The Guardian
Ahead of the World Blood Donor Day (WBDD) today, June 14, the World Health Organisation (WHO), Nigerian Medical Association (NMA) and National Association of Resident Doctors (NARD) have warned that 95 per cent of donor blood units used yearly in the country are unsafe, as it could be infected with Human Immuno-deficiency Virus (HIV) 1 and 2, syphilis, hepatitis B, hepatitis C and other deadly infectious diseases.
They said Nigeria needs two million units of safe blood yearly but produces only 25,000 even as only five per cent of donor blood used in Nigeria come from voluntary donors. According to them, family replacement and paid donors are still major sources of donor blood procurement, even as poor infrastructure, inadequate manpower, underfunding and inadequate regulation mar provision of safe blood in the country.
Of this number, the Executive Secretary of the Lagos State Blood Transfusion Service (LSBTS), Dr. Bodunrin Osikomaiya, said Lagos will require over 260,000 units of blood to meet the growing demand for blood transfusion.
The medical experts in recommendations made on how to improve funding and regulation of blood transfusion services in the country, urge President Muhammadu Buhari to assent to the National Blood Service Commission Bill, which was recently passed by the National Assembly.
According to WHO, the aim of WBDD is to raise global awareness on the need for safe blood for transfusion and the critical contribution voluntary, unpaid blood donors make to national health systems. The day also provides an opportunity to call to action governments and national health authorities to provide adequate resources and put in place systems to increase the collection of blood from voluntary, non-remunerated blood donors.
Everyday, 537 women in Sub-Saharan Africa die from pregnancy-related complications. Many of these deaths are due to lack of blood. Half of the maternal deaths from severe bleeding in the world occur in Sub-Saharan Africa. About 65 per cent of these deaths occur in the post-partum period, according to reports.
The maternal mortality ratio per 100,000 live births is estimated to be 542 in Sub-Saharan Africa and 10 in Europe. Up to 75 per cent of these maternal deaths are directly due to five complications: haemorrhage, sepsis, eclampsia, obstructed labour, and complications of abortion. Most of these complications require timely availability of blood to save the life of the mother and child.
This year, the WBDD slogan is ‘Give blood and keep the world beating.’ Committee Chairman, Blood Transfusion and Haematological Services of the NMA, Dr. Attah J. Ahmed, told The Guardian that blood banks as a component of the Nigerian health system is faced with the same challenge, which include poor infrastructure, inadequate manpower, underfunding and inadequate regulation.
Ahmed said these challenges combine to give the current picture of poor blood transfusion services in Nigeria. He said while the National Blood Transfusion Services (NBTS) under the Federal Ministry of Health is making frantic effort to bridge the yawning gap of challenges and provide safe and secure blood to the people, the practices are far from the standard in many centres across Nigeria.
Ahmed, who is also a consultant haematologist, Special Assistant on Health to Governor Yahaya Bello of Kogi State and former National Secretary of NMA, said WHO recommends a minimum of two million safe blood units yearly for the current population in Nigeria. This, he said, is a far cry from the current situation of 25,000 blood units via voluntary blood donation and one million via commercial blood donation yearly.
“Commercial blood donation is not considered as a good source of safe blood. This means we are left with 25,000 units of safe blood yearly in Nigeria, which is grossly inadequate and a huge challenge to the provision of quality healthcare to the people,” he said.
To improve the funding and regulatory powers of the NBTS, Ahmed said President Buhari should assent to the National Blood Service Commission Bill, which was recently passed by the National Assembly.
Ahmed said safe blood in Nigeria comes highly subsidised when you take into consideration what is needed to create awareness for voluntary blood donation, collection, screening and storage. “What is paid for a unit of blood ranges from N5,000 to N10,000 depending on the location and facility, which is small compared to the production cost of N20,000 to N30,000,” he said.
While urging residents to donate blood voluntarily, Osikomaiya said that efforts were being intensified by the state government through LSBTS to ensure that all blood for transfusion were from voluntary blood donors.
She said: “The demand for blood is ever present and increasing especially with the growing population of Lagos. At least, 260,000 units of blood yearly is required to meet our blood transfusion demand and this is according to the WHO estimate that blood donation from at least one to two percent of the population is needed to meet their blood needs. This is why we need residents to donate voluntarily to meet these demands and save precious lives.”
The Executive Secretary also hinted that Lagos has less than 10 per cent of voluntary blood donors, stressing that more than 90 per cent of blood was sourced from replacement donors who according to her, have a higher risk and prevalence of transmissible infections such as HIV, Hepatitis C and Syphilis.
To bridge this gap, in 2016, Mrs. Temie Giwa-Tubosun developed an initiative to use technology to save lives. Having seen how hospitals find it difficult to get blood on time for patients, she co-founded Lifebank to make it easier. Giwa-Tubosun is able to bridge the gap between hospitals and blood donors or providers through tech app and by drones. It currently services over 500 hospitals in Nigeria and Kenya.
A consultant oncologist and radiologist at the College of Medicine, University of Nigeria Teaching Hospital Enugu (UNTH), Prof. Ifeoma Okoye, told The Guardian that Nigeria does not have a centralised blood supply body like the United Kingdom (UK) does with National Health Service (NHS) Blood and Transplant. Okoye said the blood supply system here is fragmented as private hospitals rely on private blood banks.
She said the closest approximation to a national blood bank is the NBTS, which collects only about 66,000 units per year and currently operates from 17 centres across the six geo-political zones.
Okoye said the blood banking system in Nigeria is still poorly developed as a number of centres depend on paid donors whose hematological and infectious status may not be determined oftentimes prior to blood donations.
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