PREAMBLE

Transfusion medicine is a distinct discipline with a vital role in the health care system. It
is concerned with many subjects including: public education, donor recruitment and
retention; donor selection, counselling and blood collection; laboratory processing
(including testing and preparation of components, storage and distribution of blood and
blood products); organization and management of the blood service; and working with
clinicians to promote the appropriate clinical use of blood and blood products.
Transfusion medicine includes the clinical and scientific background to all of these
topics and therefore impinges on many areas of medical practice.

The Blood Transfusion Division (BTD) mission is to provide safe, effective and adequate
blood and blood components to all patients in need and the vision is to be a center of
excellence by conforming to international standards.

BTD strategic plan highlights key activities to be implemented from the year 2020 to
2025.
The Rwanda Biomedical Center is grateful for the commitment of all contributors who
made this strategic plan possible.

Dr NSANZIMANA Sabin

Director General-RBC

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ACKNOWLEDGMENT

The elaboration of the Blood Transfusion Division strategic plan has been made
possible through the efforts and contribution of many people.
Special thanks go to Dr NSANZIMANA Sabin, the Director General of the Rwanda
Biomedical Center and Dr MAZARATI Jean-Baptiste, the Head of the Biomedical
Services for their strategic vision that inspired the BTD strategic plan 2020-2025.
The Blood Transfusion Division acknowledges, in no particular order, the efforts of Dr
KATARE Swaibu, the RBC/BTD Division Manager, Dr DUSENGUMUREMYI Theophile,
Director of RCBT Butare, Dr RUHINDA Eria, Director of RCBT Rwamagana, Dr
MUYOMBO Thomas, Director of RCBT Kigali, Mr. UWAYO Henri Desire, Ag.Director of
RCBT Karongi, Mr NTIBANYENDERA Jean Damascene, Ag.Director of RCBT
Ruhengeri, Mr. KAMUGUNGA Jules, Blood Bank equipment maintenance Officer, Mr.
NDUNGUTSE Adam, Blood Establishment Computerised System Officer, Mr. SANGWA
Innocent, Serology Senior Officer of RCBT Ruhengeri, Mr.KAYONDE Peter,
Immunohematology Senior Officer of RCBT Rwamagana, Ms. UMUTESI Gisele,
Serology Senior Officer of RCBT Rwamagana, Ms. UWERA Lydie, Blood Donor
Mobilisation and Selection Senior Officer of RCBT Rwamagana, Mr. RWEMA Fidele,
Immunohematology Senior officer, Mr. NSEKUYE Olivier, Serology Senior Officer of
RCBT Karongi, Ms. MUHORACYEYE Jeannette, Immuno-hematology Senior Officer of
RCBT Kigali, Ms. UWISANGA Agnes, Platelet Production Senior Officer of RCBT Kigali,
Ms. UWIZEYE Marie Florence, Serology Senior Officer of RCBT Kigali, Ms.
MUKAMAZIMPAKA Alexia, Blood Donor Mobilisation and Selection of RCBT Kigali, Mr.
NDIZIHIWE Patrick, Immunohematology Senior Officer of RCBT Butare, Mr.
NDICUNGUYE, Serology Senior Officer of RCBT Butare, Ms. LUMUMBA Patrick, Mr.
TUYISHIMIRE Moise, BTD Blood Donor Recruitment and Retention Senior Officer, BTD
Laboratory Operations Officer, Mr. BIGIRUMWAMI UWAYO Desire, Blood Donor
Mobilisation and Selection Senior Officer of RCBT Karongi and NDAHIRIWE Olivier,
BTD Quality Assurance and Accreditation Senior Officer.

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TABLE OF CONTENTS

PREAMBLE ................................................................................................................................................ 1
ACKNOWLEDGMENT .............................................................................................................................. 2
Abbreviations and Acronyms ............................................................................................................... 4
1. Introduction ........................................................................................................................................... 6
2. Situation Analysis of Blood Transfusion in Rwanda ................................................................. 8
3. Brief recapitulation of the implementation of BTD 2013-2018 strategic plan ................ 10
4. Key Success Factors .................................................................................................................... 10
5. Key Hindrances .............................................................................................................................. 11
6. Guiding principles and values .................................................................................................... 11
7. Methodology .................................................................................................................................... 12
8. BTD Strategic Plan 2020-2025 .................................................................................................... 13
9. Monitoring and Evaluation Matrix.............................................................................................. 22

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Abbreviations and Acronyms

AABB: American Association of Blood Banks

Ab: Antibody
AfSBT: Africa Society for Blood Transfusion
BBEMO: Blood Bank Equipment and Maintenance Officer
BBIS: Blood Bank Information System
BDEOO: Blood Donor Education and Outreach Officer
BDMSSO: Blood Donor Mobilisation and Selection Senior Officer
BDRRSO: Blood Donor Recruitment and Retention Senior Officer
BECSO: Blood Establishment Computerised System
CMV: Cytomegalovirus
DM: Division Manager
DoUs: Director of Units
GIZ: Deutsche Gesellschaft für Internationale Zusammenarbeit
HBV: Hepatitis B Virus
HCV: Hepatitis C Virus
HFs: Health Facilities
HIV: Human Immunodeficieny Virus
HoSs: Heads of Services
HSSP IV: Health Sector Strategic Plan
IMH: Immunohematology
IT: Information Technology
LOSO: Laboratory Operations Senior Officer
MOH: Ministry of Health
NAT: Nucleic Acid Testing
BTD: Blood Transfusion Division
NCDs: Non communicable Diseases

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NST1: National Strategy for Transformation 1
PPSO: Platelet Production Senior Officer
QAASO: Quality Assurance and Accreditation Senior Officer
QMS: Quality Management System
RBC: Rwanda Biomedical Center
RCBT: Regional Center for Blood Transfusion
RHCC: Rwanda Health Communication Center
RISA: Rwanda Information Society Authority
RMH: Rwanda Military Hospital
SDGs: Sustainable Development Goals
SERO SO: Serology Senior Officer
SWOT: Strength Weakness Opportunities Threats
SYPH: Syphilis
T-ACE: Terumo Automatic Component Extraction
Tech:Technician (s)
TTIs:Transfusion Transmissible Infections
VPN: Virtual Private Network

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1. Introduction

The development of the health sector is one of the priorities of the Government of
Rwanda. The National Strategy for Transformation 1 (NST1) primarily emphasizes on
enhancing the demographic dividend through ensuring access to quality health for all by
improving health care services at all levels, strengthening financial sustainability of the
health sector, and enhancing capacity of the health sector workforce. In addition, the
Health Sector Strategic Plan IV supports both the Sustainable Development Goals
(SDGs) and the NST1 through the promotion of universal coverage of essential health
interventions, health promotion, the development of the health sector workforce,
sustainable availability of critical products and commodities as well as quality
improvement.

The fourth Rwandan Health Sector Strategic Plan (HSSP IV July 2018-June 2025)
proposed by the Ministry of Health presents an opportunity to ensure that the
BTD strategic plan is consonant with the direction of the national plan.
HSSP IV set forth the following strategic objectives:

1. Full implementation of the main health programs (improve demand, access and
quality) with the main intended outcomes including increased coverage of maternal and
child health services, HIV and Viral hepatitis testing services as well as Non-
communicable Diseases (NCDs) management.

2. Strengthen the health systems building blocks (strengthen policies, resources and
management). This objective intends to ensure that all building blocks of the health
sector provide relevant packages of health services in accordance with international
best practices.

3. Strengthen all levels of service delivery (organise the services effectively at all
levels). This objective entails the development of the health sector workforce,
strengthening infrastructure, accessible, quality and efficacious medicines and medical

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products, health information systems interoperability and functionality, research to
support evidence based interventions and sustainable health financing.

4. Ensure effective governance of the sector: strengthen decentralization, partnership,

private sector coordination and strengthened health security. This involves
strengthening the institutional capacity, leadership, accountability and a resilient and
responsive health system.

Of the programs referenced in the HSSP IV, four have implications for BTD:
1. Maternal and Child Health, HIV and hepatitis testing services and cancer
management services
2. Service Delivery of quality, accessible and efficacious medical products and the
development of health information system as well as promotion of evidence based
interventions through research
3. Strengthen the health systems through international accreditation
4. Establishing a system that is resilient and responsive to all degrees of crises

The BTD Strategic Plan supports HSSP IV priorities through:

1. Ensuring the safety of blood by decreasing TTIs prevalence among collected Blood
from 0.07% to 0.045% for HIV, 0.5% to 0.35% for HCV, 0.8% to 0.65% for HBV, and
0.38% to 0.23% for Syphilis.
2. Increasing the number of regular blood donors from 40.6% to 45% to enhance the
safety of blood.
3. Providing adequate blood by increasing the number of Collected Blood Units from
65,000 to 104,683
4. Maintaining international accreditation by conforming to the Quality management
system requirements in all BTD processes
5. Enhancing the accessibility by ensuring that everyone who is eligible to donate have
access to blood collection services.

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6. Improving the quality of blood and blood components through introduction of the
current blood safety enhancement technology.
7. Increasing hospital satisfaction in blood components from 95% to 98%.
8. Strengthening the supply chain and stock management of medical equipment and
commodities
9. Reinforcing the rational use of blood components and hemovigilance system.
10. Ensuring the prompt availability of all types of blood components to all Transfusing
Health Facilities.

2. Situation Analysis of Blood Transfusion in Rwanda

Universally available, accessible and safe transfusion is an important factor to health

care. Specifically, blood transfusion is a key therapy in alleviating morbidity and
mortality in addressing anaemia due to malaria, anaemia due to severe malnutrition,
chronic infections and cancer and haemorrhage in obstetrical and gynecologic settings.

The BTD is one of the divisions of the Rwanda Biomedical Center and is comprised of
five Regional Centers for Blood Transfusion (Kigali, Ruhengeri, Butare, Rwamagana
and Karongi) that collect, test, process and distribute blood and blood components. In
addition, blood components are distributed to the transfusion facilities using drones
operated by Zipline Inc. Currently, BTD serve blood components to 71 health facilities
including public and private transfusing health facilities in Rwanda.

Blood donation is obtained from voluntary non-remunerated blood donors. All donated
blood is screened for HIV, hepatitis B, hepatitis C and Syphilis. Also, collected blood is
processed into different blood components (Packed red blood cells, platelets, plasma
and cryoprecipate). Furthermore, blood is typed to determine blood groups and
unexpected clinical significant antibodies.
Both Transfusion Transmissible Infections (TTIs) and blood processing have been
centralised in Kigali to improve cost-efficiency. Blood typing and antibody screening is
performed using automation in RCBT Kigali whereas the blood typing in other RCBTs

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remains manual and antibody screening not done at all. This strategic plan will ensure
that all collected blood units are tested using the same standards.

The screening window period of the current testing platform may potentially increase the
residual risks of transmission of blood borne infections. To enhance the safety and
efficacy of blood, BTD 2020-2025 strategic plan will explore feasibilities to implement
Nucleic Acid Testing for HIV, HCV, HBV and the testing of other epidemiologically
relevant blood borne infections. In addition, feasibility studies to implement leuko-
reduction and pathogen inactivation technology will be undertaken.

To promote continuous availability of blood, the BTD 2020-2025 strategic plan will
ensure the supply chain and the management of equipment and commodities inventory
is effective and robust. Currently, processes defining the management of equipment
from acquisition to disposal are not properly functional. Additionally, the supply chain of
medical commodities from quantification of needs to the management of stock presents
deficiencies that will require appropriate interventions.

To attain BTD mission, the organizational structure must effectively support the
operations. Currently, the BTD organizational structure does not effectively support its
critical activities. For example, the current structure considers administrative units in
terms of geographical locations instead of functional needs. This means that all RCBTs,
that normally perform similar functions, are considered as administrative units while
critical operations such as hemovigilance, quality management, recruitment and blood
testing are not properly coordinated. In addition, critical activities that require
centralization to enhance cost-effeciency cannot be supported by the current BTD
organizational structure. This strategic plan will advocate for BTD restructuring to
support critical operations effectively.

Furthermore, the use of data to inform decisions and interventions need to be

strengthened. In the 2020-2025 strategic plan, BTD will promote research and the use
of collected data to ensure continual improvement.

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BTD strategic plan 2013-2018 encompassed a number of interventions that were
intended to ensure accessibility, safety, adequacy and effective blood components

3. Brief recapitulation of the implementation of BTD 2013-2018 strategic plan

2013-2018 objectives Target Attained Explanation for

results 2018 shortfalls
Increasing the number of regular blood 75% 40.6% The target was
donors to 75% by 2018. not realistic
Prevention and control of blood borne SOPs to be SOPs were
infectious diseases through enhancing developed developed and
donor education, selection and TTI and used in use
screening
Extending component production in all 5 RCBTs Centralized. Centralisation
Regional Centers as well as producing producing Apheresis was was proven to be
new types of components to meet the components introduced but more efficient.
demands of changing clinical practice leuko-reduced Budget constraint
and improved patient care in Rwanda components
not produced
Extending BTD services to all provinces All 5 RCBTs Only 5 RCBTs Not cost effective
in Rwanda for easy geographical plus RMH,
accessibility Gihundwe
and Rubavu
offering blood
services
Identifying and diversifying sources of Advocacy for Advocacy was The cost recovery
external funding; and working with MoH, cost recovery made mechanism
Health Insurance Schemes and other done and cost proposed was
BTD stakeholders to develop a cost- recovery considered to be
recovery mechanism associated with mechanism in an unbearable
producing a unit of blood or blood place cost to the health
components system
Improving quality and technical expertise AABB All RCBTs AABB
through implementation of an effective accreditation accredited by accreditation
Quality Management System in all in all RCBTs AfSBT program was
Regional Centers and achieving AABB costly
accreditation
Strengthening equipment maintenance System to System Equipment
capabilities manage documented management
equipment but with some system not
from deficiency in established to fit
acquisition to implementation current
condemnation operational needs
established
and working

4. Key Success Factors

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To implement this strategic plan, BTD will require the following support:

3.1. Government support

3.2. Organizational commitment and strong management
3.3. Skilled and committed staff
3.4. Committed Voluntary Non-Remunerated Blood Donors
3.5. Sustainable funding
3.6. Functional quality management system

5. Key Hindrances

5.1. The lack of sustainable and sufficient funding remains the major impediment to
ensuring a safe and adequate blood supply accessible to all patients in need.
Consequently, resource mobilization will continue to be high on the agenda to
facilitate collection, transportation, processing, testing and storage and
sustainability of blood and blood products supply. The BTD 2020-2025 Strategic
Plan will advocate for more funding to enhance the safety, adequacy and
effectiveness of blood components.

5.2. The current organizational structure cannot effectively accommodate all the
required functions. BTD will advocate for restructuring of the current
organizational structure to meet operational needs.

5.3. Inefficient system to report on blood utilization and adverse events by hospitals,
which impedes the implementation of haemovigilance program.

6. Guiding principles and values

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To execute this strategic plan and attain desired outcomes, the BTD commits to the
following principles and values:
6.1. Promote a value system that ensures quality and integrity in all endeavors.
6.2. Respond to crises, big and small.
6.3. Provide outstanding customer service.
6.4. Support a safe and respectful environment for staff and guests.
6.5. Build a strong partnership with all stakeholders
6.6. Embrace technological advances intended to improve blood safety and
accessibility
6.7. Commit to research, education, and training.

7. Methodology

The BTD strategic plan 2020-2025 was developed through internal consultation and
scanning of stakeholders need and expectations. The SDGs, NST1, HSSP IV were
consulted to identify priorities that are relevant to BTD mission. In addition, a SWOT
analysis was conducted using unstructured brainstorming.

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 8. BTD Strategic Plan 2020-2025

Objectives Strategy Process Indicator Baseline Target Year BUDGET Stakeholders

(FRW)
To decrease 1. Educate Blood Donors Prevalence HIV: 0.07% Y1 All 5 years 89,631,696 BTD
TTIs of TTIs HIV: 06%
prevalence in 1.1. Provide pre-donation talk to HCV: 0.5% HCV: 0.45%
Collected everyone who comes to donate HBV: 0.75%
Blood blood and emphasize on eligibility HBV: 0.8% SYP: 0.33%
criteria to enhance auto-exclusion Y2
of ineligible blood donors SYPH: 0.38% HIV: 0.06%
HCV:0.45%
1.2. Notify all blood donors after HBV:0.75%
every donation SYP:0.33%
Y3
HIV:0.05%
HCV:0.4%
HBV:0.7%
SYP:0.28%
Y4
HIV:0.05%
HCV:0.4%
HBV:0.7%
SYPH:0.28%
Y5
HIV:0.04%
HCV:0.35%
HBV:0.65%
SYPH:0.23%

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Objectives Strategy Process Indicator Baseline Target Year BUDGET Stakeholders
(FRW)
Enhance the 2. Purchase equipment for blood Number of 13 cool boxes 4 Sysmex Year 1: 1,000,000,000 BTD/RBC
quality of components processing, quality equipment 2 Sysmex 12 T ACE 12 T- ACE
blood and control and transportation purchased 2 centrifuges PH meter PH meter
blood 6 T ACE Sterility tests Sterility tests
components 1 Coagulation 20 cool boxes
factors 6 freezers
analyzer 50 Data
4 Apheresis loggers
machine Year 2
20 cool boxes Coagulation
6 freezers factors
50 data analyzer
loggers Year 3:
2 Apheresis
machine
Year 4:
2 sysmex
3. Reinforce the validation of all Number of NA All non- 6,000,000 BTD/RBC
incoming and existing equipment validated validated
before being used equipment equipment

4. Avail special blood components Number of units of 0 Leuko- Year 1: Need 1,300,000,000 BTD/RBC
Special blood reduced assessment
components RBCs Year 2:
prepared CMV neg Purchase of
RBCs equipment
Year 3: Leuko-
reduced RBCs,
CMV neg
RBCs
5. Purchase confirmatory test for Number of 385 confirmed 385 to be Year 1: 10,000,000 BTD/RBC
HIV and HCV confirmatory tests HIV per year, confirmed for Confirmatory
for HIV and HCV 1612 HIV per year, tests for HIV
performed within confrimed 1612 to be Year 2:
BTD HCV per year confirmed for Confirmatory
HCV per year tests for HCV

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Objectives Strategy Process Indicator Baseline Target Year BUDGET Stakeholders
(FRW)
6. Conduct a study on the Study progress NA Available Year 1: 5,000,000 BTD/RBC
prevalence of CMV,HTLV among report report Proposal
blood donors Year 2: Fund
mobilisation
Year 3:
Conduct study
7. Compare the testing performance Study report NA Available Year 1: 5,000,000 BTD
of RPR and ELISA during Syphilis report Proposal
screening Year 2: Fund
mobilisation &
Conduct study
8. Implement the Nucleic Acid Number of NAT NAT= 0, RR NAT= ?, RR= Year 4: 1,200,000,000 BTD/RBC
Testing (NAT test) tests performed on =? reduced Feasibility
donated blood , study
level of residual Year 5:
risks Purchase

9. Upgrade Immuno-Hematology Number of tests Ab id:0, All units Year 1: Need 1,000,000,000 BTD
testing by introducing antibody performed Phenotyping:0, tested 100% assessment,
screening, identification and Ab screening: Ab screening
extended phenotyping Year 2: Ab
Identification
Year 3:
Phenotyping
10. Develop and implement a cost- Functional system eProgesa Made in Year 1: Piloting BTD, RBC, RISA, GIZ
efficient blood bank information (imported Rwanda, cost- Year 2:
system system) efficient BBIS implementation
Year 3:
Interfacing of
lab equipment
11. Upgrade the BTD bandwidth for Speed of internet VPN: 12.5 VPN: 25 Year 1: BTD/RBC
internet and VPN to facilitate the Megabytes, megabytes, Upgrade
use of Blood Bank information Internet: 12.5 Internet: 25
system megabytes megabytes

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Objectives Strategy Process Indicator Baseline Target Year BUDGET Stakeholders
(FRW)
12. Advocate for the proposed BTD New structure in Organogram Structure Year 1: BTD, RBC, MIFOTRA
organizational structure to meet place not reflecting reflecting Advocacy
current and future operations BTD current BTD Year 2:
operations operations approval
13. To reinforce monthly and Performance Quality Use of Year 1: 80,000,000 BTD
quarterly performance evaluation evaluation reports indicators data available data implementation
and improvement plan and improvement for continual
plan improvement
14. To determine residual risks for Study report Available Year 1-5: 1,000,000 BTD
TTIs in blood supply every year report Conduct a
study
15. Establish BTD infrastructure & Available plan No Safe and Year 1: 0 BTD
facilities maintenance plan maintenance refurbished implementation
plan facilities
16. Establish BTD research team Number of NA 5 published Year 1: 5,000,000 BTD
published papers studies Development
of proposals &
fund
mobilization
Year 2:Carry
out research
Year 3:Carry
out research
Year 4: Carry
out research
Year 5: Carry
out research

To increase 17. Recruit and retain blood donors Number of 40,6% Y1: 41% 5 Year 632,812,496 BTD
the number of collected blood Y2: 42%
regular 17.1. Create Rwanda club 25 units from regular Y3: 43%
donors blood Y4: 44%
17.2. Create new collection sites in donors Y5: 45%
remote areas

17.3. Organize at least 3 blood

collection sessions annually at each

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Objectives Strategy Process Indicator Baseline Target Year BUDGET Stakeholders
(FRW)
newly created and previously
existing site.

18. Motivate regular blood donors BTD

18.1. Gratify Regular Blood donors

with tokens of appreciation at least
once every year

To increase 19. Recruit New Blood Donors and Number of collected 65000 Blood Y1: 71500 All 5 years 2,448,237,580 BTD/Media/RHCC
the number of retain repeat donors blood units Units Blood units
Collected Y2: 78650
Blood Units 19.1. Use Patient stories to Blood Units
by 10% enhance blood donation through Y3: 86515
Annually TVs, Radios, Printed and online Blood Units
media Y4: 95166
Blood Units
19.2. Use SMS to recruit new blood Y5: 104683
donors and retain repeat donors Blood Units

19.3. Organize mass mobilization

activities

19.4. Purchase Tents for mobile

blood collections sessions

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Objectives Strategy Process Indicator Baseline Target Year BUDGET Stakeholders
(FRW)
19.5. Conduct workshops with
Leaders of religious organizations,
private and public institutions to
engage them in
blood donation activities

19.6. Develop and implement

annual Blood collection plan every
year

20. Strengthen Blood Donor

Representative Committees

20.1. Conduct meeting sessions

with Blood donor representatives in
each RCBT every year

20.2. Reinforce blood donor

representative committees by
introducing youth

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Objectives Strategy Process Indicator Baseline Target Year BUDGET Stakeholders
(FRW)
21. Increase the number of blood BTD
collection sessions

21.1. Carry out activities related to

blood collection in military camps,
civic education camps, other youth
camps and other remote areas
22. Increase the number of platelets BTD
units donated on apheresis
machine

22.1. Purchase and maintain 4

Apheresis machines (2 RCBT
Kigali, 1 RCBT Ruhengeri, 1 RCBT
Butare)

23. Reduce weight related discards BTD

23.1. Purchase automated blood

bag mixers
Increase 24. Increase the stock levels of Number of blood 95,000 Number of Year 1: BTD
Hospital blood components to meet the components units Blood 104500
satisfaction hospital demands. produced components Year 2:
increased by 114950
10% each Year 3:
year 114950
Year 4:
137940
Year 5:
152884
24.1. Increase the number of staff in Number of staff 11 production 16 production BTD
blood components production, appointed in RCBT tech, 10 IH tech, 6
serology and Immuno-hematology Kigali tech and 4 serology tech,
testing lab (RCBT Kigali) serology tech 14 IH tech
(RCBT Kigali)
24.2. Advocate for the expansion of Adequate working Inadequate Expanded Year 1: BTD/RBC
RCBT Kigali working area area working area working area Advocacy

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Objectives Strategy Process Indicator Baseline Target Year BUDGET Stakeholders
(FRW)
Improve 25. Re-define the supply chain, Functioning system No well- Defined Year 1: BTD
supply chain stock and medical equipment in place defined store system Development
and stock management system management available of system
management system Year 2:
of medical Implementation
equipment
and
commodities
26. Establish an inclusive team to Technical No clear Technical Year 1: NA BTD
develop technical specifications and specification and system on how specification Establish a
quantification of equipment and quantification done quantification and team
consumables to be procured every financial year is done quantification
provided by
an
established
team

To maintain 27. To regularly train staff on QMS AfSBT Step 3 AfSBT Y1-Y5: All 5 years 150,339,600 BTD
QMS requirements in all processes of Accreditation Accreditation Maintain Step
requirements BTD activities 3 AfSBT
in all Accreditation
processes of 27.1. Conduct induction training to
blood donor all new BTD staff
mobilization
activities 27.2. Conduct training to
strengthen the knowledge and
techniques of BTD staff on QMS at
least once every year

28. Ensure the safety of blood BTD

donors who regularly donate on
apheresis

28.1. Test serum total proteins by

Year 2

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Objectives Strategy Process Indicator Baseline Target Year BUDGET Stakeholders
(FRW)
Improve 29. Enhance the knowledge of BTD Number of BTD All staff Year 1: BTD 60,000,000 BTD/HFs
rational use of and Hospital staff on the use of staff trained & involved in staff & Hospital
blood blood components, identification Number of blood staff training
components and management of donor Hospitals staff transfusion Year 2:
and &patients adverse reactions trained and chain trained Initiation of
hemovigilance mentored eLearning
system Year 3: BTD
staff & Hospital
staff training
Year 4: BTD
staff & Hospital
staff training
Year 5: BTD
staff & Hospital
staff training
29. Ensure the integration of Transfusion related In 60% of 100% of Year 1: 25,000,000 BTD/HFs/MOH
hemovigilance system into Drug reports provided by hospitals, hospitals, Integration
and Therapeutic Committee of DTC hemovigilance Functional done
Transfusing Hospitals system hemovigilance
integrated in system
DTC integrated in
DTC
30. Incorporate hemovigilance Functional system Hemovigilance Functional Year 1: Piloting BTD,RBC, RISA, GIZ
program into the blood bank system hemovigilance Year 2:
information system incorporated system implementation
on RBC
website

31. Advocate for the implementation Number of lookback Lookback data Lookback Year 1: BTD, RBC, MOH
of the lookback policy cases investigated collected at system Advocacy
BTD level properly Year 2: Piloting
functioning Year 3:
Implementation

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Objectives Strategy Process Indicator Baseline Target Year BUDGET Stakeholders
(FRW)
To ensure that 32. To organize urban and rural Number of 65000 Blood Y1: 71500 5 Year 1,100,000,000 BTD/RBC
everyone who blood collection drives collected blood Units Blood Units
is eligible to units Y2: 78650
donate blood 32.1. Purchase and maintain Blood Blood Units
has access to mobile collection trucks to be used Y3: 86515
blood in urban areas Blood Units
collection Y4: 95166
services 32.2. Purchase and maintain Blood Blood Units
and staff transport Vehicles Y5: 104683
Blood Units
Improve 33. Advocate for the acquisition of Number of facilities No facilities Zipline and Year 1: BTD/RBC/Zipline
availability of equipment used to split adult units performing the split able to split Transfusing Advocacy
blood into pediatric units at Zipline of adult units into adult units into Health Year 2:
components pediatric units paediatric Facilities able implementation
to the units to perform
Transfusing transformation
Health of adult units
Facilities into pediatric
units
34. Advocate for the acquisition of Number of facilities Only Zipline and Year 1: BTD/HFs/MOH
equipment used to store & thaw performing storing Gihundwe DH all Advocacy
FFP&Cryo ( freezers and plasma FFP and Cryo storing FFP & Transfusing Year 2:
thawer) in Transfusing facilities with Cryo facilities not implementation
high consumption of FFPs&Cryo served by
(KFH, RMH, BAHO, KIBAGABAGA, zipline storing
HCS) FFP and Cryo
35. Advocate for the increase of Number of health 25 Health 40 Health Year 1: BTD/RBC/MOH/Zipline
Health Facilities supplied by Zipline facilities supplied by facilities facilities Advocacy
Zipline supplied by supplied by
Zipline Zipline

9,034,021,372

9. Monitoring and Evaluation Matrix

No Indicators Baseline Indicators target Responsible Means of

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 verification
Y1 Y2 Y3 Y4 Y5
1 Prevalence HIV: 0,07% Y1 HIV: 0,06% HIV: 0,05% HIV: 0,05% HIV: 0,04% BDMSSO Quality indicators
of TTIs HCV: 0,5% HIV: 0,06% HCV: 0,45% HCV: 0,4% HCV: 0,4% HCV: 0,35% report
HBV: 0,8% HCV: 0,45% HBV: 0,75% HBV: 0,7% HBV: 0,7% HBV: 0,65%
SYPH: HBV: 0,75% SYPH: 0,33% SYPH: 0,28% SYPH: 0,28% SYPH: 0,23%
0,38% SYPH: 0,33%

2 Number of 13 cool 12 T ACE Equipment

equipment boxes
PH inventory
purchased 2 sysmex
2 Sterility tests
centrifuges
20 cool
6 T ACE
boxes
6 freezers
50 Data
loggers
Year
2:Coagulatio
n factors
analyzer
Year 3: 2
Apheresis
machine
Year 4: 2
sysmex
3 Number of TBD Validation of Validation of Validation of Validation of Validation of BBEMO, Validation reports

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 validated all incoming all incoming all incoming all incoming all incoming HoSs
equipment critical critical critical critical
critical
equipment equipment equipment equipment
equipment
4 Number of Need Purchase of Leuko- LOSO Blood
blood assessment
equipment reduced components
component
s that are RBCs, CMV inventory
leuko-
neg RBCs
reduced,
CMV
tested,
Special
blood
component
s
5 Number of None Confirmatory Confirmatory DM, LOSO, TTIs confirmation
confirmator tests for HIV tests for HCV
QAASO reports
y tests for introduced introduced
HIV and
HCV
performed
within BTD
6 Study on None Proposal Fund Conduct DoUS, Articles published
CMV and mobilization
study QAASO,
HTLV
prevalence SERO SO
7 Comparativ None Proposal Fund DoUs, Study report
e study mobilisation
QAASO and
between & Conduct
RPR and study SERO SO
ELISA
8 Number of None Feasibility Implementati LOSO, DM Equipment
NAT tests
study on inventory
performed
on donated
blood ,
level of
residual
risks

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9 Number of Need Ab Phenotyping IMH SO, Test reports
antibody assessment, Identification
LOSO
screening, Ab screening
identificatio
n and
phenotypin
g tests
performed
10 Developed eProgesa Piloting implementati Interfacing of QAASO, System in use
and (imported on
lab BECSO, GIZ,
functional system)
made-in equipment RISA
Rwanda
blood bank
information
system
Ma
de in
Rwanda
11 Upgraded VPN: 12.5 VPN: 25 - - - - BECS O, Measure
BTD Megabytes, megabytes,
RBC IT Bandwidth
bandwidth Internet: Internet: 25
for internet 12.5 megabytes
and VPN to megabytes
facilitate
the use of
Blood Bank
information
system
12 New BTD Structure - Advocacy Approval - - DM, RBC Structure in place
structure not properly
reflecting reflecting
current current
operational operations
needs
13 Performanc None Implementati Implementati Implementati Implementati Implementati DoUs, HoSs Performance
e on on on on on
evaluation reports
evaluation
and and improvement
continual
plan
improveme

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 nt
14 Calculated None Conduct a Conduct a Conduct a Conduct a Conduct a DoUs, Residual risk
residual study study study study study
QAASO calculation report
risks for
TTIs in
blood
supply
15 BTD None Establish a - - - - BBEMO Replacement plan
infrastructu plan
re &
facilities
maintenanc
e plan
16 Number of None Development Carry out Carry out Carry out Carry out Research Published articles
published of proposals research research research research
team
papers & fund
mobilization
17 Number of 40,6% 41% 42% 43% 44% 45% BDMSSO, Reports
collected
BDRRSO
blood units
from BDEOO
regular
blood
donors
18 Number of 65,000 71,500 78,650 86,515 95,166 104,683 BDMSSO, Reports and
collected
BDRRSO Hospital
blood units
BDEOO Satisfaction
19 Number of 95,000 104500 114950 114950 137940 152884 BDMSSO, Reports and
blood
BDRRSO Hospital
component
s units BDEOO Satisfaction
produced
PPSO
20 Number of 11 16 production - - - - DM Availability of staff
staff production tech, 6
appointed tech, 10 IH serology
in RCBT tech and 4 tech, 14 IH
Kigali serology tech
tech (RCBT
Kigali)

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21 Functioning No well- Development Implementati - - - BBEMO System
supply defined of system on
QAASO developed and
chain and store
equipment managemen BECSO functional
system in t system
place

22 AfSBT Step 3 Maintain Step Maintain Step Maintain Step Maintain Step Maintain Step QAASO Accreditation
Accreditatio AfSBT 3 AfSBT 3 AfSBT 3 AfSBT 3 AfSBT 3 AfSBT
DoUs certificate
n Accreditatio Accreditation Accreditation Accreditation Accreditation Accreditation
n HoSs
23 Transfusion In 60% of 100% of - - - - DoUs Reports on
related hospitals, hospitals,
transfusion
reports hemovigilan Functional
provided by ce system hemovigilanc reactions
DTC integrated in e system
DTC integrated in
DTC
24 Number of Lookback Advocacy Piloting Implementati - - DM Notification of
lookback data on
DoUs hospitals on
cases collected at
investigate BTD level seroconverted
d
blood donors

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