THE 2018 proclamation by the then Minister of Health and Child Care (MoHCC), Dr David Parirenytwa of a free blood initiative in all public health institutions has resulted in increased demand for the precious liquid. As a result, the country’s blood bank has been running on less than the required stocks for a prolonged period now.
By Michael Gwarisa
According to global blood stocks standards, a healthy blood bank should have at least five days’ supply at any given time. However, in most cases, the Zimbabwean blood bank, the National Blood Service of Zimbabwe (NBSZ) operates on less than a day’s supply. The NBSZ daily stock requirements nationally are at 315 units of blood. For one to be eligible to donate blood in Zimbabwe, they must be aged 16 years or older, weigh at least 50kgs or more and be in general good health. One donated unit of whole blood can save up to three lives but donated blood has a short shelf life. Regular donors are therefore essential to secure a constant supply.
NBSZ has however been experiencing critical blood shortages and during school holidays, the situation worsens since senior schoolchildren who make up to 70 percent of the regular donors won’t be available to donate blood. Adults make less donations but consume 80 percent of the donated blood. The blood-bank is currently facing critically low stocks of Blood Group O in Harare and Bulawayo branches, which at the beginning of the 2023 New Year, only a few days’ supply was in stock.
According to NBSZ Data, 52 percent of Zimbabwe’s population are type O blood group, while 24 to 26 percent are blood group A and 18 percent are group Bs and this continually exerts pressure on the blood type which is on high demand at any given time. According to the NBSZ, whenever they go into any public forum to collect blood, 52 percent of donors at any given time are blood group O, 26 Group A and 20 Bs then Group A-B about 4 percent. Once they receive the same blood, demand will be in accordance to that same ration whereby 52 percent of patients in the health facilities are Group O as well so there will be high demand for this blood group. It’s a plenty in, plenty out scenario.
While there have been growing calls for the NBSZ to dangle incentives or cash payments to lure new blood donors, they have over the years maintained that it was unethical and against the World Health Organisation (WHO) blood donation standards to pay blood donors.
In a move to avert the critical blood stocks situation that was recorded at the beginning of 2023, the NBSZ partnered one of Zimbabwe’s leading fuel powerhouses, Redan Petrolium where blood donors claimed 5-litre fuel coupons after making donations at some designated points around the country during the Pledge 25 blood drives.
In an interview with HealthTimes, NBSZ Communications Officer Mr Kudakwashe Chidziya said the coupons incentive for blood donors was not a form of payment since blood is collected only from volunteers.
To make things clear, this is not any form of payment but rather appreciation to those who would have prioritised the call to donate blood and boost national stocks which are critically low. It’s actually a gesture to appreciate those who believe in saving people’s lives,” said Mr Chidziya.
Following the successful hosting of the blood drives across the country where Redan was giving out fuel coupons to donors, the NBSZ invited more corporates on board to chip in any way that would motivate blood donors.
Coming up with incentives for blood donors?
In 1997, the World Health Organization (WHO) recommended that all blood donations should come from unpaid voluntary donors. However, by 2006, only 49 of 124 countries surveyed had established this as a standard. Zimbabwe is one of the countries that have adopted this standard and believes donating blood is purely an altruistic gesture. For years, blood donors, especially school children would receive a glass of Mazowe and bread as a way of saying thank you for giving blood. While this may appeal to young blood donors of school going age, adult blood donors might not find it appealing.
The NBSZ has been struggling to attract adult blood donors and this probably could be due to lack of attractive incentives for adult donors. The COVID-19 pandemic era where schools were closed for almost two years, also heavily affected blood stocks as majority of blood donors (School children) were under lockdown and a few adult blood donors came through to donate. In 2020, at the height of the pandemic, the NBSZ only managed to collect slightly above 50% of its 2020 blood collection target.
The recent CSR gesture by Redan Petroleum could herald the beginning of a new era for blood donation in Zimbabwe as the blood bank may start seeing more new adult blood donors coming on board should such initiatives continue.
“Corporates have Corporate Social Responsibility (CSR) initiatives and Redan saw it fit to also give back to the community it serves by appreciating blood donors and anyone who was willing to donate blood on the 6th. The partnership was made to ensure that there is adequate stock of blood in the nation.
“As a service, we would be glad to have more corporate partners which would support our blood drives initiative. Resources permitting, and corporates coming on board with such initiatives we would be glad to continuously have tokens of appreciation to our donors,” added Mr Chidziya.
What Health Experts say about the NBSZ Fuels coupon incentive?
Medical doctors deal with patients on a daily basis including some in need blood transfusion. Zimbabwean medical and health experts who spoke on the recent move by Redan and NBSZ to put up fuel coupons as an appreciation gesture said there was nothing outlandish or unethical about the move.
“There is no coercion. In the United States, blood banks will sometimes pay money to drive donations. Plasma collection centers regularly pay significant amounts of money to drive donations. So the fuel coupons gesture does not seem unusual,” said Dr Joshua Dziba, the Founder and Executive Director for Health Access Zimbabwe (HAZ).
Mental Health expert, Dr Rosemerry Musesengwa said the move was, “Perfectly ethical! It’s just an incentive and a way to say thank you that suits the environment rather than giving them biscuits and juice only I think. Remember they also have a sort of screening procedure so not everyone will be allowed to give.”
Global status regarding incentives or cash payment towards blood donors
Though Zimbabwe believes selfless and voluntary blood donations is the way to go, some countries around the world especially Europe believe paying blood donors cash could motivate new adult blood donors. The world over, the debate over paying for plasma has been raging for years. There are questions, too, over what constitutes compensation. To date only four countries — Germany, Austria, Hungary and the Czech Republic give a flat-fee payment, many others offer non-monetary compensation like time off work or vouchers. For many, the idea of paying for plasma elicits concerns about the commodification of the human body. For others, paying donors a flat fee for their time and trouble should be part of the solution to the EU’s plasma deficit.
Meanwhile, Classic research has found that monetary incentives to blood donors may crowd out blood supply as purely altruistic donors may feel less inclined to donate if a reward is involved.