Donor management in South-East Asia region (SEAR).
Quality management of a BTS starts with safe donor recruitment and donor care. In the South-East Asia region (SEAR) almost all countries except Thailand depend heavily on replacement of blood from relatives and friends. Most of these countries except Bangla Desh have ruled out the paid-donor system; however in the guise of replacement donation it still exists. Lack of resources, lack of professional management, myths and misconceptions arising from cultural and social differences form a barrier to blood donation. Most of the countries still do not have a National Blood Policy and/or a well planned blood programme. Besides recruitment, the donor screening and donor management are also not well addressed. The donors are mainly males of 20-35 years who come from the middle class of the society. Only 3-6 % of females donate blood. Most of the donors donate once in a lifetime as there is no emphasis on retention programmes. Only 5-10 % are repeat donors. The autologous transfusions are not widely practised. However, insistence on directed donors has increased. The prevalence of transfusion-transmissible infections in the region is variable; HIV 0-1.6 %, HBV 0.06-8.5 %, HCV 1.2-3 %. Training of staff and volunteers involved in the programme has started. Countries such as India and Sri Lanka are introducing NBP and moving towards reorganisation of their blood programme. All countries have now realised a need for regulation and implementation of a quality system as well as increased their efforts towards donor recruitment and retention. To improve the safety of blood supply, all are trying to phase out the replacement system and move towards 100 % voluntary non- remunerated regular blood donation. The aim of the presentation is to highlight the problems encountered as well as strategies used in making adequate and safe blood available.