The global surgery blood drought: frontline provider data on barriers and solutions in Bihar, India
Background: Limited access to safe, timely banked blood is a critical barrier to providing basic surgical care in resource-limited settings globally. Contextual, locally driven data are required to elucidate country needs, develop effective interventions, and guide policy decisions. Objective: We em...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-01-01
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| Series: | Global Health Action |
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| Online Access: | http://dx.doi.org/10.1080/16549716.2019.1599541 |
| _version_ | 1818891905999568896 |
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| author | Rachita Sood Rachel R Yorlets Nakul P Raykar Remya Menon Hemant Shah Nobhojit Roy |
| author_facet | Rachita Sood Rachel R Yorlets Nakul P Raykar Remya Menon Hemant Shah Nobhojit Roy |
| author_sort | Rachita Sood |
| collection | DOAJ |
| description | Background: Limited access to safe, timely banked blood is a critical barrier to providing basic surgical care in resource-limited settings globally. Contextual, locally driven data are required to elucidate country needs, develop effective interventions, and guide policy decisions. Objective: We employ qualitative methodology to describe barriers faced and solutions proposed by front-line obstetric providers in Bihar – a poor, populous Indian state where maternal mortality exceeds the national average. We aim to make locally driven recommendations for ongoing policy work in India to strengthen the country’s blood transfusion system. Methods: From February to May 2016, two researchers conducted semi-structured interviews with 19 obstetric providers across Bihar. Snowball sampling was employed until thematic saturation was reached. Following immersion into de-identified texts and dual codebook development, a primary analyst completed topical coding, and a secondary analyst confirmed reproducibility. Results: Providers report that pervasive banked blood shortages force hospitals to require replacement donation, but patients’ families often cannot or will not donate. Providers wait one to six hours for blood, depending on availability of staff and supplies, blood bank proximity, and the ability of the patient being treated to navigate the system. Providers feel forced to refer their patients, often to distant, poorly equipped centers. Providers identify donor education, improved infrastructure, and improved local coordination as focus areas for intervention. Conclusions: A multi-stakeholder approach that aims to increase blood donation through community education, mitigate limited infrastructure through short-term workarounds, and improve local-level coordination through state support and policy change is required in Bihar. This study generates data to guide policy and future research aimed at generating affordable, contextually appropriate interventions to the blood drought. |
| first_indexed | 2024-12-19T17:48:15Z |
| format | Article |
| id | doaj.art-c2ea6712444c411eafe019917dd43cd3 |
| institution | Directory Open Access Journal |
| issn | 1654-9880 |
| language | English |
| last_indexed | 2024-12-19T17:48:15Z |
| publishDate | 2019-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj.art-c2ea6712444c411eafe019917dd43cd32022-12-21T20:11:59ZengTaylor & Francis GroupGlobal Health Action1654-98802019-01-0112110.1080/16549716.2019.15995411599541The global surgery blood drought: frontline provider data on barriers and solutions in Bihar, IndiaRachita Sood0Rachel R Yorlets1Nakul P Raykar2Remya Menon3Hemant Shah4Nobhojit Roy5Northwestern UniversityBoston Children’s HospitalHarvard Medical SchoolCARE India – BiharCARE India – BiharKarolinska InstitutetBackground: Limited access to safe, timely banked blood is a critical barrier to providing basic surgical care in resource-limited settings globally. Contextual, locally driven data are required to elucidate country needs, develop effective interventions, and guide policy decisions. Objective: We employ qualitative methodology to describe barriers faced and solutions proposed by front-line obstetric providers in Bihar – a poor, populous Indian state where maternal mortality exceeds the national average. We aim to make locally driven recommendations for ongoing policy work in India to strengthen the country’s blood transfusion system. Methods: From February to May 2016, two researchers conducted semi-structured interviews with 19 obstetric providers across Bihar. Snowball sampling was employed until thematic saturation was reached. Following immersion into de-identified texts and dual codebook development, a primary analyst completed topical coding, and a secondary analyst confirmed reproducibility. Results: Providers report that pervasive banked blood shortages force hospitals to require replacement donation, but patients’ families often cannot or will not donate. Providers wait one to six hours for blood, depending on availability of staff and supplies, blood bank proximity, and the ability of the patient being treated to navigate the system. Providers feel forced to refer their patients, often to distant, poorly equipped centers. Providers identify donor education, improved infrastructure, and improved local coordination as focus areas for intervention. Conclusions: A multi-stakeholder approach that aims to increase blood donation through community education, mitigate limited infrastructure through short-term workarounds, and improve local-level coordination through state support and policy change is required in Bihar. This study generates data to guide policy and future research aimed at generating affordable, contextually appropriate interventions to the blood drought.http://dx.doi.org/10.1080/16549716.2019.1599541blood transfusion systemmaternal mortalityindiahealth system strengtheningobstetric hemorrhageglobal surgery |
| spellingShingle | Rachita Sood Rachel R Yorlets Nakul P Raykar Remya Menon Hemant Shah Nobhojit Roy The global surgery blood drought: frontline provider data on barriers and solutions in Bihar, India Global Health Action blood transfusion system maternal mortality india health system strengthening obstetric hemorrhage global surgery |
| title | The global surgery blood drought: frontline provider data on barriers and solutions in Bihar, India |
| title_full | The global surgery blood drought: frontline provider data on barriers and solutions in Bihar, India |
| title_fullStr | The global surgery blood drought: frontline provider data on barriers and solutions in Bihar, India |
| title_full_unstemmed | The global surgery blood drought: frontline provider data on barriers and solutions in Bihar, India |
| title_short | The global surgery blood drought: frontline provider data on barriers and solutions in Bihar, India |
| title_sort | global surgery blood drought frontline provider data on barriers and solutions in bihar india |
| topic | blood transfusion system maternal mortality india health system strengthening obstetric hemorrhage global surgery |
| url | http://dx.doi.org/10.1080/16549716.2019.1599541 |
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