Percent of donated blood units screened for HIV in a quality assured manner
The percent of blood units transfused in the last 12 months that have been adequately screened for HIV according to national or WHO guidelines
The indicator requires three pieces of information: the number of blood units transfused in the previous 12 months, the number of blood units screened for HIV in the previous 12 months, and among the units screened, the number screened up to WHO or national standards.
The number of units transfused and the number screened for HIV should be available from health information systems. Quality of screening may be determined from a special study that re-tests a sample of blood previously screened or from an assessment of the conditions under which screening occurred. Where this approach is not feasible, data on the percent of facilities with good screening and transfusion records and no stock outs of test kits may be used to estimate adequately screened blood for this indicator.
This indicator is calculated as:
(Number of blood units transfused in the last 12 months that have been adequately screened for HIV / Total number of blood units transfused) x 100
MEASURE Evaluation blood safety protocol
Blood safety programs aim to ensure that the overwhelming majority (ideally 100 percent) of blood units are screened for HIV, and that those included in the national blood supply are indeed uninfected. This is demonstrably not the case in many countries. Some blood units are not screened at all; others are screened by poorly trained personnel using outdated equipment or insufficient inputs. Moreover, poor blood testing facilities mean that some blood is screened using antibody tests at a time after the donor has become infected with HIV but before the donor has developed antibodies to the virus. Together, these factors mean that a significant proportion of blood units may be classified as safe even though they are infected. This indicator reflects the overall percentage of blood units screened to high enough standards that they can confidently be declared free of HIV.
Where sufficient information exists to construct it, this measure is a strong indicator of the overall safety of the blood supply. However, changes in the indicator could reflect changes in the proportion of blood units screened or changes in the quality of the screening process. The indicator may also reflect a successful campaign to reduce unnecessary transfusions, because the overall number of transfused units would fall and the proportion of those screened to WHO/national standards should rise in consequence. However, the different elements of the indicator should be reported separately for programmatic purposes.
Where health systems are decentralized, or where the private sector is involved in blood screening and blood banking, one may have difficulty obtaining good enough information to construct a robust indicator on a national scale. In this case, selecting sentinel hospitals and laboratories in both the public and the private sector for facility-based surveys of blood transfusion and screening quality will probably be necessary.
policy, management, quality, HIV/AIDS