Nigeria Maternal mortality is as a result of bleeding complications due to shortage of blood Blessing Otobong-Gabriel Examined
Every year on 14 June, people around the world celebrate World Blood Donor Day, it is a day recognized worldwide for raising awareness on the importance of voluntary blood donation to the health sector.
But like many other African nations and some other developing countries globally, Nigeria suffers greatly from her poor culture of blood donation largely due to the challenges of poor policy formulation and implementation, lack of enabling legislative framework and funding difficulties, collection, distribution and use of safe blood for a healthier population has been a herculean task for government agencies and non-state actors in the line of such responsibilities in Nigeria.
Over 200 million citizens of Nigeria, a very low eligible blood donor population 4% and currently only about 1 million units of blood is donated annually, of which less than 30,000 is via voluntary blood donation. Nigeria contributes about 25% to the global maternal mortality rate and the dominant cause is due to bleeding surrounding pregnancy and child birth.
Blood banks are maintained in many hospitals as a way of ensuring ready and constant access to blood for emergency uses, plasma treatments and in some cases research purposes. Blood donation has been one of the most important ways of providing aid to the ailing parts of the world and supporting new discoveries to advance the improvement of health and wellness.
Studies have revealed a predominance of low haemoglobin concentrations in commercial blood, thereby reducing the quality of blood available for transfusion. This, therefore, increases the burden of transfusion-transmissible infections in blood and blood products, and increases risks for the recipients.
Addressing the challenge of blood loss during and after delivery remains crucial to reducing the high maternal mortality rate in Nigeria. Blood loss during and after delivery, they said, is still a major cause of maternal mortality that have efforts to reduce death of women from childbirth complications.
Global health body says Nigeria needs an average of 1.8 million pints of blood annually to keep the health of her people safe and sound. But the country’s agency in charge of blood donation- Nigeria’s National Blood Transfusion Service (NBTS) says it collects only 500,000 pints of blood every year, leaving a shortfall of about 73.3 per cent.
According to the NBTS’ head of planning, research and statistics department, Adaeze Oreh said only about 25,000 blood units sourced exclusively from voluntary unpaid blood donors were screened, collected and distributed in 2019 and 2020.
Mrs Oreh said recent available data show that only eight per cent of Nigerians donate blood freely, and that about 80 per cent of donors donate to relatives in need and from the data available to NBTS, approximately 80 per cent of donations are from family members, which we call family replacement donations,” she said.
By virtue of the National Blood Policy of 2006, NBTS is mandated to develop a system of blood donor mobilisation and motivation based on a voluntary, non-remunerated donation of blood; and standardise its methods of collection, transportation, processing, testing, storage and distribution, blood components and derivatives which are safe for transfusion and other therapies.
2021 World Blood Donor Day report the agency’s mandate, based on the provisions of the National Health Act of 2014, is to coordinate, regulate and ensure the provision of safe, quality blood and blood products to “all who may need it in Nigeria.”
However, to ensure that this mandate is achieved, the agency said it faces a herculean task, saying ensuring safe blood “from vein to vein” isn’t easy to achieve in the country.
The NBTS is facing challenges of not just making sufficient blood available, but also ensuring quality and safety.
The theme of this year’ is “Donating blood is an act of solidarity. Join the effort and save lives,” this highlights the critical role of voluntary blood donations in saving lives, and enhancing community solidarity and social cohesion by donating just one unit of blood can save the lives of up to three patients.
On 14 June every year, selfless individuals who donate blood to be used by others in need, either known or unknown to them, are given special recognition as this year will not be any different.
There is usually a unique theme for every year. However, this year’s message highlights the essential contribution blood donors make to keeping the world pulsating.
As Nigeria joins the rest of the world to celebrate this year’s World Blood Donor Day, the World Health Organisation, WHO has urged African governments and political leaders to prioritise the provision of adequate human and financial resources to secure the future of national blood transfusion services.
Making the call in her message to mark the day, WHO Regional Director for Africa, Dr Matshidiso Moeti called for more people to become regular blood donors a blood service that gives patients access to safe blood and blood products, in sufficient quantities, is a key component of an effective health system.
The WHO Regional Director stated that compared to other regions globally, the African region sees a disproportionate number of conditions requiring donor blood, impacting as many as seven million patients every year.
She listed some of the conditions to include haemorrhage associated with pregnancy and childbirth, severe anaemia due to malaria and malnutrition, bone marrow and inherited blood disorders, trauma and accidents, as well as man-made and natural disasters.
She said: “While the need for donor blood is universal, access for everyone who needs it is not. In the African Region, demand regularly outstrips supply, negatively impacting timely access for all patients who need safe and quality-assured blood to save their lives.
According to her, as a consequence of the COVID-19 pandemic, voluntary unpaid blood donations dropped significantly, countries across the African Region have worked hard to improve blood donation frequency, and the situation is showing signs of stabilizing. Blood transfusion services in many countries reached out to blood donors through public awareness campaigns, transporting donors from and to their homes, using digital platforms and establishing call centres.”
She further stated that the situation remains challenging, and exacerbated by issues such as staff shortages and limited funding from governments and partner organisations for effective blood donor education, recruitment, and retention.
She said in the region, WHO provides support to countries at various levels, including resource mobilisation for the implementation of national blood transfusion plans, advocacy for integrating blood safety in these plans, and strengthening the legal and regulatory framework for blood safety.
She added that seeking out opportunities for partnerships and collaborations with media, the private sector, and faith-based and non-governmental organizations, will help increase the recruitment and retention of voluntary unpaid blood donors.
She thank Africa’s blood donors for their selfless contribution to national health systems, through this life-saving gift to patients who need transfusion therapy while acknowledging the tireless efforts of blood services staff who are deeply committed to maintaining critical blood supplies, of the research and development professionals pursuing new technologies and uses for donated blood, as well as the medical teams who use blood rationally to save lives.
“Donating blood is an act of solidarity. By becoming a blood donor, you will help ease the pressure on health systems still struggling under the burden of the COVID-19 pandemic,” she stated.
Experts have said Nigeria’s uninviting culture of blood donation cannot be dissociated from the country’s poor transfusion system and lack of legal framework.
Countries must also invest in a structured system for banking donated blood and through screening of same to ensure safety for users and preservation.