Regional
Strengthening blood transfusion safety and logistical support during armed conflict in Yemen
Yasser Ghaleb
National Blood Transfusion and Research Center, Yemen
Aymn Zaid Alshahari
National Blood Transfusion and Research Center, Yemen
Timely and adequate access to safe blood forms an integral part of universal health coverage, but it may be compromised by natural or man-made disasters.1
The ongoing eleven-year conflict in Yemen has resulted in a prolonged humanitarian crisis, and a severely strained healthcare system. Ensuring a safe, sufficient, and accessible blood supply remains a critical public health objective in Yemen, particularly given the ongoing operational challenges facing national health infrastructure. Blood transfusion services across primary healthcare centers and major tertiary hospitals frequently face resource constraints, variable adherence to standardized operational procedures (SOPs), and limited access to continuous technical training for laboratory staff.2
To address these systemic gaps, a multi-center collaborative project was launched across major centers and blood banks in Sana'a, the capital city of Yemen. The initiative aimed to harmonize transfusion safety protocols, optimize voluntary donor recruitment strategies, streamline supply chain logistics, and implement structured quality management systems across the network of participating centers.
Project framework and implementation
The National Blood Transfusion and Research Centre (NBTRC) (Figure 1) in Sana’a is responsible for managing and regulating blood transfusion services across Yemen, as well as providing lifesaving blood. The NBTRC and its nine provincial branches deliver these services in collaboration with hospital blood banks and the National Central Public Health Laboratories across various governorates. To sustain operations amid ongoing conflict and severe systemic constraints, key initiatives were implemented across two parallel tracks:
Local multi-sectoral & community initiatives
Over the past ten years, the NBTRC spearheaded a comprehensive multi-sectoral strategy to maintain operational continuity and blood safety. The Center actively coordinated with local non-governmental organisations (NGOs), civil society groups, and telecommunication companies to promote voluntary blood donor drives, raise public awareness, and support service logistics. This localized, multi-sectoral approach was vital in ensuring the continuous supply of safe blood and components to war-wounded casualties and patients in critical need.
International strategic partnerships
In parallel, institutional capacity-building was reinforced through strategic international support. Over the past eight years, the World Health Organization (WHO) and the World Bank partnered to support nine primary blood transfusion centers across Yemen through key equipment procurement and technical training.3 Since 2021, this assistance has been institutionalized through the Yemen Emergency Human Capital Project (EHCP)4— a large humanitarian and development program established in response to the deterioration of Yemen’s health system and essential public services during the prolonged conflict. This project, implemented primarily through United Nations Children’s Fund (UNICEF), World WHO, and United Nations Office for Project Services (UNOPS), working with Yemeni authorities and local organizations, represents the backbone of Yemen's health sector—enabling essential operational stability, quality control enhancements, and foundational digitalization of blood bank registries.
Figure 1: National Blood Transfusion and Research Centre (NBTRC) in Sana’a, Yemen
Project execution & operational phases
To harmonise these joint efforts, a structured quality improvement project was executed across participating centers in three distinct phases over an 18-month period: • Phase One: Focused on establishing a standardized operational assessment tool to evaluate pre-analytical, analytical, and post-analytical workflows, as well as mapping cold chain reliability between central and governorate blood centers. • Phase Two: Centered on rolling out standardized training modules covering immunohaematology best practices, transfusion-transmitted infection (TTIs) screening, and proper cold chain maintenance. • Phase Three: Introduced inter-laboratory proficiency testing and monthly peer-review clinical audits to ensure sustained compliance.
Key achievements and impact
Through structured capacity-building workshops and collaborative inter-laboratory monitoring, the project achieved remarkable operational improvements. Over 170 laboratory technicians and blood bank personnel received certified training in advanced serological testing and component separation techniques. Crucially, the introduction of a unified donor screening questionnaire significantly improved donor deferral accuracy and reduced blood discard rates due to TTIs. Furthermore, community engagement drives conducted in partnership with local non-governmental organizations successfully increased the proportion of voluntary non-remunerated blood donors. From a logistical and administrative perspective, the establishment of a comprehensive database of blood donors and patients has significantly streamlined archiving and documentation processes.
Key performance indicators are summarized in the table below:
Figure 2: NBTRC; National Blood Transfusion and Research Centre, SOP; standard operating procedure, TTID; Transfusion Transmitted infection
Lessons learned and future outlook
Sustained backing from donors and health authorities for blood transfusion infrastructure during the conflict transformed a landscape of operational distress into one of stability and hope.
This collaborative endeavor demonstrates that substantial quality improvements in transfusion medicine can be realized in resource-constrained settings through local institutional partnerships, continuous peer mentoring, and standardised protocol adoption. Moving forward, the consortium aims to expand this quality framework to blood banks at governorate-level hospitals and integrate automated digital tracking systems for inventory management nationwide.
Sustainability Challenge: The systems, technical capacity, and collaborative networks established through this initiative provide a strong foundation for maintaining transfusion safety, strengthening service resilience, and supporting the continued development of blood transfusion services in Yemen. Sustaining the progress achieved will require continued financial support, national commitment, strengthened local partnerships, and innovative approaches to resource mobilisation.
References
1. Laermans J, O D, Van den Bosch E, et al. Impact of disasters on blood donation rates and blood safety: A systematic review and meta-analysis. Vox Sang. 2022;117:769–79. doi: 10.1111/vox.13255
2. Ghaleb YA, Al-Somainy AA, Alamad MA, Al Serouri AA, Khader YS. Evaluation of blood transfusion services in public and private blood bank centers, Sana’a capital, Yemen. INQUIRY: J Health Care Organ Prov Financ. 2019; 56:0046958019870943. doi:10.1177/0046958019870943
3. WHO supports the Blood Bank in Sana'a, Yemen. Available from: https://www.youtube.com/watch?v=QrNkinbdlU8. Last accessed 13 Sept 2026 4. Yemen: Investing in Human Capital to Protect the Future. Available from: https://www.worldbank.org/en/news/feature/2022/11/07/yemen-investing-in-human-capital-to-protect-the-future?utm_source=chatgpt.com. Last accessed 13 Sept 2026
5. World Health Organization. A new system of possibilities: digitalizing blood bank information in Yemen. Available from: https://www.emro.who.int/yemen/news/a-new-system-of-possibilities-digitalizing-blood-bank-information-in-yemen.html. Last accessed 13 Sept 2026
