title: The costs of producing a unit of blood in Zimbabwe.
abstract: There is lack of published data on the costs of blood and blood transfusion in sub-Saharan Africa. This study aimed to assess the unit costs of producing blood in Zimbabwe using an activity-based costing (ABC) method.
  
  
  
  A management accounting approach, based on the ABC method, was used to develop a cost model for blood. The production of blood was broken down into recruitment, collection, testing, processing, and storage plus distribution. Data for the year 2013 were collected retrospectively from budgets, financial and expenditure reports, databases, and interviews with transfusion personnel and managers. All direct and indirect costs, in 2013 US$, were allocated, accordingly, to the activities of blood acquisition.
  
  
  
  The total cost of producing safe blood in Zimbabwe for the year 2013 was US$8.6 million. Variable costs accounted for 51.2% of the total cost of production. The unit production costs for red blood cells (RBCs) were US$15.94 for recruitment, US$34.62 for collection, US$17.88 for testing, US$11.49 for processing, and US$3.06 for storage plus distribution. The overall cost of production of one unit of whole blood was US$118.42 and RBCs was US$130.94 constituting 12.4 and 13.7% of the country's annual GDP per capita.
  
  
  
  The high unit cost of producing blood relative to the annual GDP per capita demonstrates that acquiring safe blood is a burden on the health care sector in Zimbabwe. Introducing additional safety measures, such as nucleic acid amplification testing and pathogen reduction technology, although desirable, will further increase this burden.
authors.affiliation: Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, Groningen, the Netherlands.|National Blood Service Zimbabwe.
authors.forename: Nyashadzaishe
authors.initials: N
authors.lastname: Mafirakureva
authors.affiliation: School of Pharmacy.
authors.forename: Herbert
authors.initials: H
authors.lastname: Nyoni
authors.affiliation: National Blood Service Zimbabwe.
authors.forename: Sisodwa Z
authors.initials: SZ
authors.lastname: Nkomo
authors.affiliation: New York Blood Center, New York, New York.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Jacob
authors.affiliation: National Blood Service Zimbabwe.
authors.forename: Radhi
authors.initials: R
authors.lastname: Chikwereti
authors.affiliation: National Blood Service Zimbabwe.
authors.forename: Zamile
authors.initials: Z
authors.lastname: Musekiwa
authors.affiliation: Department of Clinical Pharmacology, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Star
authors.initials: S
authors.lastname: Khoza
authors.affiliation: National Blood Service Zimbabwe.
authors.forename: David A
authors.initials: DA
authors.lastname: Mvere
authors.affiliation: National Blood Service Zimbabwe.
authors.forename: Jean C
authors.initials: JC
authors.lastname: Emmanuel
authors.affiliation: Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, Groningen, the Netherlands.|Institute of Science in Healthy Aging & healthCare (SHARE).|Department of Epidemiology, University Medical Center Groningen (UMCG).
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Postma
authors.affiliation: Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, Groningen, the Netherlands.|Department of Clinical Pharmacy and Toxicology, Martini Hospital, Groningen, the Netherlands.
authors.forename: Marinus
authors.initials: M
authors.lastname: van Hulst
mesh_terms: D001803:Blood Transfusion / Q000191:economics*; D006801:Humans; D015030:Zimbabwe