Cross-Sectional Survey of Haemophilia Treatment Centres (HTCs) in India: Towards a Context‑Sensitive Stratification Model

Introduction

Haemophilia treatment centres (HTCs) coordinate multidisciplinary care, yet the European HTC standards on which global accreditation systems really do not reflect the wide resource gradient found in India.

Aim

To assess HTC capacities across India and explore a tiered stratification model suited to diverse settings.

Methods

A nationwide, self‑administered survey (February 2021–April 2022) was e‑mailed to all 291 HTCs registered with the Indian Association of Haemophilia and Allied Disorders. It captured infrastructure, laboratory capability and clinical services. Descriptive statistics and Spearman correlation were applied.

Results

Ninety centres (30%) responded from 24 states/UTs. Only 34% fulfilled European HTC (EHTC) criteria and 11% met comprehensive‑care (EHCCC) criteria; 55% were unclassified despite providing haemophilia care. Laboratory‑to‑clinical functionality showed a moderate correlation (r = 0.61, p < 0.001). Twenty‑seven percent of centres operated without an onsite coagulation laboratory, whereas 40% lacked full‑time nurses and 60% lacked multidisciplinary teams. Factor VIII/IX supplies were uninterrupted at 31% of sites; 38% offered prophylaxis to at least one patient.

Conclusion

Rigid European categories mask the stepwise growth of Indian HTCs. A four‑tier model—anchored in predefined criteria for clinical and laboratory services could guide incremental upgrading while preserving patient safety.