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National data from India
shows that there are 1 585 licensed blood banks with more than half of the
blood banks collecting less than 1 000 units of blood annually. These blood
banks, of which 45% are in the public sector and about 23% in the private
sector, have different management structures and no effective coordination.
Nationally, 40% of total blood collection is from voluntary non-remunerated
blood donors and the rest from family/replacement donors. It is estimated
that only 20% of the total blood collected is separated into blood
components. Data shows that 74% of transfusions in adults are inappropriate.
Interventions for improving clinical use of blood have been evaluated; from
which it is clear that single interventions do not work and that a package of
interventions with active clinician involvement is necessary. There is a lack
of awareness of existing national policies and guidelines for the clinical
use of blood. Of the 13 hospitals represented, none of the transfusion committees
are active and none have provisions for preoperative or perioperative
autologous transfusions. They do however, have access to plasma substitutes
and nine blood banks prepare different blood components. Graduate training
programmes exist in all the hospitals from where the participants came to
attend this workshop.
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