MUGYENYI: It costs nothing because every drop of blood counts

Thursday September 19 2019

A woman packs a box of vaccines to be delivered

A woman packs a box of vaccines to be delivered by a Zipline drone, in Ghana April 22, 2019. PHOTO | GAVI | REUTERS 

PHILANA MUGYENYI
By PHILANA MUGYENYI
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Every day, nearly 830 women die globally from preventable causes related to pregnancy and childbirth.

Almost all maternal deaths (99 per cent) occur in developing countries, with more than 50 per cent of these deaths occurring in sub-Saharan Africa. This is a particular problem for pregnant women in rural areas in sub-Saharan Africa.

According to the World Health Organisation, post-partum haemorrhage (severe bleeding) is the leading cause of maternal mortality worldwide. Having an on-hand, sustainable blood supply available for a severely bleeding new mother would significantly improve her chances of survival.

In every country and culture, the death of a mother not only affects the health of her surviving family members, it also undermines the well-being and economic health of her community.

African governments and our health sectors must prioritise gathering an adequate safe supply of blood for women and children to achieve the sustainable development goal 32, of good health and well-being.

Why is this not already a priority in sub-Saharan Africa? Is there is a lack of awareness on the importance of having an adequate supply of blood, particularly in rural areas? Are there enough resources to support these communities to make this a priority?

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Statistics from WHO underline the problems. Almost half (42 per cent) of the blood collected globally comes from high-income countries.

Not enough people in low-income countries are donating blood, where it is needed the most. Only 4.4 per 1,000 people in low-income countries donate blood, compared with 32.6 per 1,000 in upper-income countries.

This sadly does not even meet the minimum requirement of 10 people per 1,000. And unfortunately, the limited blood that is donated by people living in low-income countries has a higher prevalence of carrying transfusion transmissible diseases such as HIV, malaria and hepatitis.

Why aren’t more people donating blood?

Socio-cultural barriers play a significant role when it comes to voluntary blood donation in low-income countries. There are common misconceptions that one must be extremely strong or have extra blood to donate, or that one must be related to the person to whom one is donating blood. Some cultures believe that donating blood exposes them to witchcraft.

Given these conditions, it is crucial for health administrations in African countries to invest in sensitisation and education campaigns around the importance of blood donation, advocating for better health systems.

For example, Zambia has successfully managed to reduce maternal deaths by 55 per cent from 2012 to 2016 through a public-private-partnership initiative called “Saving Mothers, Giving Life.”

Zambia was able to improve access to a safe blood supply because of strengthening the health systems across the country’s districts. They ensured mothers had birth plans, improved communication and transport to a hospital, as well as access to training and mentoring medical staff.

A key to achieving a sustainable blood supply in Africa is to form partnerships which can generate innovative solutions. The Organisation of African First Ladies for Development has taken a deliberate step to steer the process by convening public and private stakeholders on the sidelines of the United Nations General Assembly.

Working closely with Terumo BCT, this gathering will provide a platform to discuss the challenges and devise solutions to address blood shortages and maternal health in Africa.

Partnerships

Some partnership solutions are already in effect in Africa, for example in Nigeria. Google has partnered with a blood-and-oxygen-delivery tech company, LifeBank, to help transport blood safely and efficiently by integrating Google maps into its mobile application

Rwanda has adopted the use of aerial drones to transport blood into rural areas, delivering blood quickly to those in need. They use an advanced temperature-tracking technology that allows the temperature of the blood to be monitored while it is being transported.

These examples reveal that partnerships with non-health-sector-specific companies can dramatically contribute to the overall success of important health-sector goals.

Blood is a critical part of healthcare and essential to saving lives. It is fundamental to treating pregnancy-related complications and severe childhood anaemia (common in people born with sickle cell disease).

African governments need to acknowledge the importance of blood and become more intentional in their policy-making to ensure that the healthcare and well-being of their citizens are prioritised and integrated into the country’s national health strategy.

We must acknowledge that we cannot achieve this sustainable development goal in isolation. We must mobilise resources wherever possible and develop innovative partnerships to help get us there.
Research plays a critical role as well in addressing these challenges. If we can support our policy-makers with evidence-based information, we can also help them develop policies which are geared towards achieving an adequate, safe and sustainable blood supply for all our citizens.

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