Obstetric hemorrhage and safe blood for transfusion in Ethiopia: the challenges of bridging the gap.

BACKGROUND: Obstetric hemorrhage is a leading cause of maternal death in sub-Saharan Africa, and the shortage of blood for transfusion is a contributory factor. In Ethiopia, the National Blood Bank Service continues to be confronted with challenges in its efforts to ensure the availability of blood for health care facilities. This paper reviews the available data on the contribution of obstetric hemorrhage to maternal mortality and examines the current status of the blood supply in Ethiopia.

STUDY DESIGN AND METHODS: We reviewed the published literature and data from the Ethiopian Federal Ministry of Health. To assess the status of the current blood supply, we applied the five cornerstones of a safe and effective blood donor service advocated by the World Health Organization.

RESULTS: Our review indicates that there are insufficient national data on the prevalence of obstetric hemorrhage and the contribution of blood supply shortage to maternal death. Also, transfusion safety may be compromised by inadequate testing of donated blood and ineffective hospital transfusion policies.

CONCLUSION: To overcome the shortage of blood to treat obstetric hemorrhage, the first step is to evaluate the demand and supply gap by acquiring comprehensive data on the current status of the blood supply and the prevalence of obstetric hemorrhage in Ethiopia. Subsequent steps would include the implementation of transfusion policies, the optimization of whole blood collection, ensuring quality-assured testing of donated blood, and the implementation of transfusion guidelines for the appropriate use of blood products. Strategies for long-term, viable solutions to maintain an adequate blood supply should be simultaneously developed.