Voluntary Blood Donations: A Path to Adequate Blood Supply and Fewer Maternal Deaths in Nigeria
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Purpose Maternal mortality in Nigeria represents a substantial fraction of the burden of pregnancy-related deaths globally. Obstetric hemorrhage is a major cause of maternal death in Nigeria. The prompt transfusion of safe blood could save many women with obstetric hemorrhage. The World Health Organization (WHO) recommends national blood bank systems that are exclusively supplied by voluntary donors. Blood donors in Nigeria include relatives of transfusion recipients, commercial suppliers, and altruistic donors. This review examines global experiences with blood donation and the applicability of WHO recommendations in Nigeria for improved maternal outcomes. Methods The WHO recommendation for voluntary blood donation and its justification were examined in scientific literature and grey literature. The search terms ‘blood donation,’ ‘voluntary,’ and ‘Nigeria,’ were used in PubMed to locate 24 publications spanning the last 10 years. Successful experiences with WHO recommendations in 4 developing countries were reviewed. An analysis of Nigerian studies was conducted to identify prevalent attitudes and practices related to blood donation. Results The WHO recognizes voluntary blood donations as a viable means of collecting safe blood for clinical use. Nicaragua, Iran, and China are developing countries that have recorded notable success with blood systems exclusively supplied by voluntary donors. Between 2002 and 2016, in the African country Mauritius, total blood supply increased as the proportion of voluntary donations rose from 60 to 82.5%. Despite a good level of knowledge that could facilitate blood donation in certain segments of the Nigerian population, voluntary donations are unsatisfactory. Nigerians with a favorable attitude to donation report inadequate opportunities and a lack of prompting. Additional barriers to voluntary donations in Nigeria could be classed into the categories of fear and policies. Potential donors report fear of needle pricks, negative health effects, HIV detection, and the inappropriate use of donated blood. A policy environment that is insufficiently supportive of blood donations is reflected in absent legislation. Conclusion A national blood bank system underpinned by voluntary donations is desirable and achievable in Nigeria. Strategic leadership, education that dispels fears surrounding blood donation, infrastructural investments, and collaborative partnerships with domestic and international stakeholders are required for improvements in Nigeria’s blood transfusion system. By improving the availability of safe blood for transfusion, the burden of maternal deaths in Nigeria could be reduced.