Management of Anaemia: An Advocacy for the Integration of Bloodless Medicine and Surgery Program (BLMS) into the Health Care System of Sub-Saharan African Countries


  • Friday Wokoma Nephrology Unit, Department of Internal Medicine, University of Port Harcourt Teaching Hospital


Anaemia, Blood transfusion, Bloodless medicine &surgery, sub-Saharan Africa



Background: The prevailing high sero- prevalence of the human immuno deficiency virus (HIV) and hepatitis B and C viral infections in the sub-Saharan African populations such as Nigeria, has further increased the risks associated with allogenic blood transfusion. It has also made the availability of free blood for transfusion to needy patients increasingly difficult in recent times in these populations. It has thus become imperative for clinicians to begin to adopt less blood dependent approaches in the care of anaemic patients. This review article introduces the subject of the principles and practice of bloodless medicine and surgery (BLMS) with a view to advocating its adoption and integration into the health care programs of sub-Saharan African countries such as Nigeria.

Methods: The literature base for this article was obtained through relevant manual and on-line search using Medline, goggle and other resources.

Results: Bloodless medicine and surgery (BLMS) program is currently being practiced in major hospitals in North America, Europe and other parts of the developed world. BLMS was primarily developed to cater for the needs of the Jehovah's witness(JW) religious group whose religion forbid the use of blood as a means of therapy. It is now of universal application. Virtually all medical and surgical procedures including organ transplants, open heart surgeries etc, are undertaken under the BLMS programs with outcomes as good as blood based therapies. BLMS has the potential of reducing the demand for allogenic blood transfusions, reduce morbidity and mortality associated with blood transfusions as well as reduce costs of prolonged hospitalization due to delayed surgical procedures on account of unavailability of blood.

Conclusions: The development and the integration of the BLMS program into the medical care services of resource poor, HIV/AIDS and hepatitis virus endemic sub-Saharan African countries will contribute significantly in reducing the demand for blood which is scarce, reduce the rate of irrational blood transfusions, reduce the transfusion acquired HIV/AIDS and viral hepatitis infections, as well as reduce the incidence of other transfusion related morbidities.

Author Biography

Friday Wokoma, Nephrology Unit, Department of Internal Medicine, University of Port Harcourt Teaching Hospital

Senior Lecturer and Consultant Nephrologist


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How to Cite

Wokoma, F. (2015). Management of Anaemia: An Advocacy for the Integration of Bloodless Medicine and Surgery Program (BLMS) into the Health Care System of Sub-Saharan African Countries. The Nigerian Health Journal, 9(1 - 4), 1. Retrieved from

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