Haemovigilance System Assessment and Improvement Strategies for the National Blood Transfusion Service, North Central Zone, Nigeria

This study assesses the haemovigilance system of the National Blood Transfusion Service (NBTS) North Central Zone, Nigeria, and proposes evidence-based improvement strategies. Haemovigilance, the systematic monitoring of adverse effects of blood transfusion, is a critical component of transfusion safety that remains underdeveloped in many sub-Saharan African settings. A mixed-methods professional evaluation was conducted combining structured audits of NBTS reporting systems, document review of two years of transfusion records from five affiliated hospitals, and focus group discussions with transfusion medicine practitioners and nursing staff. Against a benchmarking framework derived from the International Haemovigilance Network standards, the assessment revealed that adverse reaction reporting rates were below 15 percent of expected incident rates, and only two of five hospitals maintained a functioning adverse reaction documentation system. Serious hazards of transfusion (SHOT) classification was not applied systematically. Near-miss event reporting was virtually absent from all facilities. Barriers to reporting included lack of formal training (identified by 81% of nursing staff), fear of punitive consequences, and absence of feedback mechanisms that reinforce the value of reporting. The study recommends a haemovigilance training cascade targeting all transfusion-involved staff, introduction of anonymous near-miss reporting pathways, and a regional haemovigilance database linked to the NBTS central records system for the North Central Zone. Keywords: haemovigilance, blood transfusion service, adverse reactions, transfusion safety, North Central Nigeria.