MENDAMI 2 - Resilience of the Libyan Transfusion System through Quality Management

Contribute to increase capacities of the Libyan National Blood Transfusion System to enable its resilience at local and national levels

Libyan context

Libya continues to suffer from the impact of a protracted political crisis, which leads to outbreaks of violence, displacements and a general worsening of people’s living conditions. The 2011 conflict has caused a collapse in oil revenues with severe consequences to the capacity of the Libyan institutions to raise public revenues and deliver basic services. The Libyan health system has been severely weakened by the political situation and does not allow the provision of sufficient public and therefore health services such as blood transfusion.

Blood transfusion In Libya

The Libyan blood transfusion system currently faces two critical challenges that prevents it from adequately delivering its mission and providing the Libyan population with sufficient safe blood products:

- The first challenge is the fragmented nature of the blood transfusion system institutional organisation.

- The second one is the very low number of voluntary non-remunerated blood donors in the country.

Such fragile basis makes the Libyan blood transfusion system ill-prepared to withstand sudden changes in its environment. The severe effects of the current political and security situation as well as the COVID-19 pandemic showed this point: blood banks outside Tripoli or Benghazi face regular shortages and some are even forced into temporary closure.

Moreover, the absence of a centralised and efficient national management of blood supply made it difficult for the system to reform and improve from within.

From MENDAMI 1 to MENDAMI 2

Since 2019, the Ministry of Health and Expertise France have worked jointly through the MENDAMI project, to strengthen elements of the Libyan Blood Transfusion System. This initiative has managed some encouraging successes in the fields of continuing education for blood banks staff, clinical use of blood and national awareness campaigning, proving that is still possible to bring changes to a weak and fragile national system. With its network of scientific consultants, the MENDAMI project offers an ideal platform to continue building a much needed resilience into the public blood transfusion system.

The MENDAMI programme phase 2 works on instilling the critical concept of “Quality Management” and “Quality Culture” into the Libyan Blood Transfusion System at both national and local levels.

Find out more about MENDAMI 1

Resilience and quality management

Tools, mechanisms and reflexes adapted to blood banks act as the backbone of a system which robustness is rooted in logic: a rigorous top-down organisation, a capacity to document every steps, an ability to monitor and evaluation of activities and finally the capacity to identify and address problems. For the Blood Transfusion System it is therefore an essential step to become resilient and improve its capacity to deal with sudden changes or problems. The system thus acquires strength through its top-down cascading logic and the systematic and structured documentation of all activities including contingency planning.

As a process, quality system has to ensure traceability, from the motivation and selection of blood donors to the transfusion of blood and blood products to patients.

Expertise France and the National Blood Transfusion Services Authority is also being supported from both WHO Libya office and EMRO regional office in Cairo and creates interactions with WHO training on quality management project for blood transfusion launched in 2000.

Targeted domains of intervention are the following ones:

- Organizational management of the Blood Transfusion Services,

- Standards implementation with blood banks,

- Documentation and data collection,

- Training of technician and managing staff,

- Assessments of quality standards,

- Awareness raising on blood donation for the general population of Libya.

The programme is conducted in liaison with local authorities and public institutions at national and sub-national level, and specifically the National Blood Transfusion Services Authority, which is the direct beneficiary of the programme.

The capacity building strategy encourages the ownership by the participants to ensure sustainability of results over time. Thus, the migration of the e-learning platform developed during phase 1 of MENDAMI and the appropriation of its management at the level of the national blood transfusion agency, contributes to this objective of sustainability of actions.

The technical committee is working with Tripoli University to ensure integration and institutionalisation of transfusion medicine in curricula.

The main written documentation and publications produced during the programme are disseminated to all key programme stakeholders as one of the National Blood Transfusion Services Authority’s missions.