As WHO flags gaps
GAZETTE REPORTER
Botswana’s blood transfusion services are facing significant structural and operational weaknesses that could threaten the availability of safe blood supplies, a World Health Organisation (WHO) assessment has warned.
The WHO Botswana Country Office Biennial Report 2024–2025, released recently, highlights a series of challenges affecting the National Blood Transfusion Service (NBTS), including fragmented coordination, ageing equipment, weak information systems and recurring shortages of critical laboratory supplies.
The report calls for urgent reforms to strengthen the country’s blood management system, warning that existing gaps could undermine the safety, reliability and sustainability of blood transfusion services.
According to the assessment, Botswana’s National Blood Policy, drafted in 2018, has not been finalised and lacks an implementation strategy, while the absence of a national advisory body has weakened governance, oversight and accountability.
“Blood transfusion services coordination remains fragmented,” the report states, noting that several blood centres continue to operate with outdated equipment, inadequate cold-chain infrastructure and manual processes for blood component preparation.
PROCUREMENT BOTTLENECKS FUEL SHORTAGES
WHO says procurement challenges have contributed to periodic shortages of essential reagents and consumables required for blood testing and processing.
These supply interruptions, the report warns, pose risks to continuity of services and the ability of health facilities to maintain adequate blood stocks.
The assessment further identifies shortages of specialised personnel, particularly in laboratory services, quality management and donor recruitment.
“Staff require further training in quality assurance, automation and regulatory standards,” WHO notes.
The report also raises concern over the absence of a unified national blood information system, which limits the ability of health authorities to track blood availability, demand trends and safety indicators in real time.
Hospitals, WHO says, do not consistently submit blood-related data to the NBTS, making effective planning and resource allocation difficult.
WEAK OVERSIGHT OF TRANSFUSION SAFETY
The global health agency also highlighted weaknesses in monitoring transfusion safety, revealing that most hospitals do not have functioning transfusion committees. This has contributed to under-reporting of adverse transfusion reactions and gaps in quality assurance mechanisms.
WHO has recommended a comprehensive overhaul of the blood system, including the completion of the National Blood Policy, establishment of a National Blood Advisory Group and strengthening of the NBTS organisational structure.
The agency has also called for investment in automated blood component production technologies, improved cold-chain systems and stronger procurement processes to prevent future shortages.
“The path forward requires deliberate reforms, sustained investment and strengthened partnerships,” the report says.
WHO further recommends the establishment of a national blood information system integrated into Botswana’s broader health information framework.
BROADER HEALTH SYSTEM PRESSURES
The concerns over blood services come amid wider pressures facing Botswana’s health sector.
Beyond blood transfusion services, WHO highlighted continuing challenges in maternal and child health programmes, including shortages of healthcare workers, vaccine stockouts, weak data reporting systems and limitations in cold-chain capacity.
Botswana’s emergency response capacity remains weak, with delayed approval of key emergency plans and no fully operational centre to coordinate outbreak responses.