Report

Resolving the chronic blood shortage in Zambia: Insights from non/donors

Kashif Ahmed , Jake Gulinello , Jeffery McManus , Sylvia Mwamba , Mtise Mwanza 25 October 2024

©IDinsight

Executive Summary

Over the past decade, Zambia has struggled to meet blood collection targets, resulting in persistent blood shortages that have adversely impacted individuals reliant on blood transfusions. Using a mixed-methods approach, including a survey of donors and non-donors, this study provides data and evidence-driven solutions aimed at addressing the blood shortage.

The findings of this study will be instrumental in shaping the decision-making of the Zambia National Blood Transfusion Service (ZNBTS), as well as in formulating effective communication strategies, and enhancing the targeted development of blood donor recruitment and retention interventions.

Key Findings

Donor Recruitment and Retention: Challenges and opportunities for improving donor recruitment and retention include:

Myths and fears surrounding blood donation

Myths such as “Donated blood is not safe and may have diseases,” “Blood is sold for profit and “Blood is used for Satanism and the underworld” are prevalent and, prevent many from making their first donations. For instance, 16.6% of blood donors and 27.6% of non-donors express neutrality or agreement with the myth that “Blood is used for Satanism and the underworld.”

Fear of needles, fainting, and contracting disease is the most common reason for not donating blood (45.4%), followed by limited information (22.8%), particularly regarding awareness talks and donation locations.

Communication and targeted messaging to encourage blood donation

About two-thirds of the respondents indicate mainly receiving information about blood donation through word-of-mouth, demonstrating its significance as a primary source of information. However, individuals with higher incomes and those residing in urban areas, such as Lusaka, are more likely to obtain blood donation information through television and social media. Conversely, respondents with lower incomes and those from rural areas predominantly rely on word-of-mouth communication and radio for such information.
While donors expect feedback on their blood donation results, ZNBTS often fails to provide this information, especially during mobile drives.
Both donors and non-donors are primarily motivated by altruistic reasons. On average, 73% of donors cite the desire to help their community or country as motivation for donating, while 28% indicate that they are driven by the wish to assist a friend or family member. Messaging highlighting the impact of blood donation on vulnerable groups like mothers in childbirth or patients with anaemia resonates more with potential donors than those emphasising personal gain.

ZNBTS and health professionals are the most trusted influencers for encouraging blood donations across all groups. Specifically, 90% of donors and 77.8% of non-donors either agree or strongly agree that they trust ZNBTS. However, older respondents in rural areas tend to trust community leaders such as headmen and chiefs, while students are more inclined to trust their friends and teachers.

Demographic targeting

Most non-student donors are young, with over 50% of those surveyed being under 27 years old.
There is potential to boost blood donations by targeting individuals in the 45 to 65 age bracket. Currently, ZNBTS only reaches approximately 10% of donors in this age group, which is well below its potential of 16%.
Gender-tailored messaging in donation campaigns is essential. Males are more inclined to mention limited access to information as a reason for not donating, while females are slightly more likely to express concerns about fainting and needles. Nevertheless, all respondents expressed an interest in receiving incentives for donating blood.

Donation Locations: Nearly half of donors (43.95%) prefer fixed sites for future blood donations, with preferences varying across different provinces. In Lusaka, the preference for fixed sites is particularly strong at 67.9%. Convenience and privacy play a significant role in site preferences, with students expressing a notably higher preference for fixed sites (51.3%) compared to non- students (34.9%).

Data Systems and Frameworks: ZNBTS continues to grapple with inadequate data systems and regulatory frameworks. First, there are duplications in the donor identification system. Second, there are inconsistencies in the digitisation of donor information, resulting in numerous data entry errors and omissions. Additionally, the National Blood Transfusion Bill is still pending finalization, impeding ZNBTS’ effectiveness in addressing the national blood shortage.