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This chapter discusses the problems faced in the development of transfusion services in lower medium-income countries, predominantly focusing on sub-Saharan Africa. A safe supply of blood is an essential part of medical services and an intrinsic part of any strategy to reduce maternal and childhood mortality. The World Health Organization recommends that all blood donations should be screened for infections before use. Screening for human immunodeficiency virus, hepatitis B, hepatitis C and syphilis should be mandatory. Blood screening should be performed according to quality system requirements. Recruiting voluntary donors from the community is complex, expensive and depends on regular education programmes, collection teams, vehicles and cold storage. Pregnant women are the second most common recipients of blood, particularly for haemorrhagic emergencies. The use of guidelines can reduce unnecessary transfusions and many institutions in sub-Saharan Africa and Asia have developed guidelines to promote the rational use of blood and blood components.

Original publication





Book title

Practical Transfusion Medicine: Sixth Edition

Publication Date



324 - 336