An interesting development in Gujarat State of India where the government has imposed geographical restrictions on blood banks. Under this a blood bank can not promote voluntary blood donation activity outside the province/district neither conduct a blood donation camp. State administration argues that by restricting blood banks a donor is compelled to donate blood in local blood banks and hence blood availability in district will increase. Blood requirement in cities could be higher than towns (due to high density of hospitals and advanced medical care). State bureaucrats and politicians argue that a patient should manage family replacement instead of depending on blood availability without replacement.
I think any restriction, no matter how well intentioned placed on voluntary blood donation hampers rather than promote blood donation.
Dear colleague,
A very interesting question. In general, territorial restrictions can only be implemented when there is a contract guaranteeing blood supply between regions in case of shortage or emergencies. Otherwise, regions with less blood donors might end up in need of emergency supply. It might be helpful to know the attitude of your healthy volunteer unrelated non-remunerated blood donors regarding territorial organisations. If you have good data, that your donors might love the feeling, that they donate for their neughbors in need, this might increase the local donation rate. On the other hand, if donors feel, that there should be a nationwide cooperation and help, this might be a good reason NOT to implement territorial restrictions.
Obviously, big cities have a higher use of blood components than the more rural areas due to the reasons you already mentioned. On the other hand, at least in Europe, the more rural areas have a higher percentage of inhabitants donating blood on a regular basis. Therefore, it is mandatory that the territorial restriction has a fair balance between cities and more rural areas. This might be different in your country.
The most important issue is to promote donations by unrelated healthy non-remunerated blood donors. This is a joint action of your local and regional health authorities, the hospitals and the blood transfusion services as well as the blood banks. Education of the population starting with children at school about the need of blood donations, the health benefit for the donor, the use of single use items for donations only, etc. is a key element in this. Don´t forget other options to show your competence and professionality as blood bankers! Organise "open lab days", ask clinicians to tell the population about their inability to perform certain operations without blood components, etc. There are a lot of ways to help increasing awareness and potentially also willingness of parts of the population to donate blood.
Such activities - at least from our experience in Europe - offer a more promising approach compared to territorial restrictions.
You might want ot have a look at the Donor Management in Europe (DOMAINE) project: http://www.domaine-europe.eu/
Best wishes,
Markus
I agree a state can't improve voluntary blood donations by restrictions only. But don't you think that a geographical organization is better than none ? What donors can think if the same location is explored by two different blood banks ? And how go about blood units expectation if you don't know if somebody else was there one week ago ? It's certainly a restriction, but it gives a clearer responsability to blood banks. This can generate a virtuous competitive spirit which will be the real cause of a blood donations improvement.
Thank you Markus for such a wonderful reply. I will surely visit the site. And Francis.. Thank you. I think that promotional activities rather controls yield better results in long run.
Dear Jean Yves, in administrative perspective your concerns are right. But what is happening in Gujarat is what you have stated in your reply. Some cities with higher medical care facilities have plenty of blood banks (hence generating competition and multiple approaches to the same location for donors). Some of them started approaching rural areas as there are more voluntary non remunerated blood donors. However, the smaller towns located around neighborhoods have family replacement based blood banks operating in 10x10 ft (in some cases) premise. Voluntary blood donors who have experienced quality blood banking are not willing to donate at these blood banks. At the same time the need for more blood and intense competition among blood banks in bigger cities compelled some to move to rural areas for voluntary blood donors. However the smaller family replacement based blood banks here have approached the state to protect their interest. Here the state has imposed territorial restrictions to reduce conflict. But that has impacted the supplies at major blood banks. To plug this crisis, officials asked the major blood banks to go for family replacement system to meet the crisis instead of voluntary blood donations.
To go back to a family replacement donation system once you´ve started with voluntary unpaid blood donation increases the risks and is not a good strategy. On the long run, replacement donations should vanish and voluntary non remunerated donations should become the standard donation.
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