Blood Centres (MAT02/ES/9/1). The project is managed by HeapResearch bv (Dr. Frans van Andel) and will last for 2 years.

The objectives are:

  • A uniform management and quality management system for the blood centres of Tallinn, Pärnu and Tartu;
  • An efficient and uniform information system for the blood supply (blood centres-blood centres and blood centres-hospitals);
  • An improved information supply to the public and donors about relevant elements in the quality system of the blood supply, in line with EU recommendation 98/463.

The project was terminated by the end March 2005.


Cyprus
EU Twinning Light project nr CY/2003/IB/OT/02-TL started in September
and will last for a period of 6 months. The project is done jointly with NSPOH, Amsterdam and the Dutch Ministry of Health, Welfare and Sport.

The prime objectives are:

  • To safeguard the safety, quality and adequacy of blood and blood components in compliance with the acquis communautaire.
  • To introduce a new organisational structure with a clear role definition of its various components so that a new National Blood Establishment is created to undertake, in an efficient and secure way, all aspects of blood transfusion in Cyprus including collection, processing, testing, storage and distribution of blood and blood components in compliance with the EU acquis. Contribution focused on guidance and advice, transfer of knowledge, training and evaluation.

The missions in 2005 contributed to the two major objectives being

  1. The development of a National Blood Establishment – defining the role of the various components; the legal framework; the organizational, departmental and operational structure; logistical and communication structures; levels of personnel and JDs and a study visit.
  2. Development and upgrading of the hospital BTSs – advice on ICT for labelling, monitoring and traceability; advice on successful retention and motivation of donors; blood stock, clinical use and haemovigilance; effective blood distribution; flow charts for allocation of tasks and working areas; specifications of equipment; parameters for safety and hygiene; development of a quality system.

Estonia
Senter Matra/EVD Pre-accession project on Development of the Capacity of the Estonian Blood Centres (MAT02/ES/9/1).
The project is managed by HeapResearch bv (Dr. Frans van Andel) and will last for 2 years.

Objectives:

  • A uniform management and quality management system for the blood centres of Tallinn, Pärnu and Tartu;
  • An efficient and uniform information system for the blood supply (blood centres-blood centres and blood centres-hospitals);
  • An improved information supply to the public and donors about relevant elements in the quality system of the blood supply, in line with EU recommendation 98/463.

Cyprus
EU Leonardo da Vinci vocational project as a partner of Cyprus (CY/2002/EX-133219).
Exit seminar on Quality Management, EU Directive 2002/98 and Haemovigilance


USA HSS PEPFAR
A project application for the USA HHS-CDC programme Rapid Strengthening of Blood Transfusion Services in selected African and Caribbean countries under the President Bush’s Emergency Plan for AIDS Relief. The application focuses on four African countries – Uganda, Rwanda, Tanzania and Zambia. (HHS/CDC – January 2004)


Portugal (AABB Consulting Service)
Consultation of the PortuguesemBlood institute including Lisbon,Oporto and Coimbra.

Terms of Reference:

  • to explore the progress made as a result of the pilot assessment and report of September 2002;
  • to advice that all necessary processes and procedures in place are in compliance with AABB Standards for Blood Banks and Transfusion Services and requirements in preparation for a formal AABB audit;
  • to train appropriate staff for – Good Manufacturing Practices (specific to blood banking) – AABB Standards – Self Assessment Process
  • to assist PBI in identifying documentation to be developed, and assist in identifying a suitable format, milestones and timelines. An integral aspect of the consulting service will be the on-going guidance and assistance through-out the period of preparation for Audit A final consultation was done in June to prepare PBI for self-assessment and application for audit and accreditation. Terms of Reference were:
  • to explore the progress made as a result of the 2002 pilot audit and the 2003 consultation and educational workshops;
  • to perform an additional assessment (SWOT analysis) of the organisation with an emphasis on the operational functions of the three PBI Blood Banks in Lisbon, Oporto and Coimbra;
  • to advice that all necessary processes and procedures in place are in compliance with AABB Standards for Blood Banks and Transfusion Services and EU requirements1, in particular the observed gaps;
  • to educate and inform appropriate staff for:
    • details of European Community Standards and Specifications relating to a Quality System for Blood Establishments
    • Good Manufacturing Practices (specific to blood banking)
    • self assessment process
  • to assist PBI in identifying documentation to be developed, and assist in identifying a suitable format, milestones and timelines. An integral aspect of the consulting service will be the on-going guidance and assistance through-out the period of preparation for audit.

Singapore
(AABB Consulting Service) – consultation and pilot assessment of the Centre for Transfusion Medicine of the Health Sciences Authority.

Terms of Reference:

  • to study the range of services, processes and procedures of CTM with the purpose of establishing the level of compliance with respect to the AABB Blood Bank and Transfusion Service standards and requirements;
  • to identify gaps and set work plans and measures to bridge the gaps from existing level of compliance to that which would comply with AABB Standards for Blood Banks and Transfusion Services;
  • to provide advice on all necessary processes and procedures which need to be in place for compliance with AABB Standards for Blood Banks and Transfusion Services and related requirements;
  • to advise CTM in preparations for a formal AABB audit and accreditation.

The CTM was guided into self-assessment and application for audit and
accreditation


Singapore
(AABB Consulting Service) – consultation of CordLife.

Terms of Reference:

  • to explore the progress made as a result of the pilot audit and report of May 2002;
  • to advice that all necessary processes and procedures in place are in compliance with AABB Cord Blood Services standards and requirements in preparation for a formal AABB;
  • to train appropriate staff for
    • details of Quality System Essentials and Management
    • Good Manufacturing Practices (specific to cord blood Banking) – AABB Standards
    • Self Assessment Process
  • to assist CordLife in identifying documentation to be developed, and assist in identifying a suitable format, milestones and timelines. An integral aspect of the consulting service will be the on-going guidance and assistance through-out the period of preparation for Audit

Unfortunately the project came to a hold due to a change in priorities within CordLife.

Slovenia
Senter Matra pre-accession project Establishing Quality Assurance in the Centres for Blood Supply in Slovenia (MAT00/SL/9/1).


Estonia
Senter Matra Pre-accession projecton Development of the Capacity of the Estonian Blood Centres (MAT02/ES/9/1).
The project is managed by HeapResearch bv (Dr. Frans van Andel) and will last for 2 years.

Objectives:

  • A uniform management and quality management system for the blood centres of Tallinn, Pärnu and Tartu;
  • Anefficientanduniforminformationsystemforthebloodsupply(blood centres-blood centres and blood centres-hospitals);
  • An improved information supply to the public and donors about relevant elements in the quality system of the blood supply, in line with EU recommendation 98/463.

Cyprus
EU Leonardo da Vinci vocational project as a partner of Cyprus (CY/2002/EX-133219).

EU Leonardo da Vinci vocational project
As a Partner of Cyprus.
The project was granted and will be executed in 2003 (CY/2002/EX-133219).


Senter Matra Pre-accession project
On Development of the Capacity of the Estonian Blood Centres.
The project was granted and will start by January 2003 (MAT02/ES/9/1).

Slovenia
Senter Matra pre-accession project Establishing Quality Assurance in the Centres for Blood Supply in Slovenia (MAT00/SL/9/1).


Portugal
AABB project developing standards, quality system and management in the Portuguese Blood Institute with the objective to prepare for audit and accreditation.


Singapore
AABB project developing standards, quality system and management in the Health Sciences Authorities Centre for Transfusion Medicine to prepare for audit and accreditation.


Singapore
AABB project developing standards, quality system and management in CordLife Ltd Pta to prepare for audit and accreditation.

[/1-2-kolom]

Region country sponsor
Central Asia (CAR) Kyrgyzstan HSS PEPFAR
Tajikistan HSS PEPFAR
Kazakhstan WB
Uzbekistan ADB / HSS PEPfAR
Eastern Mediterranean  

Afghanistan

 

WHO EMRO

Jordan WHO EMRO
Pakistan GIZ
Syria WHO EMRO
Sudan WHO EMRO
Europe Belarus WHO EURO
Croatia EU IPA
Cyprus EU Twinning
Estonia NL MATRA
Georgia WB
Montenegro EU IPA
Portugal AABB CSD
Romania EU PHARE
Slovenia NL MATRA
South East Asia Bangladesh WB
India WHO/WFH
Indonesia ICBS
Singapore AABB CSD
Sub Sahara Africa Rwanda HHS PEPFAR
Tanzania HHS PEPFAR
Uganda HHS PEPFAR
Zambia HHS PEPFAR
Western Pacific Mongolia ADB