Punjab is the most populous province of Pakistan, with approximately 55% of the country’s total population 110 million (2017). The urban population is 40% while 60% is rural. There are 36 districts in Punjab and the capital city is Lahore. The Government of Punjab drafted a comprehensive Health Sector Strategy (2012-20) to improve health and life expectancy and ensure equitable health services for all population groups in Punjab. The strategy entails a series of goals that essentially reconstruct the health system in Punjab. Punjab Health Sector Strategy supports the Department of Health to progress further with a sense of direction, purpose and urgency by prioritizing policy related interventions consistent with availability of financial resources. Among the 12 identified strategies of the Punjab Health Sector Strategic Plan, strategy 5 and 6 are relevant to Blood Safety.
Strategy 5: Focus and strengthen MNCH, family planning and nutrition services at all levels as part of EPHS: This strategy focuses on provision of blood transfusion services in all THQ and DHQs of Punjab 24/7.
Strategy 6: Strengthen prevention and management of infectious diseases, as part of EPH: This strategy among others promote the establishment of blood banks in secondary level healthcare facilities lacking such arrangements and ensure safe blood transfusion in all existing public and private blood banks.
Punjab government promulgated the Punjab Transfusion of Safe Blood Ordinance, XVI of 1999 in April 1999. Under Section 5 clause (a) of this Ordinance, Punjab Blood Transfusion Authority was established. The Authority remained largely ineffective and poorly functional for many years till 2014 when the Authority was re-notified under the Chairmanship of Health Advisor to the Chief Minister. The Authority comprises of 16 members including parliamentarians, haematologists, clinicians, public health specialists and provincial health managers. In 2016, the blood safety legislation in Punjab was revised and approved by the provincial legislature. The new Act is consistent with the international recommendations and practices. A new Secretary was appointed following the passage of the new Act who is proactively conducting the process of registration and licensing of blood banks in the province.
The Punjab Blood Transfusion Authority aims to ensure supply of safe blood throughout Punjab by setting safe blood standards and ensuring that these standards are implemented effectively. In addition to maintaining a regulatory oversight, the Authority has also assumed a steering role to guide the development of blood transfusion sector by increasing awareness among general public and blood bank workers about safe blood transfusion and trainings of various staff cadres.
The Authority now holds regular Board meetings to address operational problems and monitors the progress of the Authority. The Punjab BTA is coordinating closely with the SBTP and IBTA and adopting procedures and systems developed by the IBTA to introduce more uniformity. So far 300 applications have been received for registration out of which 100 blood banks have been inspected and licensed. The Authority has nominated 22 haematologists/pathologists as Inspectors. The Authority has also prescribed minimum data which must be provided by all blood establishments at regular intervals. The data is collected for planning purposes, as well as for surveillance and estimation of the transfusion transmissible infectious diseases that burden Pakistan
According to the SBTP’s National Data Collection Report 2018, 112 blood banks were identified in the province. The total annual donations collected from these blood banks was 908,156. Male donors among these were 878,217 (97%) while female donors were 29,939 (3%). The larger part of the total donations comes from family/replacement donors that is 760,258 (84%) while voluntary donations are 147,898 (16%) in number. In 2018, 352,977 (39%) blood collections in Punjab were processed into at least three blood components, i.e. Red Cell Concentrates (RCC), Fresh Frozen Plasma (FFP) and Platelet Concentrates while 555,179 (61%) blood collections were used as whole blood
Two modern Regional Blood Centers have been developed in Multan and Bahawalpur and 12 linked hospital blood banks renovated through the German government funded Safe Blood Transfusion Programme. These RBCs are functioning through Public Private Partnership and providing model services to the people of the Southern Punjab. In the second phase of the project large public sector blood banks are being upgraded to Regional Blood Centers in addition to the development of a new Regional Blood Center in Faisalabad. The Punjab government is also planning to upgrade the tehsil level hospital blood banks along the RBC-HBB model to streamline the blood transfusion services in the province.