b3 nepal project

Betterment of Blood Bank (B3) in Nepal

Dear Readers,

We are pleased to release the inaugural

issue of „‟B3 Nepal project Newsletter‟‟.

B3 Nepal project stands for Betterment

of Blood Bank in Nepal recently

initiated by a group of Nepalese

diaspora, currently residing in different

countries in association with international

collaborators and Central Blood

transfusion service (CBTS), Nepal. More

on project is inside the newsletter. This

newsletter will be released every three

months and is aimed at sharing update

on development of the project and future

plans as the project moves on.

While the articles in the newsletter are

not peer reviewed, they undergo editorial

review and quality-control to ensure

dissemination of relevant and informative

articles.

We are confident that the newsletter will,

to a certain extent, contribute to share

the idea of the project and keep the

readers updated with the project. With

that objective, we welcome any

comments from the readers for our future

issues.

Volume 1, Issue 1

Newsletter

July, 2017

Message from the editor N E W S LE T TE R T E AM :

B3 Nepal Project a quarterly newsletter

Editors:

Ashwini Kumar Nepal

Dr. Roshan L. Shrestha

I NS I DE T H I S I S S U E :

Editorial………………………………………………………………………………………1

Betterment of blood bank (B3), a brief overview.……………………………..…...2-3

Fact finding workshop- a report……………………………………..………………..4-6

Steering committee members of B3 project………………………………….......7-10

Future plan………………………………………………………………………………....11

News and views…..……………………………………………………………………….12

This issue contains an overview of the

project, Betterment of blood bank (B3)

in Nepal. This issue also contains a

report on the first phase of the project,

under the chapter- Fact finding report.

Since this is the first issue of the

newsletter, we have introduced the

steering committee members of the

project. Finally, we have included the

future plans of the project and we

heartily welcome any suggestions or

comments. Some of the photographs

of our recent activities can be found at

the end of this newsletter.

FIND US ON

Facebook:

https://www.facebook.

com/bloodstudy/

Mailing detail: [email protected]

‘’Promoting safe and sustainable blood transfusion system in Nepal’’

It is a technical development program for quality system development in Central

Blood Transfusion Service (CBTS), Nepal, initiated by NRNA in technical

collaboration with Sanquin Consulting Service, the Netherlands.

Blood Transfusion Service (BTS) is one of the priority programs of the Government of

Nepal (GoN). The Nepal Red Cross Society (NRCS) started providing the institution‐based BTS through the Department of Pathology at Bir Hospital in 1964 and the first BTS was established as Laxmi Blood Bank in 1966. In recognition of the pioneering and long service of NRCS, in 1992 His Majesty’s Government of Nepal (HMG/N) mandated NRCS as the sole agency to conduct the blood programs in Nepal. A national policy on BTS was then developed and approved by HMG/N through a cabinet decision in 1993.

During the initial years, BTS in Nepal was available only in Kathmandu but over the years, it has been expanded to 105 BTS Centers (BTSC) in 73 of the 75 districts of the country. Out of these 105 centers, one is functioning as NRCS Central BTS Centre (CBTSC). At present, BTS is being regulated by Central Blood Transfusion Service (CBTS) under Nepal Red Cross Society. Ministry of health (MoH) has established a regulated body, NBBTS, under National Public Health Laboratory (NPHL).

The supply of safe and adequate blood and blood products has remained one of the main goals of the National Blood program. However, several limitations exist within the CBTS to reach the goal in satisfactory levels. Among many, the major limitations are the lack of technical expertise and the state-of-art facility in preparation of blood products required for any sort of demand. Additionally, in current situation the CBTS also lacks the availability of latest screening assays for supply of safe and quality blood or blood products. With the objective to uplift the standards of BTS in Nepal, NRNA SKI teamed up with a few Nepalese professionals working in different parts of the world. The team aims to develop and establish a strategy for promoting safe and sustainable blood transfusion system in Nepal. The team has technical collaboration with Sanquin Blood Supply Foundation, The Netherlands who technical expertise will be used for this project.

Aims and Objectives:

The objectives are planned to meet in different phases.

Support for strategic planning and capacity building for the basic necessity of CBTS Nepal to develop: “Centrally Coordinated Blood Transfusion Service with the guarantee of Minimum Standard Quality Overall the Country”, with the intellectual and technical support from Sanquin Blood Supply Foundation,

The Netherlands.

Betterment of blood bank (B3), a brief review:

Blood Transfusion Service (BTS) is one of the priority programs of the government of Nepal

B3 Nepal project Newsletter

During the initial

years, BTS in Nepal

was available only in

Kathmandu but over

the years, it has been

expanded to 109 BTS

Centres (BTSC) in 73

of the 75 districts of the

country

B3 Nepal project Newsletter:

Review the existing status of blood centers in Nepal in terms of infrastructural facilities, human resources, managerial and technical aspects.

Conducting research with the help of trained staff under Sanquin - CBTS training program to Identify gaps between current practices and WHO recommended standards. Apply the uniform methods for gradual improvements in the system.

Support in the development of donor screening and diagnostic assays for safe supply of blood and blood products as per demand.

Support in expansion of production of different blood products as per demand in Nepal’s medical and surgical context.

Collaborating Partners:

Sanquin Consulting Services, NL

CBTS, Nepal

Funding Partners:

TBI Group

NRNA, NL

Facilitator:

NRNA


Fact finding mission – a report

Betterment of the Nepal Blood Transfusion System; an Assessment of do able Priorities for

Training & Development steps.

Fanindra Panta, Sanquin Blood Supply, Amsterdam, Netherlands, Shrawan Shrestha, Nepal Red

Cross Central Blood Bank, Kathmandu, Nepal, Surendra Koju, Dhulikhel Hospital, Dr Manita

Rajkarnikar, Nepal Red Cross CBTS, Kathmandu, Nepal and Willem Martin Smid, MD, PhD, MBA,

Sanquin Consulting Services, Amsterdam, Netherlands

Background/Case Studies:

The Nepal blood supply system is centrally coordinated by Central Blood Transfusion Service of the

Red Cross Society. In the aftermath of the earthquake the need for improvement was identified with the

support of the Non Resident Nepali Association. During a fact finding mission the present situation and

priorities for improvement were assessed. The assessment of priorities is crucial input for the next step,

the development of a training program of a three years project collaboration between CBTS Nepal &

Sanquin Blood Supply Foundation the Netherlands where NRNA is a facilitating partner and TBi Group

is main sponsor.

Study Design/Method:

After two years of preparation Sanquin in collaboration with CBTS, in a fact-finding mission to different

blood bank units of Nepal, assessed the present situation and the next step for improvement. A team of

special representative from stakeholders conducted four days intensive field observation of CBTS in

Kathmandu- Lalitpur , RBTS Chitwan, Regional Hospital, Cancer hospital , Academic Hospital in

Chitwan ,Kavre , Patan .


Moreover, to facilitate participatory collaboration a one day workshop was held with the important

stakeholders of the Nepal blood transfusion system with representatives of blood banks, the MoH, Nepal

RCS and hospitals. The outcome was a listing of priorities for improvement of five groups. After the

workshop this list was sent out to the main stakeholders in the country as questionnaire. Stakeholders

were asked to score the main priorities for improvement for ten groups and to add their opinion whether

results are feasible for each priority within 2-3 years.

Results/Finding:

Answers of key stakeholders on the questionnaire revealed the priorities for the five groups on a National

level for Nepal and are summarized in the table:

Follow-up: response on Workshop questionnaire & doable Priorities*

1 Management & Organization

1.1 Cost effective work process

1.2 Quality Management

1.3 Blood Supply management using software.

2 Infrastructure & Equipment’s

2.1 Water, electricity supply and backups.

2.2 Basic lab equipment (directive and maintenance)

3 Donation 4 Products 5 TTI

3.1 Blood Donor selection, recruitment SOP

3.2 Voluntary Donors, Promotion Material and database

3.3 Donor care & Counselling

4. Blood Products

4.1 Processing, storage and release.

4.2 Components

4.3 logistics and cold chain

5. Blood safety, taste technique

5.1 Screening strategies.

5.2 Hepatitis B,C and HIV.

5.3 Blood group serology, antibody screening and phenotypering.

Participants : NBBTS , MoH , CBTS , RBTS : Chitwan, Pokhara , Nepalgunj , Biratnagar , DBTS :

Dharan , Birgunj , Dhangadi , Kavre , Lalitpur , Kathmandu , Bhaktapur , Kailali , Hospitals:

Dhulikhel , Patan , Bharatpur , BP Kiorala Cancer hospital , Redcross

#Total follow up responses, 43 of 58, including collective.## Priorities selected when doable in 2 to

3 years with high priority.

Not doable priorities recently but realized: “centrally coordinated system”, “nationwide LIMS”,

“typing special donors”, “clinical transfusion” etc.

Periodic training for lab technologists and clinicians are amongst doable priorities.

The approach for the next phases is stepwise including technical guidance and training where

appropriate. Already existing collaborations of the NRCS with other partners like Global Advisory

panel, are also considered.

Conclusion:

During the workshop priorities for five groups were listed and prioritized by key stakeholders with a

questionnaire. Organization, training and basic blood bank processes were amongst the feasible

priorities. These will be the basis of a training in Nepal and the Netherlands in 2017.

Implementation of new technologies showed lower priority or found not doable within few years.

Thus, strengthening and motivating human resource for future steps, working on basic uniform

national system and quality standards are the initially realized steps. To develop “Nepal Solution”

for sustainable improvement process for longer term, Nepalese diaspora professionals ( NRN) shall

facilitate the international collaborations. Corporate partners and social partners shall initiate the

innovative solutions for system improvement.


B3 Nepal Project Team:

Shisheer Bhatta

Director, TBi Group, Nepal

Dr. Manita Rajkarnikar

Director, NRCS, CBTS, Nepal

Lorkar Sharma

Chair, NRNA ICC, Denmark

Fanindra Panta

Coordinator, NL, Prog. Exec. Comm.

Dr. Martin Smid

Sanquin, Natherlands

Dr. R. Manandhar

Ministry of health, Nepal

GAP, ICRC

Dr. Yuvaraj Sharma

Program execution committee

Dr. Roshan L. Shrestha,

NIH, USA

Ashwini Kumar Nepal,

Netherlands

Fanindra Panta,

Sanquin, Netherlands

Shrawan K Shrestha,

CBTS, Nepal

Dr. Saroj Ghimire,

Switzerland

Sita Shrestha,

NIH, USA

Dr. Ravi Khadka,

Netherlands

Surendra Koju,

KUMS, Nepal

Himal Gurung,

NRNA, NCC, NL

DR, Janak L. Pathak,

China

Ram K. Shrestha,

CBTS, Nepal

Dharma Adhikari,

NRNA, SEDC, Australia

Thaneshwor Kandel,

Netherlands

Sandesh Thapa,

CBTS, Nepal

Advisors:

Steering committee:

Dr Manita Raj Karnikar

Director, CBTS, Nepal.

Residence: Lalitpur , Nepal .

Portfolio in the project: Head of Collaborating Partner Nepal Blood

Service. Selection of priorities & project implementation

Dr. W. Martin Smid Managing Director, Sanquin Consulting Services Director, Academic Institute IDTM Residence: Zwolle, The Netherlands Portofolio in the Project: Representative of the collaborating partner Sanquin Blood Service, Resource Person, Programming, Training, International Cooperation



Fanindra Panta , Senior Laboratory Technician, Sanquin , The Netherlands, NRNA Global Committee Member of Social Enterpreneurship Development,

Patron; NRNA NCC NL.

Residence: Hoofddorp , The Netherlands .

Portofolio in the Project: Project Developer, International Coordinator for the project.

Bhaban Bhatta , Chairman: TBi Group, Vice-President: NRNA

Residence: Japan

Portfolio in the project: Resource Person. Main Sponsor.

Shishir Bhatta, Director : TBi Group Nepal

Residence: Lalitpur, Nepal.

Lokraj Sharma, NRNA Deputy Youth Coordinator,

Chair of Social Entrepreneurs Development Committee.

Portfolio in the Project: International Relation in NRN

Professionals through NRNA.

Residence: Copenhagen, Denmark

Dr. Roshan Lal Shrestha, Researcher, National

Institutes of Health, USA.Founder: Center for

health and disease studies Nepal (CHDS)

Residence: Maryland, USA Portfolio in the project

Project Developer, Newsletter Editor, and Resource person.

Ashwini K Nepal,PhD student, VU , Amsterdam,

Residence: Amstelveen, The Netherlands

Portfolio in the project: Project developer, Newsletter

Editor Resource Person.


Si ta Shrestha, MLS (ASCP), MT (AMT), MSc,

Medica l Technolog is t , Nat i ona l I ns t i tu tes o f Heal th , USA

Residence: Maryland USA.

Portfolio in the project: Trainer, Resource person.

Himal Gurung, President, NRNA, NCC NL

Residence: Netherlands

Portfolio in the project: Chair of the NRNA, NL

Thaneshwar Kandel, Social Entrepreneur

Residence: Amsterdam, The Netherlands

Portfolio in the Project: Resource Person, Social support and

sponsoring.

.

Dr. Saroj Raj Ghimire, AC Immune, A Swiss Biotech Company

Residence: Switzerland

Portfolio in the Project: Project Developer,

Member of trainees selection committee.

Dr. Ravi Khadka, Tech Arch Manager at

Accenture, Utrecht University, Utrecht Area, Netherlands

Residence: Netherlands

Portfolio in the Project: Project developer, Resource person.

Shrawan K. Shrestha, Quality and technical Officer,

CBTS, Nepal

Residence: Bhaktapur Nepal

Portfolio in the Project: Program Coordinator, NPL.

|

Ram K. Shrestha, Officer at

CBTS Nepal

Residence: Nepal

Portfolio in the Project: Project

administrator

Sandesh Thapa, Publicity

officer, CBTS, Nepal

Residence: Kathmandu, Nepal

Portfolio in the project:

Publicity in National Blood

System in Nepal.

.

Surendra Koju, Head of

Blood Bank Unit, Dhulikhel

Hospital

Residence: Bhaktapur, Nepal.

Portfolio in the Project:

Program organization,

reporting. Blood System in

Nepal.

Dr. Janak Lal Pathak, Researcher, Huazhong University

of Science and Technology, Wuhan, Hubei, China

Residence: China

Portfolio in the Project: Program Developer,

Technical support

Dharma Raj Adhikari, Clinical Educator, St. Vincents

Private Hospital, Darlinghurst, Sydney, Australia

Residence: Sydney, Australia

Portfolio in the Project: Coordinator for Material

Support as “Gift” for BTS Nepal .

Midas Thapa: Coordinating from

NRNA NCC NL

Trainers

Dr. Martin Smid Dr. Hans Molijns Sita Shrestha, MLS

(ASCP)


B3 Nepal project Newsletter:

After completion of the fact finding workshop that was held from 30th January 2017 to 3

rd February

2017, the project executive committee developed a training module to address the outcomes obtained from the workshop.

Title of the training: Quality Management Training for Blood Transfusion Service in Nepal.

Preliminary program 1: 17 July 2017 – 21 July 2017 > course on technical modules

Preliminary program 2: 24 July 2017 – 28 July 2017 > course on management modules.

One day workshop & evaluation of the training phase.

Training topics and module that will be included on training:

1. Management & Organization

1.1 Cost effective work process 1.2 Quality Management 1.3 Blood Supply management using software.

2. Infrastructure & Equipment’s

2.1 Water, electricity supply and backups. 2.2 Basic lab equipment (directive and maintenance)

3. Blood Donation

3.1 Blood Donor selection, recruitment SOP 3.2 Voluntary Donors , Promotion Material and database 3.3 Donor care & Counselling

4. Products

4.1 Processing, storage and release. 4.2 Components 4.3 logistics and cold chain

5. TTI

5.1 Screening strategies. 5.2 Hepatitis B,C and HIV, TPHA 5.3 Blood Group Serology; antibody screening: donors side as well as patient sides

Detail report of the training will be published in next issue of the newsletter.

Ram K. Shrestha ,

Officer at CBTS Nepal

Residence: Nepal

Portfolio in the Project :

Project administrator

Future step ahead:


News and Events:

Memorandum of understanding (MoU)

was signed between the B3 Nepal

project team, TBi group and CBTS in

presence of minister of health, Mr.

Gagan Thapa.

From left to right: Mr Shishir Bhatta,

Mr. Fanindra Panta, Hon minister Mr.

Gagan Thapa, Dr. Martin Smid and Dr.

Manita Rajkarnikar.

Participants of fact finding workshop at

Dhulikhel Hospital. Dr. Martin Smid

and Mr. Fanindra Panta travelled to

Kathmandu from Netherlands for the

workshop.

Dr W. Martin Smid with Regional Blood Bank incharges from Chitwan , Pokhara , Nepalgunj , Biratnagar and District incharges from Birgung , Dharan and Dhangadi .


News and Events:

b3 nepal project

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