Blood transfusion service readiness and its associated factors in health facilities providing blood transfusion services across Ethiopia: A secondary analysis of the 2018 Service Availability and Readiness Assessment (SARA) survey.

Introduction: Timely and safe blood transfusion services are crucial for saving lives in emergencies. Previous studies have focused on hospital inpatient care access but have overlooked blood transfusion service readiness. This study examined the readiness of blood transfusion services in health facilities across Ethiopia and its determinants.

Methods: This study used Service Availability and Readiness Assessment (SARA) 2018 data from 632 facilities. Readiness was measured based on seven components: the presence of at least one trained staff for appropriate use of blood and safe transfusion; guidelines for appropriate use and transfusion; blood storage refrigerator; blood typing; cross-match typing; blood supply safety; and blood supply sufficiency. Data were analyzed using descriptive and inferential statistics. Facility characteristics were summarized using frequency tables and summary statistics. Bivariate and multivariable linear regression analyses examined the predictors of service readiness.

Results: Facilities offering blood transfusion services had a mean readiness score of 4.5 (out of 7), with only 5% having all items. Most facilities performed blood typing, but less than one-third conducted cross-match testing, and over half lacked guidelines and trained staff. Service readiness varied significantly across regions. Facilities in Oromia (Coef.: -0.74; 95% CI: [-1.32, -0.15]) and Somali (Coef.: -1.26; 95% CI: [-2.21, -0.31]) had lower readiness scores compared to Addis Ababa. Increased availability of medical equipment corresponded to a 49% increase in readiness scores (Coef.: 0.49; 95% CI: [0.19, 0.79]).

Conclusion: The study highlights deficiencies in blood transfusion service readiness and regional disparities, emphasizing the need for targeted support to enhance readiness across regions.