Guidance on centralization of blood donation testing and processing

Overview

Multiple barriers to the safety and availability of blood components for transfusion were identified in the 2015 Global Database on Blood Safety, many of which derive from weak regulatory oversight, insufficient financing, and fragmentation of the national blood system. Centralization of key functions of the blood service within a limited number of blood establishments, particularly testing and processing of blood donations, can overcome several shortcomings that often exist in decentralized blood systems that are highly fragmented.

Guidance in this area contributes to meeting a strategic objective of the World Health Organization (WHO) Action framework to advance universal access to safe, effective and quality-assured blood products 2020–2023 to promote functioning and efficiently managed blood services.  Supporting access to quality and safe blood and blood components at global level aligns with the objectives of World Health Assembly (WHA) resolution 63.12 (2010) on availability, safety and quality of blood products.

This guidance provides decision-makers, particularly in low- and middle-income countries, a roadmap for consideration of whether to centralize blood donation testing and processing and the steps needed to implement these functions in selected blood establishments.  Centralization of blood donation testing and processing in designated blood establishments (BEs) is one strategy to improve the overall function and efficiency of the national blood system. Practical advice on the creation of such BEs is provided.