Need for blood

The trouble about Nigeria’s blood requirement doesn’t call for rocket science. The World Health Organisation recommends enough blood units to cover at least 1% of a nation’s population.
That figures works out to around 1.8 million units of blood needed every year for the country’s entire population. What’s rocket science is that the country is not getting anywhere near that figure, and accurate data of what is available is uncertain.
Last year, close to 1.3 million units of blood was collected from a range of sources – more than 85% of them came from commercial donors.
The National Blood Transfusion Service, NBTS, which sets the benchmark for best practice when it comes to donated and transfused blood, deals mostly with voluntary unpaid donations. It screens for HIV, hepatitis B, C and syphilis.
A database of voluntary blood donors is building across NBTS network of 17 zonal centres. Last year, it collected just a little over 60,000 units from voluntary donors. Out of that, it issued 45,000 for use in transfusion in hospitals.
“We have not met the blood need of Nigeria,” says NBTS national coordinator Dr Oluwatoyin Smith.
The need is shared between what’s collected at NBTS and what’s collected elsewhere. Each unit must be screened within days, stored and issued within a maximum 35 to 40 days, or discarded.
Nearly every hospital with capacity for blood screening and banking collects blood from patients in one guise or another. Collection for in-hospital antenatal and emergencies uses are the commonest.
Customs Staff Clinic is among centres mandating relatives of pregnant women to donate blood during antenatal visits if a woman intends to give birth at the hospital.
Staff allot a few hours two days every week to bleed patients’ relatives.
“They said if my wife delivers here and happens to need blood transfusion while giving birth, I won’t have to pay anything, no matter how many bags,” said Dennis Ochefa, a husband who took out a Saturday afternoon to donate on his pregnant wife’s behalf last September.
“If you don’t donate, she can still give birth here, but you will have to pay for blood before,” a staff explained. “And if it turns out the blood is not used, you don’t get a refund.”
Staff working to bleed patients confirm the blood is taken into NBTS supply for screening. NBTS confirms it gets blood from hospitals for screening, but only from those with which it has an arrangement.
A second arrangement with hospitals is blood rotation, an exchange in which hospitals take a cache of collected blood to NBTS and leave with the same number of previously screened blood.
That arrangement contributes about 30% to what NBTS issues out. Nationally, the figure is uncertain. It is also the bulk of blood units that patients pay for in hospitals outside the control of NBTS.
“If we have blood rotation from every facility where blood transfusion actually takes place, we will be seen to satisfy to a certain extent the blood need of Nigeria. As it is, it is not possible,” according to Smith.