Building Sustainable Blood Donation Systems in Resource-limited Settings: Addressing Challenges, Innovative Strategies for Donor Recruitment and Retention

Proposed Session Description: This session presents strategies for improving blood donor recruitment and retention in resource-limited settings where challenges like low public awareness, cultural misconceptions, and weak infrastructure persist, focusing on practical innovations, community engagement, and technological solutions. Studies at the UCTH, Nigeria (Okoroiwu, et al., 2018), reveal persistent challenges: high TTI rate (14.96%), among commercial donors (62% of infections), and critically low voluntary (0.5%) and female participation ( < 2%). Repeat donors (62.9%) and seronegative individuals show strong potential for retention. During COVID-19, vulnerabilities in logistics and mobilization were exposed, but innovations like mobile drives, public campaigns, and "lowest hanging fruit" donor policies emerged (Okoroiwu and Okafor, 2021). Donor attitude surveys in Calabar and Ethiopia reveal high awareness (>85%) but low practice ( < 16%), with barriers including fear, time constraints, and lack of invitation. Ethiopian findings mirrored Nigerian patterns, low female participation and knowledge-practice gaps. A study emphasized that all West African countries fell below WHO's benchmark of 10 donations per 1,000 people, with poor national coordination and policy enforcement. However, Rwanda has emerged as a regional success story, achieving a donation rate of approximately 8 per 1,000 population through a coordinated national strategy. Key to this success is the integration of centralized, digital blood tracking system, strong community health worker engagement for donor education and mobilization and nationally-led campaigns that have significantly reduced reliance on family/replacement donors, increased voluntary non-remunerated donation and improved female participation.
What has worked includes routine screening (HIV prevalence dropped from 5.7% to 1.7%), mobile blood drives, youth donor clubs, short-term follow-up, NGO involvement, and leveraging community health structures for donor recruitment. However, overreliance on commercial donors, poor follow-up systems, and lack of political will remain critical barriers in many regions. Blood use analysis at UCTH shows that women of reproductive age dominate recipients (75.23%), with whole blood (70%) overused due to limited component separation.