埃塞俄比亚各地提供输血服务的医疗机构的输血服务准备情况及其相关因素：对2018年服务可用性和准备情况评估（SARA）调查的二次分析。

Blood transfusion service readiness and its associated factors in health facilities providing blood transfusion services across Ethiopia: A secondary analysis of the 2018 Service Availability and Readiness Assessment (SARA) survey.

作者信息

Fenta Tirualem Asmare, Tiruneh Gizachew Tadele, Ayele Nebiyou Fasil

机构信息

Ethiopian Food and Drug Administration, Addis Ababa, Ethiopia.

JSI Research & Training Institute, Inc. and Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.

出版信息

PLoS One. 2024 Dec 12;19(12):e0315665. doi: 10.1371/journal.pone.0315665. eCollection 2024.

DOI:10.1371/journal.pone.0315665

PMID:39666720

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11637254/

Abstract

INTRODUCTION

Timely and safe blood transfusion services are crucial for saving lives in emergencies. Previous studies have focused on hospital inpatient care access but have overlooked blood transfusion service readiness. This study examined the readiness of blood transfusion services in health facilities across Ethiopia and its determinants.

METHODS

This study used Service Availability and Readiness Assessment (SARA) 2018 data from 632 facilities. Readiness was measured based on seven components: the presence of at least one trained staff for appropriate use of blood and safe transfusion; guidelines for appropriate use and transfusion; blood storage refrigerator; blood typing; cross-match typing; blood supply safety; and blood supply sufficiency. Data were analyzed using descriptive and inferential statistics. Facility characteristics were summarized using frequency tables and summary statistics. Bivariate and multivariable linear regression analyses examined the predictors of service readiness.

RESULTS

Facilities offering blood transfusion services had a mean readiness score of 4.5 (out of 7), with only 5% having all items. Most facilities performed blood typing, but less than one-third conducted cross-match testing, and over half lacked guidelines and trained staff. Service readiness varied significantly across regions. Facilities in Oromia (Coef.: -0.74; 95% CI: [-1.32, -0.15]) and Somali (Coef.: -1.26; 95% CI: [-2.21, -0.31]) had lower readiness scores compared to Addis Ababa. Increased availability of medical equipment corresponded to a 49% increase in readiness scores (Coef.: 0.49; 95% CI: [0.19, 0.79]).

CONCLUSION

The study highlights deficiencies in blood transfusion service readiness and regional disparities, emphasizing the need for targeted support to enhance readiness across regions.

摘要

引言

及时且安全的输血服务对于在紧急情况下挽救生命至关重要。以往的研究主要集中在医院住院护理的可及性上，但忽视了输血服务的准备情况。本研究调查了埃塞俄比亚各医疗机构输血服务的准备情况及其决定因素。

方法

本研究使用了2018年来自632家医疗机构的服务可用性和准备情况评估（SARA）数据。准备情况基于七个组成部分进行衡量：至少有一名经过培训的人员负责血液的正确使用和安全输血；正确使用和输血的指南；血液储存冰箱；血型鉴定；交叉配血鉴定；血液供应安全；以及血液供应充足。使用描述性和推断性统计方法对数据进行分析。通过频率表和汇总统计对医疗机构特征进行总结。双变量和多变量线性回归分析检验了服务准备情况的预测因素。

结果

提供输血服务的医疗机构的平均准备得分是4.5（满分7分），只有5%的机构各项都达标。大多数机构进行血型鉴定，但不到三分之一的机构进行交叉配血检测，超过一半的机构缺乏指南和经过培训的人员。各地区的服务准备情况差异显著。与亚的斯亚贝巴相比，奥罗米亚州（系数：-0.74；95%置信区间：[-1.32，-0.15]）和索马里州（系数：-1.26；95%置信区间：[-2.21，-0.31]）的医疗机构准备得分较低。医疗设备可用性的提高对应着准备得分增加49%（系数：0.49；95%置信区间：[0.19，0.79]）。