Assessing baseline knowledge, attitudes and practices of national orientation agency staff on voluntary unpaid blood donation in Nigeria-The role of multi-sectoral partnerships in donor recruitment

Background: The recruitment and retention of voluntary nonremunerated blood donors (VNRD) is a challenge in many low- and middle-income countries (LMICs), including Nigeria. Low levels of awareness and numerous cultural beliefs, myths and misconceptions have discouraged blood donation in many communities. To address these challenges, the National Blood Service Commission (NBSC) (Federal Ministry of Health) partnered with the country's National Orientation Agency (NOA) (Federal Ministry of Information and Culture) which has a network of thousands of community mobilization officers nationwide to begin public enlightenment and sensitisation campaigns on VNRD across the country even in rural and remote regions. Previous campaigns led by NOA have included drives against drug abuse, HIV/AIDS and COVID-19. Aims: We aimed to assess staff of NOA across sociodemographic characteristics, knowledge, attitudes and practice of VNRD. Methods: A comprehensive self-administered questionnaire was developed and distributed between October and December 2021 among staff of NOA across Nigeria's 36 states and the federal capital to determine their knowledge, attitudes and practices of VNRD via the organization's official platforms. Results: A total of 1567 staff from 34 states responded to the survey, indicating a 37% response rate. Responses were received from 508 local government areas (LGAs) out of 697(73%) in the 34 respondent states, representing 66% (508/774) of the total LGAs nationwide. Majority (42%) were aged 46-55 years, 88% were married, and 97.9% had tertiary education. Nearly all respondents had heard of VNRD (93.7%), and healthcare providers, friends/relatives, and radio/ television accounted for 40%, 21% and 20% of sources of VNRD information respectively. Social media accounted for only 9%. About 31.5% believed that donating blood was harmful, while 22.5% were unsure. Fainting (49%) and infections (11%) were the commonest types of harms thought to arise from VNRD. Transfusions were deemed harmful by 36.6%, while 24.7% were unsure. Only 30.1% knew where their state/zonal blood centre was located. About 96.8% believed VNRD should be encouraged, and 62.8% disagreed with paid blood donations. Whereas 81.6% were willing to donate blood to meet a friend/relative's need, up to 70.8% were willing to donate blood for an unknown person, and about 86.3% were willing to advocate for VNRD. However, out of 36.9% respondents who had ever donated blood, 39% had donated for an unknown person, and only 13.1% of these had donated three or more times. Summary/Conclusions: Despite myths and misconceptions surrounding VNRD in Nigeria, there is a high level of altruism that can be leveraged to mobilize regular unpaid blood donations in Nigerian communities. Multi-sectoral partnerships such as that between NBSC and NOA can be leveraged to tackle the socio-cultural barriers that have hindered blood donation in LMICs. However, it is vital to ensure that wrong perceptions among community mobilization officers are addressed, and that these partner advocates are adequately trained and built up in knowledge and awareness to effectively collaborate with the National Blood Service. Therefore, through effective behaviour change communication (BCC) materials, a pool of sustainable VNRDs can be mobilized to grow a country-wide culture of unpaid blood donation to save the millions of Nigerians in need of safe and regularly donated blood.

Effect of the COVID-19 pandemic on blood donations and transfusions in Nigeria - A multi-facility study of 34 tertiary hospitals.

Background: The coronavirus disease 2019 (COVID-19) pandemic affected blood supplies globally. Mobile blood drive campaigns halted, and voluntary blood donations reduced, challenging available blood supplies. Furthermore, fears of virus transmission led to deferrals of elective surgeries and non-urgent clinical procedures with noticeable declines in blood donations and transfusions. Aims: We aimed to assess the effect of the COVID-19 pandemic on the number of blood donations and transfusions across the country by blood product type across various hospital departments. Materials and Methods: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 34 tertiary hospitals in Nigeria, comparing January to July 2019 (pre-COVID-19) to January to July 2020 (peri-COVID-19). Data were collected from the country's web-based software District Health Information System, Version 2 (DHIS2). Results: A 17.1% decline in numbers of blood donations was observed over the study period, especially in April 2020 (44.3%), a 21.7% decline in numbers of blood transfusions, especially in April 2020 (44.3%). The largest declines in transfusion were noted in surgery department for fresh frozen plasma (80.1%) [p = 0.012] and accident and emergency department transfusion of platelets (78.3%) [p = 0.005]. The least decline of statistical significance was observed in internal medicine transfusions of whole blood (19.6%) [p = 0.011]. Conclusions: The COVID-19 pandemic significantly affected the numbers of blood donations and transfusions in Nigeria. Strengthening blood services to provide various blood components and secure safe blood supplies during public health emergencies is therefore critical.

COVID-19 impact on Nigeria's National Blood Transfusion Service-lessons for low-and middle-income countries (LMICs)

Introduction: On the 27th of February 2020, Nigeria's Federal Ministry of Health officially announced the country's first case of COVID-19. As case numbers started to rise, what ensued was government-led interventions similar to those instituted across the world in the form of non-pharmaceutical interventions such as lockdowns, curfews, restrictions on mass gatherings and other physical distancing measures. These measures negatively affected blood donor mobilisation activities. Nigeria, like many other countries in sub-Saharan Africa prior to COVID-19 had encountered challenges with recruiting sufficient voluntary blood donors to meet the huge blood needs in the country, and so dire consequences of these infection prevention measures on national blood supplies were anticipated. A noticeable decline in blood donations and available safely screened blood for transfusions thus followed. We aimed to assess the blood service activities across seventeen (17) National Blood Transfusion Service centres in Nigeria, including numbers of blood donations, mobile blood drives, blood units screened, outcomes of screening, number of hospitals the NBTS provided services to and number of blood units discarded over the study period. Method: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in seventeen (17) NBTS centres in Nigeria, comparing the months of January to December 2019 (pre-COVID-19) to the months of January to December 2020 (peri-COVID-19). Results: A 100% decline was observed in mobile blood donation drives in the first two months following government-imposed lockdowns, and numbers of all blood donations and voluntary blood donations declined by 9.8%. An 11.9% decline was also observed in the number of blood units screened;while the number of blood units that screened positive for transfusion-transmissible infections reduced by 28.6%. The number of discarded blood units declined by 3.1%;however, a 32.6% increase was observed in the number of hospitals that accessed blood for transfusion purposes from NBTS. Conclusions: The COVID-19 pandemic affected NBTS operations in Nigeria. However, by strengthening hospital linkages and employing innovative strategies, NBTS ensured continuity of operations, thereby significantly managing the challenges of COVID-19 to voluntary blood donor recruitment and the availability of safe blood for transfusion.