Administrative Audit of Blood Transfusion Services in a Hemoglobinopathy-Endemic District of Central India: Implications for Clinical Practice
Rudraksh Kesharwani, Anjali Kumari, Aanavi Malik, Ritika Agarkar, Shubhangi Nagpal, Sheryl Francisca Godinho, Rishabh Rao Singaraju, Dhruvin PatelBackground:
Transfusion-dependent hemoglobinopathies such as sickle cell disease (SCD) and thalassemia require lifelong blood support, but transfusion services in India remain largely designed for episodic care, creating systemic barriers. Aim: To assess administrative gaps in blood transfusion services in a hemoglobinopathy-endemic district and their impact on transfusion-dependent patients.
Materials and Methods:
A multi-phase administrative audit was conducted in Raigarh, Chhattisgarh (June–October 2022), evaluating four blood banks across different administrative models. Patient experience mapping included 220 transfusion recipients. Administrative assessment, triangulation of findings, and limited pilot corrective interventions were performed.
Results:
Significant inter-bank variability existed despite uniform regulatory standards. Major gaps included fragmented workflows, poor hemovigilance, inadequate counseling, donor dependency, and weak continuity of care. Patients with SCD and thalassemia faced recurrent delays, repeated donor burden, cumulative financial strain, and poor recognition of chronic transfusion needs. Most deficiencies were process-related rather than resource-related, and selected administrative reforms were operationally feasible.
Conclusion:
Transfusion-dependent hemoglobinopathies represent a chronic care systems challenge requiring continuity-oriented transfusion services. Substantial improvements may be achieved through workflow redesign and better coordination without major additional resources, while targeted financial protection remains necessary.