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Cees Th Smit Sibinga,1 Maruff A Oladejo,2 Olamide Hakeem Adejumo,3 Quentin Eichbaum,4 Midori Kumagawa,5 Shuichi Kino,5 Sima Zolfaghari,6 Silvano Wendel,7 Gordana Rasovic,8 Namjil Erdenebayar,9 Maya Makhmudova,10 Loyiso Mpuntsha,11 Charlotte Ingram,11 Bakyt B Kharabaev,12 Isaac Kajja,13 Zainab Mukhtar Hussain Sanji,14 Maria M M Satti15 1IQM Consulting for International Development of Quality Management in Transfusion Medicine, University of Groningen, Groningen, the Netherlands; 2Department of Educational Management, University of Lagos, Lagos, 3Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria; 4Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA; 5Japanese Red Cross Hokkaido Block Blood Center, Japan; 6IBTO, Tehran, Iran; 7Blood Bank, Hospital Sirio Libanês, Sao Paulo, Brazil; 8Montenegro National Blood Transfusion Center, Podgorica, Montenegro; 9National Center for Transfusion Medicine, Ulaanbaatar, Mongolia; 10Consultant IQM Consulting, Tashkent, Uzbekistan; 11South Africa National Blood Transfusion Service, Johannesburg, South Africa; 12National Blood Transfusion Service, Bishkek, Kyrgyzstan; 13Department of Orthopedics, Mulago Hospital, Makerere University, Uganda; 14Consultant, Dow University of Health Sciences, Karachi, Pakistan; 15National Blood Transfusion Service, Khartoum, Sudan Introduction: Clinical use of blood has shown the least developed part in the vein-to-vein transfusion chain. This global study was carried out in order to investigate the level of awareness, accessibility and utilization of continuous e-learning and education, and quality of blood use among blood prescribing clinicians and nurses.Approach: Descriptive ex post facto survey design.Methods: A total of 264 purposively selected blood prescribing clinicians and nurses from the four Human Development Index (HDI) groups of countries (low, medium, high, and very high) participated in this study. Three research questions were answered, while seven null hypotheses were tested at 0.05 level of significance. Descriptive statistical tools (frequency counts and percentage) were used to analyze demographic backgrounds; inferential statistics – Pearson product-moment correlation coefficient (PPMCC) and analysis of variance (ANOVA) were used to analyze hypotheses.Results: Quality of clinical blood use was positively and significantly correlated with the level of awareness (r=0.137; p=0.03; df=262) and accessibility (r=0.184; p=0.01; df=262) to e-continuous learning among clinicians/nurses. There was a significant difference in the levels of awareness (F[3,260]=53.942, p=0.01), accessibility (F[3,260]=38.582, p=0.01), and utilization (F[3,260]=24.858, p=0.01) of continuous e-learning and education among clinicians/nurses based on HDI grouping, particularly between very high and low HDI. Furthermore, there was a significant difference in the levels of accessibility (F[6,257]=6.444, p=0.01) and utilization (F[6,257]=13.704, p=0.01) of continuous e-learning and education among clinicians based on clinical specialty/department and a significant difference in the quality of clinical blood use based on clinical specialty/department (F[6,257]=9.677, p=0.01).Conclusion and recommendations: The higher the HDI level the better is the awareness, accessibility, and utilization of continuous education, both through e-learning and conventional in teaching curricula. This has an immediate impact on the quality of clinical care and in particular on supportive hemotherapy and the development of patient blood management systems. Keywords: continuous E-learning and education programs, awareness, accessibility, utilization, blood prescribing clinicians/nurses, Human Development Index, quality management, clinical blood use, patient blood management