Blood storage centres working in only 50% referral units

Nagpur: The National Health Mission (NHM) norms provide for First Referral Units (FRU) for groups of three primary health centres (PHCs) to give obstetric care with blood storage centres. Eight years after the norms came into effect, the government is finally starting to set up the storage centres. At present, not even 50% of such FRUs have blood stock. Obstetricians say this emergency branch should not be running without basic blood stock.
FRU, a project launched under NHM, provides comprehensive obstetric care services round the clock at core village level. Within Nagpur division, FRU has been set up for every three to four PHCs. FRUs provide comprehensive obstetric care services, including caesarean section, newborn care, emergency care of sick children, full range of family planning services, safe abortion services, availability of blood storage unit and referral transport services.
An official from the health department said, “It is not mandatory to provide a storage centre at such units. But every year, we are trying to set up storage centres at more and more FRUs.”
Obstetrician and gynaecologist Dr Sushama Deshmukh said, “These days it has become very common for patients to come with some or the other obstetric complication. There are cases with heavy bleeding too. There is also a condition when after delivery there is no clotting of blood and we have to immediately transfuse platelets otherwise there can be a breakdown of compensatory mechanism in the patient.”
Deshmukh said, “For delivery patients with negative blood group, we advise them beforehand to keep blood bottles in spare, since we do not know if matching blood would be available on time.”
Within Nagpur division, the government has established 41 FRUs, of which 19 have functioning blood storage centres. In Nagpur district, FRUs at Bhivapur, Kuhi, Narkhed, Parsheoni, Hingna and Deolapar lack storage centre. The storage centres were sanctioned at Ramtek, Katol and Kalmeshwar four years back, but are still not functional.
In Chandrapur district, the FRUs at Ballarpur, Bhadravati, Korpana and Gondpimpri don’t have storage centres. In Gondia district, FRU in Arjuni Morgaon lacks storage centre. In eight FRUs in Wardha district, the one at Samudrapur lack storage centre while FRUs at Selu and Wadner Deoli have sanctioned storage centres but the facility hasn’t started even four years later. In four FRUs in Gadchiroli district, the one at Gadchiroli and Aheri lack blood storage centre. At Bhandara, the storage centre sanctioned at Lakhandur FRU has still not started.
Deputy director (health) Dr Sanjay Jaiswal said, “If the delivery is well planned then there cannot be a problem of unavailability of blood”. If the doctor feels the a patient might require blood sooner or later, he can advise the family to keep blood bottles ready. It can be planned beforehand. Emergency cases, where the patient requires blood immediately, happen very rarely.”