Evaluating the quality of routinely reported data on malaria commodity stocks in Guinea, 2014-2016.

BACKGROUND: Ensuring malaria commodity availability at health facilities is a cornerstone of malaria control. Since 2013, the Guinea National Malaria Control Programme has been routinely collecting data on stock levels of key malaria commodities through a monthly routine malaria information system (RMIS). In parallel, biannual end-user verification (EUV) surveys have also assessed malaria commodity availability at a subset of health facilities, potentially representing a duplication of efforts. METHODS: Data on 12 malaria commodity stock levels verified during four EUV surveys conducted between 2014 and 2016 was compared to data for the corresponding months submitted by the same health facilities through the RMIS. The sensitivity and specificity of the RMIS in detecting stock-outs was calculated, as was the percent difference between average stock levels reported through the two systems. RESULTS: Of the 171 health facilities visited during the four EUV surveys, 129 (75%) had data available in the RMIS. Of 351 commodity stock-outs observed during the EUV in the sampled reporting health facilities, 256 (73%) were also signaled through the corresponding RMIS reports. When the presence of malaria commodity stocks was confirmed during the EUV surveys, the RMIS also reported available stock 87% (677/775) of the time. For all commodities, the median percent difference in average stock levels between the EUV and RMIS was 4% (interquartile range - 7 to 27%). CONCLUSION: The concordance between stock levels reported through the RMIS and those verified during the EUV visits provides certain evidence that RMIS data can inform quantification and procurement decisions. However, lower than acceptable rates of reporting and incomplete detection of stock-outs from facilities that do report suggest that further systems strengthening is needed to improve RMIS reporting completeness and data quality.

[Blood transfusion safety in a limited resources setting: the elaboration of a rational National Blood Policy in Togo]. / Sécurité transfusionnelle dans un contexte de ressources limitées: processus de mise en place de la politique nationale transfusionnelle au Togo.

The demand for blood transfusion is high in subSaharan Africa because of the high prevalence of the anemia especially due to malaria and obstetrical damage. Providing a safe and confident system of transfusion requires more and more resources when, in developing countries, these are in fact limited. With a double view to improve the coverage in blood transfusion and ensure the security of blood products, the Ministry of Health of Togo launched in 1999 a series of operations for setting up a rational National Blood Transfusion Policy. The following steps were undertaken. A two-week situation analysis of the blood transfusion sector highlighted the lack of sector regulation, the multiplicity of blood unit production centres (n = 33 for a country of 56,000 km(2)) that could endanger the security of the products especially in limited resources conditions, the inadequacy in quality management in all areas of blood transfusion (insufficiency of human resources, equipment and supply, lack of procedures, etc.) and the lack of an information system on blood transfusion for retrospective survey and planning. The draft of the National Blood Transfusion Policy was then written in a week by two national consultants in accordance with the findings of the situation analysis. It was validated during a three-day multidisciplinary workshop and an ultimate validation was made by an international consultant in order to assess the adequacy of the options considered to the country's specific setting. The options retained for developing the Togolese blood transfusion sector development and which are consigned in the National Blood Transfusion Policy are as follows: development and implementation of blood transfusion regulations; reorganisation of the National Transfusion System by reducing it to 3 blood unit production centres: one in Lomé (the capital town), one in the centre of the country (Sokodé, 480 km from Lomé), and one in the Northern part (Dapaong, 870 km from Lomé); setting up of a system of blood collection, storage and distribution around these centres; promotion of voluntary and anonymous blood donation; promotion of quality assurance in the system and of good blood prescription practice; development and implementation of an appropriate and simple information system for better management; identification of a sustainable and equitable financing system in which the State must play a key role. The implementation of the National Blood Policy; and in particular the achievement of its goals requires: i) permanent State commitment; ii) the building of a rational action plan - with a financing framework for all blood transfusion partners; and iii) regular program evaluation.