Indexing blood banking performance in India: A retrospective cross-sectional analysis of states and districts

Dialogues in health Pub Date : 2023-11-21 DOI:10.1016/j.dialog.2023.100160

Gaurav M. Urs , Padmavathy Krishna Kumar , Yash Kamath , Siddhesh Zadey

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Abstract

Background

Multiple international assessments have highlighted gaps in blood banking globally. However, there is a dearth of subnational assessments. We applied a thematic framework with multiple composite indices to assess blood bank performance across Indian states and districts.

Methods

In this retrospective cross-sectional analysis, data for 2493 blood banks in 35 states/union territories (UTs) and 616 districts was extracted from the National Blood Transfusion Council for 2016. The framework involved seven themes (accreditation, ownership, safety, volume, infrastructure, regulation, and workforce) with several indicators nested under them. Composite thematic indices and an overall index (0-100, with 100 being the best performance) were constructed using the adjusted Mazziotta-Pareto index method that can provide composite indices that are partially non-compensatory and easily interpretable.

Results

The state-level median [interquartile range] value of the overall index was 59.61 [46.35, 71.67]. Chandigarh had the highest values for safety, regulation, workforce, and ownership indices, Maharashtra for volume and infrastructure indices, and Manipur for accreditation index. Districts in southern and western states performed well on the overall index with inter- and intra-state variations for themes. District-level correlations depicted positive associations among indices with the strongest correlation between ownership and accreditation indices (n=616, R=0.92, p<0.001).

Conclusion

Blood banking in India is fragmented, with variations in themes across geographies. The northern and northeastern states require more attention for volume, accreditation, infrastructure, and ownership. While the southern and western-central regions need to prioritize safety. The framework with thematic indices, when applied to routine data, can be useful for monitoring and evaluation to decide local policies and resource allocations.

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索引血库性能在印度:回顾性的州和地区的横断面分析

多项国际评估凸显了全球血库的差距。然而，缺乏地方评估。我们应用了一个带有多个综合指数的主题框架来评估印度各邦和地区的血库绩效。方法采用回顾性横断面分析方法，从2016年全国输血委员会中提取35个邦/联邦属地(UTs)和616个区2493个血库的数据。该框架涉及七个主题(认证、所有权、安全、数量、基础设施、监管和劳动力)，并在这些主题下嵌套了几个指标。采用调整后的Mazziotta-Pareto指数方法构建了综合主题指数和综合指数(0-100,100为最佳表现)，该方法可以提供部分非补补性和易于解释的综合指数。结果总体指数的国家级中位数[四分位数范围]为59.61[46.35,71.67]。昌迪加尔在安全、监管、劳动力和所有权指数上得分最高，马哈拉施特拉邦在数量和基础设施指数上得分最高，曼尼普尔在认证指数上得分最高。南部和西部各州的学区在整体指数上表现良好，州际和州内的主题差异很大。在地区层面上，指数之间呈现出正相关关系，其中所有权和认证指数之间的相关性最强(n=616, R=0.92, p<0.001)。结论:印度的血库是分散的，不同地区的主题不同。北部和东北部各州在数量、认证、基础设施和所有权方面需要更多的关注。而南部和中西部地区需要优先考虑安全问题。专题指数框架在应用于日常数据时，可用于监测和评价，以决定地方政策和资源分配。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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