Dark cloud over blood donation in Nigeria

Blood transfusion is an indispensable component of healthcare. Contributing to saving millions of lives annually in both routine and emergency situations, blood donation and/transfusion dramatically improves life expectancy and quality of life of patients with a variety of acute and chronic conditions.

Patients who require transfusion as part of their clinical management have the right to expect that sufficient blood is available to meet their needs. However, many patients still die or suffer unnecessarily because they do not have access to safe blood transfusion.

The timely availability of safe blood and blood products is essential in all health facilities in which transfusion is performed, but in many developing countries, including Nigeria, there is widespread shortfall between blood requirements and blood supplies.

It is a common feature to see relatives of patients in emergencies, running to and fro in search of blood. Shortage of this life-saving fluid has become a recurrent problem in the delivery of medical care. 

The blood shortage of blood has led to the rise of illegal sources in many parts of the country.

BusinessDay investigations reveal that Nigeria is currently reeling under the onslaught of serious shortage of safe blood and blood products with over 60 percent of blood donations coming from commercial donors and 30 percent from family/replacement donors.

The general availability of blood in the country shows 0.2 units of whole blood per 1,000 population in Nigeria as against WHO recommendation of 10 units of whole blood per 1,000 population to meet clinical demand in resource-limited settings.

It is not unusual to see some individuals commercialising blood donation, a practice believed to be an illegal act. Some of these individuals are paid between N2,000 and N6,000 to donate blood at public hospitals.

There are 11 operational centres across the six geopolitical zones for National Blood Transfusion Service (NBTS). They include Abuja, Kaduna, Owerri, Ibadan, Lokoja, Jos, Maiduguri, Port-Harcourt, Benin City, Nangere – Potiskum, and Abeokuta. Six new NBTS in Sokoto, Katsina, Jalingo, Ekiti, Enugu and Calabar are expected to commence operation this year.

At Nigeria’s current level of healthcare delivery, about 1.5million units of blood annually are required. However, a National Baseline Data Survey on blood transfusion indicates that only about half a million units of blood are collected from private and public sources with paid donors accounting for over 90 percent of the blood donated.

Speaking with BusinessDay, Praveen Kapur, co-ordinator in Nigeria, Sant Nirankari Mission, a Non-Governmental Organisation, disclosed that over the years, loss of lives due to non-availability of blood for victims requiring urgent transfusion has been alarming.

“This became very worrisome for us, making it pertinent that we get involved to save lives through this effort which started 5 years ago. As far as Nigeria is concerned, this is the fifth year in succession that we are organising the blood donation camp. We have had very encouraging responses in the past and we hope to continue next year.

“Today, Indian and Nigerian doctors volunteer freely to this course, helping us attend to donors and certify if the blood being donated are suitable for transfusion,” Kapur explained during the NGO’s annual blood donation camp in Lagos.

Praveen stated that realising the delicacy of blood donation exercise, it decided to partner the Red Cross Society of Nigeria to supervise the process using the systematic process where blood pressure, grouping, weight, height etc. are checked.

“After these are checked, the donor is then found suitable and fit to donate blood. At this stage, all blood samples will be taken to Lagos State blood transfusion bank for screening of all other infections,” Praveen added.

Eka Solomon, Red Cross of Nigeria coordinator noted that a lot of patients that could have been saved have died as a result of the unavailability of it.

Solomon pointed out that inadequate awareness on blood donation is one of the biggest challenges the Red Cross International is confronted with. According to him, a lot of people are not getting the information right or the education about blood donation.

“We also encounter challenges when it comes to religious and traditional beliefs. Some do not support and believe in it. It does not matter what you tell those people, they will never support your programme. The other side is made up of those people who believe their blood could be used for ‘something else.

A cursory look at blood transfusion reveal that it is a core service within health care systems and individuals who donate their blood provides a unique contribution to the health and survival of others. 

With countries facing an ongoing challenge to collect sufficient blood from safe donors to meet national requirements, systems based on replacement donation by the family and friends of patients requiring transfusion are rarely able to meet clinical demands for blood while paid “donation” poses serious threats to the health and safety of the recipients as well as the donors themselves. 

While some countries have well-established systems of voluntary blood donation, the majority are still dependent to varying degrees on family/replacement donors and sometimes on paid donors. Blood donation rate in high-income countries is 39.2 donations per 1000 population; 12.6 donations in middle-income and 4.0 donations in low-income countries.

Experts believe that emergency preparedness to avoid blood shortages in times of increased demand or emergencies requires a high level of coordination, planning and preparation by the blood transfusion service.

Public health experts say that emergency preparedness should be undertaken in conjunction with organizations involved in donor recruitment, with other departments responsible for blood testing, processing, distribution and with clinical services.

No doubt, a well-organized blood donor programme based on regular voluntary blood donation may have a sufficient supply of safe blood to meet unexpected demands, depending on the scale of the emergency.

Alexander Chiejina