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

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.
 

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.

The appropriate tools, mechanisms and practices for blood banks are the backbone of a system whose robustness is anchored in the following logic: a rigorous top-down organization, an ability to document each step, to monitor and evaluate activities; and finally, to identify and solve the problems encountered. For the blood transfusion system, it is therefore essential to become resilient and improve its ability to cope with sudden changes or problems. The system gains strength through this cascade logic and systematic, structured documentation of all activities, including emergency planning.

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

The focus areas are:

    - organizational management of blood transfusion services,

    - implementation of standards with blood banks,

    - documentation and data collection,

    - training of technicians and management staff,

    - quality standard assessments,

    - blood donation awareness among the general Libyan population.

The European School of Transfusion Medicine provides technical assistance in transfusion medicine. No less than 5 international experts are mobilized in blood banks and the National Authority of Blood Transfusion Services.

The programme is carried out in liaison with local authorities and public institutions at national and sub-national level, and in particular through the action of the National Blood Transfusion Services Authority, the direct beneficiary of the programme.

The capacity building strategy encourages participants to take responsibility for ensuring 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 Authority for Blood Transfusion Services contributes to this objective of sustainability of actions.

The project works closely with the University of Tripoli to ensure that transfusion medicine is integrated and institutionalized in the programmes.

The main written documents and publications produced during the program are distributed to all major stakeholders of the program as part of one of the missions of the National Blood Transfusion Services Authority.