Transfusion in sub-Saharan Africa: does a Western model fit?

Abstract

This review examines the current state of transfusion services in sub-Saharan Africa and presents the argument for and against the Western model of a centralised blood service with 100% voluntary non-remunerated blood donors as advocated by the World Health Organization. The current practice of family replacement donors in hospital-based blood service is the most economical option, but in the face of high child and maternal mortality rates the blood supply has proved to be insufficient. With estimates of 5–10% of HIV transmission in Africa being the result of contaminated blood transfusions, there is a need to improve testing for transfusion transmissible diseases and the selection of blood donors. Of major concern, with respect to testing, is the quality of kits being used and the continuity of supply. The need to produce components is discussed in the context of the transfusion needs in sub-Saharan Africa. The running costs of establishing and maintaining centralised blood services need careful consideration as such projects need to be sustainable in the future. It is concluded that both options are viable while centralised programmes are being developed, and a pragmatic approach should be taken to ensure that the patients’ needs are met and that resources are suitably utilised to ensure sustainability.

The challenges of meeting the blood transfusion requirements in Sub-Saharan Africa: the need for the development of alternatives to allogenic blood

“…There are increasing concerns about the sustainability of centralized voluntary donor systems and their compatibility with the suboptimal level of healthcare facilities existing in many Sub-Saharan African countries, yet burdening patients’ families with the responsibility of finding replacement blood donors will exacerbate poverty and reduce the safety of the blood supply 20. There has been a huge debate as to whether the Western model of a centralized blood service with 100% voluntary nonremunerated blood donors as advocated by the World Health Organization (WHO) fits the African setting 25,26…”

Integrating socio-cultural paradigms in nonprofit marketing—the case of blood donation among African communities in Australia

“…On the other hand, building cultural capacity will integrate culture into the delivery of services by making social services culturally adaptive. In the context of blood donation, unique models of developing donor bases within sub-Saharan African communities have been developed elsewhere (Allain et al 2008;Field and Allain 2007). These models have often sought to develop innovative approaches in home countries (de Coning 2004) and could potentially be harder to apply or even inappropriate in host countries because of behavioural differences.…”

Travelers With Sickle Cell Disease

“…Despite the recommendation, less than 20% of sub-Saharan African countries have implemented this system. [53] Transfusion practices in most African countries are hospital based and rely on blood donation from patients’ family members. Unfortunately, this system does not provide sufficient blood to meet many patients’ clinical need.…”