Positive Attitudes, Absent Systems: A Health Workforce Perspective on Irregular Antibody Screening in Fako Division’s Blood Banks

Abstract Blood bank staff in Fako Division, Cameroon, know that irregular antibody screening matters. Every one of them told us so. However, all four Blood banks surveyed, and most of the nation, test only for ABO and RhD before transfusion, leaving a well-documented group of hemolytic transfusion risks untested (Obeagu, 2025; World Health Organization [WHO], 2021). This gap may stem from a knowledge deficiency in the workforce, which training workshops can address, or an attitude problem, which awareness campaigns can address. In the present study of 21 blood bank workers from 4 blood banks in Fako Division, neither reason was observed. Staff are not a problem. The systems that surround them are. Knowledge, Attitude, and Practice (KAP) surveys are typically read for one headline figure: the percentage of staff who know the correct answer or, if they have an opinion, support for a practice. The only framing that could ever be offered is more education or more sensitization. The most helpful information from our survey came from the section typically considered secondary: the barriers respondents volunteered when describing why screening is not implemented. That section challenges the knowledge/attitude outcome when compared with the knowledge/attitude results. It is not a story of things staff don't know or don't want. It's a story of not building systems that let them act on what they already know and want.