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(NAR) VOL. 21 NO.1/ JANUARY - MARCH 2010

[ DOH ADMINISTRATIVE ORDER NO. 2010-0002, January 07, 2010 ]

POLICIES AND GUIDELINES PERTINENT TO THE ESTABLISHMENT AND OPERATION OF LOCAL BLOOD COUNCILS TO SUPPORT THE IMPLEMENTATION OF THE NATIONAL VOLUNTARY BLOOD SERVICES PROGRAM FOR BLOOD SAFETY AND ADEQUACY, QUALITY CARE AND PATIENT SAFETY

I. RATIONALE

One of the provisions of the National Blood Services Act of 1994 (Rep. Act No. 7719) is the promotion and encouragement of Voluntary Blood Donation by the citizenry. This strategy is expected to bring about an adequate supply of safe blood under the National Voluntary Blood Services Program. Furthermore, RA 7719 states that all sectors shall be mobilized to participate in mechanisms for voluntary and non-profit collection of blood. For this purpose, the participation of communities may be obtained by organizing various sectors into Local Blood Councils, which could spearhead the Local Blood Donation Program. The critical role of community participation as the main source of low-risk healthy regular volunteer blood donors needs to be highlighted.

This Administrative Order (AO) describes the Policies and Guidelines which will govern the establishment and operation of Local Blood Councils which shall support the Regional Blood Services Network; component cities, districts, municipalities and barangays. It complements the AO on Guidelines for the Philippine National Blood Services (PNBS) and the Blood Services Network. It states that every region, province and highly urbanized city shall establish a Local Blood Council.

To support the establishment of the Local Blood Councils and assure its integration into existing health initiatives and sustainable financing at the community level, provisions of this Administrative Order for the establishment and operation of Local Blood Councils must be made consistent, whenever applicable, to the Administrative Order on Incentive Scheme Framework for Enhancing Inter-LGU Coordination in Health through Inter-Local Health Zones (ILHZ) and Ensuring their Sustainable Operations (AO No. 2006-0017).

II. SCOPE

This policy shall apply to all community-based organizations which are established and operated to promote voluntary donation and support the collection and provision of safe and adequate blood and blood components for transfusion under the National Voluntary Blood Services Program. Local Blood Councils should be established in every region, province and highly urbanized cities. They are encouraged in component cities, districts, municipalities and barangays.

III. OBJECTIVE

These Policies and Guidelines are promulgated to guide the establishment and operation of Local Blood Councils pursuant to the National Blood Services Act of 1994 (RA 7719) and its Revised Implementing Rules and Regulations. This Administrative Order supplements the following: Guidelines for the Philippine National Blood Services (PNBS) and the Blood Services Network; Operational Guidelines for Blood Services Network (BSN) in Support to the Implementation of the National Voluntary Blood Services Program for Blood Safety and Adequacy, Quality Care and Patient Safety; and, the National Policy on Patient Safety.

IV. DEFINITION OF TERMS:

A. APHERESIS FACILITY - a blood service facility where blood collection procedure is done in which whole blood is removed, a selected component separated and the remainder returned to the donor;

B. BLOOD CENTER (BC) - a non-hospital based blood service facility licensed by the DOH Bureau of Health Facilities and Services (BHFS) whose main function is to process blood units into blood components and testing of these units for the five (5) infectious disease markers. Detailed service capabilities are enumerated in A.O. No. 2008-0008;

C. BLOOD COLLECTION UNIT (BCU) - a blood service facility, duly authorized by the DOH-Center for Health Development whose main function is to collect blood from volunteer non-remunerated blood donors. Detailed service capabilities are enumerated in A.O. No. 2008-0008;

D. BLOOD DONOR PANEL - persons recruited and willing to donate blood and may be called upon anytime to donate;

E. BLOOD DONOR REGISTRY - a list of individuals who are registered as blood donors with their ABO group and Rh type, identity and contact information (complete name, address, telephone number, e-mail address);

F. BLOOD SERVICE FACILITY (BSF) - a unit, agency or institution providing blood products. The types of BSF, i.e., Blood Station, Blood Collection Unit, Hospital Blood Bank and Blood Center (National, Sub-national and Regional) are defined below;

The Blood Centers shall be classified into Regional, Sub-national and National as assigned by the National Council for Blood Services (NCBS);

G. BLOOD SERVICES NETWORK - an informal organization established to provide for the blood needs of a specific geographical areas or catchment population. It is composed of the designated blood center, hospital blood banks, blood collection units, blood stations and end-user hospitals/non-hospital health facility/ies. The objectives of the Blood Services Network is the efficient distribution of voluntarily donated blood by the blood center to different Blood Service Facilities, hospitals and other end users to make blood available to all patients, maximize utilization of available blood and avoid wastage;

H. BLOOD STATION (BS) - a blood service facility, duly authorized by the DOH - Center for Health Development (CHD) with the main function is the storage, issuance, transport and distribution of whole blood and packed red cells. Detailed service capabilities are enumerated in A.O. No. 2008-0008;

I. DIRECTORY OF DONOR REGISTRIES - an index of blood donor registries by agency or barangay, which includes the complete names, addresses and other contact information;

J. HOSPITAL BLOOD BANK - a blood service facility in a hospital, duly licensed by the DOH - Center for Health Development (CHD) whose service capabilities are enumerated in A.O. 2008-0008;

K. LOCAL BLOOD COUNCIL - a non-profit, non-governmental, multi-sectoral group whose members come from government and private sector in the local community committed to support the blood program. Its objective is to plan and implement a local blood donation program in accordance to DOH policies and guidelines on Local Blood Councils.

V. STRUCTURAL ORGANIZATION OF LOCAL BLOOD COUNCIL

A.Membership

The Local Blood Council shall be composed of representatives of various community sectors, such as Local Government Units, National Government Agencies in the localities, Local Health Services, Hospitals, PNRC and Dugong Pinoy Chapters, Health Professional Associations, Schools, Military and Police establishments, civic/religious organizations, Business and agricultural sectors, mass media, etc.

B. The Local Blood Council shall be organized as a Non-governmental organization with members coming from both the government and private sectors. It may be established in one of the following ways:

1. Memorandum of Agreement among member organizations designating the Lead Agency and the Custodian of Funds;
2. Created by an Ordinance passed by the appropriate Sanggunian or by an Executive Order of Local Government Executive;
3. Attached to Regional Blood Council and the National Council for Blood Services of the NVBSP.

C. Every region, province and highly urbanized city should establish a Local Blood Council that shall support the Regional Blood Services Network in public education, donor recruitment, organization/conduct of mobile blood donation activities, and provision of human and financial resources;

D. A Local Blood Council is likewise encouraged to be formed in component cities, districts, municipalities and barangays;

E. Objectives of the Local Blood Council:

To plan and coordinate the implementation of a Local Voluntary Blood Donation Program which aims to ensure adequate supply of safe blood for the community.

2. Specific Objectives:

a. To ensure an adequate supply of blood through promotion of voluntary blood donation.

b. To mobilize human resource/facilities/financial support for local public education and donor recruitment program.

c. To organize mobile blood donations in coordination with the Regional Blood Center and authorized Blood Collection Units (BCUs)

d. To organize the hospital and other health services in the community into a functional and efficient network consistent with the established Inter-Local Health Zone (ILHZ).

e. To assist the local blood services network in public education; donor recruitment; organization/conduct of mobile blood donation activities; and provision of human and financial resources.

F. The Local Blood Council shall elect an Executive Board which shall have at least 11 members.

G. The Executive Board shall elect Officers from members of the Board consisting of President, Vice-President, Secretary, Treasurer, PRO, Auditor, and such other officers that they deem necessary.

H. The Executive Board shall create Committees to plan and implement components of Local Blood Donation Program, such as:

Executive Committee Committee on Public Education
Committee on Donor Recruitment
Committee on Mobile Blood Donation
Committee on Ways and Means

I. A Local Blood Donation Program Coordinator shall be designated by the Local Government Health Officer.
VI. FUNCTIONS AND LIMITATION OF THE LOCAL BLOOD COUNCIL

A. The Functions of the Local Blood Council are:

1. Participate in the formulation of the Local Blood Donation Program that fulfills the needs for blood transfusion in the community;

2. Plans and implements public education, advocacy and donor recruitment activities to promote voluntary blood donation;

3. Organizes mobile blood collection activities in coordination with the Blood Centers and authorized Blood Collection Units;

4. Spearheads/assists in fund-sourcing/fund-raising from within the community and from external governmental and non-governmental organizations, financial institutions or agencies.

5. Strengthens the linkages of local hospitals, facilities providing emergency obstetric care (BEmONC/CEmONC) and health services with the Blood Center(s);

6. Coordinates and monitors the implementation of the Local Blood Donation Program.

1. Local Blood Council shall not be allowed to set-up or operate a blood service facility

VII. STRATEGIES FOR LOCAL BLOOD DONATION PROGRAM

A. To accomplish its objectives, the Local Blood Council shall implement the following strategies for the Local Blood Donation Program:

1. Public Education
2. Recruitment of blood donors
3. Mobile Blood Donations

B. Blood Services Network: The Local Blood Council shall coordinate and assist in the implementation of a functional network for the provision of an adequate supply of blood among government and private hospitals and the Blood Centers to ensure access to blood by all patients.

C. Recognition of Blood Donors: The Local Blood Council shall hold award ceremonies that shall recognize the importance of the contributions of blood donors, donor recruiters and supporting organizations.

VIII. POLICIES FOR THE LOCAL BLOOD DONATION PROGRAM

A. To assure an adequate and accessible supply of safe blood for transfusion, the Local Blood Council shall be governed by the following policies:

1. Public education and donor recruitment shall convey messages:

- Motivate healthy, low risk donors to give blood:
- Discourage persons with high risk exposure to transfusion transmissible diseases and high-risk behavior from donating blood.
- Give opportunity to such persons to defer themselves (self-deferral) or inform the Blood Center confidentially not to use the blood that they donated (self-exclusion)

2. Blood shall be collected from voluntary non-remunerated donors. There shall be no payments in cash or in kind which may motivate potential donors to withhold information of high-risk exposure or behavior. Blood from such persons may compromise the safety of the blood products, and the safety of the patients receiving the blood transfusion.
B. Blood donation activities shall be conducted in strategic locations by Authorized Blood Collection Units in coordination with the Regional Blood Center;

C. Mobile blood donation sessions shall be done in various areas in the community, barangays, churches, schools, offices, malls, military camps, police stations, etc.;

D. There shall be efficient networking among hospitals and the Blood Center to make blood available to all patients and avoid wastage;

E. The Local Blood Donation Program shall be included in the Work Financial Plan of the Local Government Unit (LGU) (DILG Memo.Circular No. 99-133, dated August 4, 1999). Resources-financial, human and material - shall be provided to the Local Blood Council and implementing organizations in accordance to the approved budget granted by the LGU;

F. All requests and issuances of blood products shall be between the hospital BSF or Clinical Laboratory and the Blood Center;

G. A registry of blood donors with rare blood types shall be maintained. All Blood Banks and BCUs shall submit the names and pertinent data to the Blood Center which shall submit them to the PNRC National Blood Center Rare Blood Donor Registry.

H. A Regional Blood Council shall supervise the local blood councils within its region and shall report to the National Council for Blood Services.

IX. ACTIVITIES OF THE LOCAL BLOOD COUNCIL

A. To accomplish their objectives and implement the strategies, the following are the suggested activities of the Local Blood Council in their operational plans:

1. Plan the Local Blood Donation Program
2. Form the committees to undertake the strategies
3. Formulate the annual operational plans for each strategy
4. Organize various groups for the implementation of the planned strategies/activities
5. Formulate policies and procedures for the provision and sharing of
-Human Resource
- Facilities
- Reagents, blood bags and supplies
- Refreshments
- Funds

6. Organize and supervise an active secretariat
7. Implement strategies/activities of the local blood donation program
8. Monitor and evaluate the activities of the local blood donation program
9. Report activities and accomplishments and financial transactions

- Periodic (quarterly) to executive board and Regional Blood Council
- Annually to general membership and Regional Blood Council.

X. FINANCING MECHANISMS AND FINANCIAL MANAGEMENT

A. Sources of funds - The Local Blood Donation Program may be financed from the following sources:

1. Allocation from the Regional Blood Center, NVBSP
2. Allocation from Local Government Unit (see memo circular)
3. Contributions from the Business sector
4. Contributions from the PNRC National Blood Services
5. Fund raising activities in the community
6. Grants from Donor agencies, local and international
7. Contributions from NGOs, civic, and religious organizations
8. Contributions from Mass media (in kind)
9. Grants from Government financial institutions
10. Subsidy from hospitals, private and government

B. Financial Management - Sound financial management principles and procedures which specifies clear lines of accountability shall be set up and maintained consistent with applicable government accounting and auditing rules and regulations. Further, for sustainable operations, applicable guidelines for ILHZ as stated in AO 2006-0017 must likewise be followed.

XI. SECRETARIAT OF THE LOCAL BLOOD COUNCIL

A. The Local Blood Council shall designate a Secretariat which shall have the following functions:

1. Provides secretarial support to the Local Blood Council and the Committees;
2. Handles communications and correspondence;
3. Assists the Secretary in the custody of documents;
4. Assist the Treasurer in the management of funds and preparation of financial reports;
5. Coordinates and monitors the activities of the Council and the Committees under the supervision of the Officers;
6. Prepares reports under the direction of the Officers and Chairperson of Committees

XII. PERFORMANCE INDICATORS OF LOCAL BLOOD COUNCIL

A. To evaluate the accomplishment of the strategies and objectives, in coordination with the DOH Centers for Health Development (CHDs), the following indicators shall be monitored by the Local Blood Council. The selected indicators shall be included in the operational plans and data collected for the evaluation of Local Blood Donation Program.

a. Number of flyers, brochures or comics distributed
b. Number of posters/billboards
c. Number of press releases, articles or features printed
d. Number of radio/TV shows attended, interviews, etc.
e. Percent increase in number of people aware of the Voluntary Blood Donation Program.
f. Percent increase in number of people who became aware and who decided to donate blood.

2. Donor recruitment:

a. Number of donor recruitment officers trained
b. Number of community meetings, seminars, etc. held
c. Number of potential donors interviewed/signed up
d. Number of donor clubs/registries established or members recruited
e. Number of potential donors recruited (Target: 2% of total population)
f. Percent increase in donors recruited
g. Percent increase in 1st-time voluntary blood donors who returned for subsequent donations (as repeat or regular blood donor)

3. Donor screening & collection of blood:

a. Number of donors screened
b. Number of persons deferred
i. Percent of persons deferred
ii. Reasons for deferral

i. Mobile blood collection
ii. In-house blood collection

i. Increased Number of repeat donors - defined as a person who donated within one year prior to current blood donation (Target of repeat donors - 20% of total blood donors).

4. Financing and Financial Management

a. Amount of Funds raised - By source
b. Amount of audited Funds disbursed to support NVBSP activities

5. Management of Local Blood Donation Program:

a. Number of meetings held (Board and Committees)
- Number of Participants

b. Number of action/operational plans formulated
c. Number of events organized (mobile blood donations, Blood Donor
Recognition Programs, Blood Donors Month Activities, etc.)
d. Number of field visits for supervision and monitoring
e. Number of reports submitted
XIII. REPEALING CLAUSE

Previous issuances that inconsistent with this Administrative Order are hereby repealed and rescinded.

XIV. EFFECTIVITY

This Administrative Order shall take effect 15 days after publication in an Official Gazette or a newspaper of general circulation.

Adopted: 07 Jan. 2010

(SGD.) FRANCISCO T. DUQUE III, MD, MSc
Secretary of Health

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