Hospital-based Clinical Transfusion Process Audit and Quality Improvement in Africa: A Critical Review

Abstract

Background: Clinical transfusion process (CTP) in Africa is an age long practice yearning for scientifically sound, evidence-based findings to address existent challenges of quality. Objective: To review relevant aspects of hospital-based transfusion practices in Africa wherein practices were assessed against standards (audit) and its impacts weighted on quality improvement. We also sought to identify challenges to auditing and proffered strategies for practice improvement where necessary. Methodology: A systemic review of literature searched on MEDLINE, Google, other internet sources using related search words as well as hand searches of review articles and files. Results: Audit reports on hospital-based transfusion process in Africa are generally few when compared to the multiple steps and procedures involved, wide geographical spread and heterogeneity of the continent. Prevailing practice challenges includes unstructured transfusion services with paucity of voluntary non-remunerated blood donors, absence of many guidelines, low funding and commitment for effective oversights and paucity of trained audit personnel. Conclusion: Quality in hospital-based CTP in Africa can continuously improve if all stakeholders evaluate their performances against acceptable standards and provide evidence-based facts that can be deployed in correcting inadequacies existing therein and in advancing transfusion therapy as obtainable in other climes. A functional and well supported structured transfusion service in all African nations that will nurture more transfusion-based researches for guideline development is advocated. Also, increased funding, legislation and general oversights by central governments as well as synergetic continental, regional and group cooperation by hospitals in proximate locations will offer opportunities for manpower development, knowledge transfer and effective inventory management desirable for promoting hospital-based CTP audit practices in Africa.