The Contribution of the Metrological Management in the Moroccan Establishments of Blood Donation (Experiment of the regional center of blood transfusion in Oujda Morocco)

Metrological verification consists of proving by calibration measurements that specified requirements are met. The result of an audit is a compliance decision followed by re-commissioning or non-compliance followed by an adjustment, repair, decommissioning, or device reform. At the regional blood transfusion center of Oujda, from 2010 to 2018 the number of metrological qualification has increased from 88 to 152 acts with compliance going from 92% to 97%, thus the number of visit for preventive and curative maintenance of the share of external companies has also increased since 2010 to 2018 from 10 annual visits to 43 annual visits, which indicates a strong progressive metrological activity and an important place of the metrological process in the continuity of guaranteeing a safety of the result obtained from the operations carried out for the practitioners and for donor and recipient patients of the blood product. An action plan was implemented to correct the anomalies identified such as the acquisition of new metrology equipment, to predict the change of climatic chambers and non-adapted devices, the acquisition of more sophisticated machines and the establishment of a continuous recording system of the cold chain.


General
In Morocco, there are currently 18 blood transfusion centers distributed in 16 regions of Morocco according to the constitutional division of advanced regionalization endowed in 2015 which has established the region as a legal entity distinct from the State [1], with regulatory power to exercise their powers follows the commitment to a process of decentralization [2].
The Regional Blood Transfusion Center in Oujda is considered one of the largest centers where it receives 100% of unpaid voluntary donors since 1999. There were 25249 blood donors in 2018, with 36% of regular donors (22% national average) and whose women represent 46% blood donors, this is the highest rate in Morocco [3].
As for the population, it reaches 1.21% of the blood donors for the population of the eastern region and 2.4% for the city of Oujda (national average: 0.96%), this allows the center to cover all the demands of the eastern region of Morocco and enjoys local and regional selfsufficiency to and which fits into a goal of World Health Organization [4].

Result and discussion
The regional center for blood transfusion CRTSO has a metrology and materiovigilance service, well organized, traceability well archived, but managed with a very insufficient human resource and whose only motivation was the advantage of having up-to-date maintenance and continuous self-training, since 2010 through 2018 the number of metrological qualification has increased from 88 to 152 with compliance going from 92% to 97%, according to an annual quarterly control program to prevent any failure likely to occur, or after the appliance has been repaired to ensure compliance during use or during the installation of a new appliance in order to establish a life card in accordance with the required standards. Thus, the number of visits for preventive and curative maintenance by external companies has also increased from 10 visits to 43 visits per year from 2010 to 2018, which indicates a strong progressive metrological activity and an important place of the metrological process in the continuity of guaranteeing a safety of the result obtained from the operations carried out for the practitioners and a confidence for the patients donors and recipients of the blood product.

Conclusion
The maintenance of medical devices does not only concern the material itself, but also its performance during its use. Therefore, the integration of the practitioner concerned by the use of the equipment must imperatively be involved either during the market for the purchase of the devices and devices or during the ratification of the maintenance contract and the specifications in order to 'identify all the circumstances that may arise or react in handling, in addition to the requirements must be respected to correct the non-conformities noted during the last audit carried out by the French laboratory of biological fractionation [10,11]  opposing the good approach of certain activities such as the insufficiency in human resources, periodically qualified metrology equipment and the nonavailability of sensors temperature sensors, not to mention the building whose small premises of laboratories do not allow a good installation of the material or to the staff of the personnel, but with a will, and the belonging of citizenship allow the challenge and to create the difference in the good sense of approach and to innovate, and of highlighting a collective work environment and achieving the targeted objectives.