CLINICIAN’S PERCEPTIONS, ATTITUDES AND APPROACH IN THE BLOOD DELIVERY SYSTEM: INSIGHTS FROM A QUALITATIVE STUDY IN KENYA janamac@outlook.com

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CLINICIAN’S PERCEPTIONS, ATTITUDES AND APPROACH IN THE BLOOD DELIVERY SYSTEM: INSIGHTS FROM A QUALITATIVE STUDY IN KENYA

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Alejandro Munoz-Valencia almunva@gmail.com University of Pittsburgh School of Medicine Anaesthesia Pittsburgh United States

Pratap Kumar pkumar@strathmore.edu Strathmore University Strathmore Business School Nairobi Kenya

Juan Carlos Puyana puyanajc@upmc.edu University of Pittsburgh School of Medicine Surgery Pittsburgh United States

Kenya

Oral or Poster

In Sub-Saharan Africa, obstacles to safe, and timely blood transfusions limit quality care and portend poorer outcomes. Clinicians are at the core of the delivery system that provides blood to patients who need it. Therefore, we undertook a qualitative study of clinicians to gain insight into the availability and transfusion of blood products with the aim of developing context-specific solutions.

We performed focus group discussions(FGDs) with clinical and medical officers and interviewed consultant specialists using key informant interviews(KII) in three counties in Kenya:Nakuru, Turkana and Siaya from August 2021-February 2022. All sessions were audio-recorded and transcribed into MAXQDA-2022.3. Using grounded theory, the data was analyzed to extract pertinent themes.

There were 57 participants across 6 FGDs and 19 interviews, 64% male, average age 35 years with a median 6 years of experience. Consultants commonly reported non-standardized approaches to blood rationing(68%). They reported blood release from the lab varied across a number of non-clinical factors such as facility type(private/public)(47%). Clinicians also reported triage parameters utilized by the lab were often inconsistent with clinical indications(37%). Over 80% of consultants participated in the recruitment of replacement donations to promote transfusions for their patients. These themes were consistent across all FGDs. 2/3 of participants reported patient demise and episodes of distress related to blood lack at the point of care.

The most frequent challenges reported arose from the unequal distribution of available blood. Moral injury was commonly experienced by participants. Solutions that address the imbalance of blood product allotment to patients requires more attention.