Donor giving blood during the 2017 World Blood Donors Day at the University College Hospital Ibadan

Health

Nigeria’s blood bank nosedives on trust deficit, growing misconceptions

By Paul Oluwatosin Akinwumi

October 19, 2022

In Africa’s biggest economy, Blood donation is supposed to be a fundamental part of the country’s health care system as blood transfusion is often a necessity for disease and bleeding disorders.

However, checks by Dataphyte showed many Nigerians are yet to embrace the culture of blood donation as most donors are still pessimistic and skeptical due to widening trust deficit, misconceptions and biases about blood transfusion.

In 2021, a total of 20,839 people donated blood without being compensated, data sourced from National Blood Service Commission (NBSC) showed. Further findings showed the number of voluntary unpaid blood donors in Nigeria has been on a steady decline since 2017. 

In 2017, a total number of 42,384 people donated blood voluntarily without being paid, this number reduced to 20,420 in 2018, then it increased slightly in 2019 to 24,527 and decreased to 22,218 in 2020 and 20,839 in 2021. 

From 2017 to 2021, Jos had the highest number of voluntary donors of 66,281 people, followed by Abuja with 15,277 people. Calabar has the lowest number of donors with just 92 people, followed by Jalingo with 524 people. 

An analysis of the NBSC data shows that from 2017 to 2021 Plateau State had the highest number of voluntary donors of 66,281 people, and FCT followed with 15,277 people. Whereas, Cross River State had the lowest number of donors with just 92 people, followed by Taraba State with 524 people. 

The distribution of the data on voluntary unpaid blood donors by geopolitical zone shows that the North Central region had a total of 83,407 donors, and the South West had a total of 16,366. The data shows that only 4,875 people across the North East and 7,397 across the South East donated blood without being paid between 2017 to 2021.

The NBSC said that only 500,000 pints of blood are donated, screened, and collected every year across the country. 

About 25,000 units of blood are collected from unpaid volunteer donors, which is far less than the WHO-recommended 1.8 million units of blood sourced from voluntary donors annually for a country like Nigeria, which has a population of over 200 million people to assure blood safety and availability for transfusion.

NBSC noted on their website that 3,400 hospitals in the country receive blood donations each year.

Nigeria has one of the lowest rates of voluntary non-remunerated blood donation in Africa, and about 90 percent of blood donations are sourced from paid donors. Blood from voluntary unpaid donors is recognized internationally as the safest supply of blood and blood products for patients.

The low unit of blood collected from unpaid volunteer donors has caused a great deficit in the national blood bank, as the blood bank relies on blood sourced from people who donated freely with remuneration. 

The number of units of blood available in the national blood bank is insufficient to meet the standard of the World Health Organization which also reflects Nigeria’s frequent blood needs.

What could be preventing people from freely donating blood?

Dataphyte spoke with Ogunbinu Modupe, a 35-year-old woman from Akure, who claimed that she had only donated blood once in 2015 to save her daughter’s life, in order to learn what might be keeping people from freely donating blood. She also shared that she knew she could give blood freely to save lives, but she wouldn't give it to someone else.

A 27-year-old man from Lagos, Obi Chukwudi also asserted that although he is aware of the country's voluntary blood donation program and is aware of the locations where it can be done, he has never donated blood due to a tattoo on his body.

The situation is different for Williams, a resident of Uyo, who claimed that he has never donated blood before and will never donate blood because doing so goes against his religious beliefs.

Miracle's story is similar to the others, as he has never donated blood before because he does not know where to donate blood and has never heard of or attended a blood donation drive in Aba. The situation is the same as that of Lukman in Ile-Ife and Zainab in Ilorin.

A health professional who spoke under anonymity noted that another challenge is that of trust.

The professional stated that blood donation to hospitals should be free and the blood should be given to patients for free, but sometimes people donate their blood for free to hospitals and the hospitals sell such blood to patients who need it.

“This discourages people sometimes from donating blood for free, not knowing if those who need it actually also get it for free,” He added.

People not donating blood could also be attributed to Nigeria’s poor blood donation culture, lack of awareness, lack of regulatory framework, religious barriers, and insufficient blood donation facilities. 

Nigeria needs to provide Blood Collection Centres in more states

While the challenge of donation remains for the country’s citizens, details provided by the NBSC show that Nigeria lacks enough facilities to cater for Nigerians who wish to donate blood.

The agency has 17 blood collection, testing, and distribution centres in 17 states across the country including FCT, Borno, and Imo states. Lagos and Kano State, the states with the largest populations in the country were not included in the data NBSC provided. 

Prof. Akin Abayomi, the Lagos State commissioner for Health declared at the commemoration of 2022 World Blood Donor Day in Lagos state that 100,000 units of blood sourced from voluntary blood donors, 50% short of the annual minimum target of 200,000 units, 

“We have a population of at least 20 million people and the blood donation age is between 18 and 65. That means that there are at least 15 million eligible people in the state to become voluntary blood donors.” 

The main source of blood in Lagos state was reported to be through family replacement, which means blood sourced from family members where spouses of pregnant women are mandated to donate blood during antenatal services. This may be strengthened by the fact that despite being the commercial Centre of Nigeria and with a huge population, Lagos does not have a safe blood collection Centre.

The low units of blood available in the state mean it would be difficult for people in need to get safe blood. NBSC should have a blood collection, testing, and distribution centre in Lagos state to ensure that 15 million young potential blood donors in the state are sensitized to donate blood freely.

The current population of Nigeria as of August 2022 is 217,065,599, according to the Worldometer.About 70% of Nigeria’s population are under 30, and 42% are under the age of 15 making it the country with the largest population of youth in the world. 

Nigeria’s large youth population is an asset of great potential to increase the number of voluntary unpaid blood donors and increase the units of safe blood in the national blood bank.

With this large and youthful population, Nigeria should be able to meet WHO’s recommendation of 2 million voluntary blood donors annually and collect 100% of its blood supply from voluntary unpaid blood donations. 

Nigeria’s low blood donation is worrying even more as 79 countries (38 high-income countries, 33 middle-income countries, and eight low-income countries) collect more than 90% of their blood supply from voluntary unpaid blood donations, according to the data from WHO. 

Nigeria collecting 100% of its blood supply from voluntary unpaid blood donations may put an end to sourcing blood commercially subjecting recipients to the risk of diseases and infections such as HIV, hepatitis B, Hepatitis C, syphilis, and others. This would also mean blood would be available and accessible to anyone in need of blood transfusion.

NBSC plan to increase the number of annual voluntary blood donors from 25,000 to 1 million by 2023 and 3 million by 2030 to make blood available for everyone in the country who is in need of blood transfusion.

Speaking on the target of the commission at the Abuja sensitization event, the Acting Director General of the NBSC, Dr. Omale Joseph Amedu, “we are targeting one million Nigerian regular unpaid blood donors, 100 per cent voluntary non-remunerated blood donors, increased innovation and use of technology as well as reduce adverse blood transfusion reactions and events.”

Health Benefits of Blood Donation

Regular blood donation has many health benefits. Health experts shared that regular blood donation lowers blood pressure, and reduces the risk for heart attacks, and other cardiovascular diseases. 

Donating blood reduces stress, benefits physical health, and improves your emotional well-being. Blood donation generally increases the likelihood of living longer.

Anyone between the ages of 18 and 65 can donate blood. Donating blood voluntarily without receiving any payment will increase the units of blood in the national blood bank and make blood available to meet the growing demand for blood in the country.

Donating blood voluntarily is like giving the gift of life to someone else because blood is the most precious gift someone can offer. One-time blood donation can save up to three lives. Donate blood today and save a life.

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