According to reports, every year, 62% of maternal deaths from pregnancy and childbirth related complications occur in Sub-Saharan Africa. Out of the 62%, severe bleeding, which is the leading direct cause of these deaths, accounts for 24.5%. Also, 26% of lives that could be saved are lost due to lack of an emergency supply of blood.
According to the latest World Health Organisation (WHO) survey on blood safety and availability, 40 African countries collect less than 10 blood donations per 1000 population per year; of these, 25 countries collect less than half the blood that they need to meet transfusion requirements. High-income countries collect around 35 donations per 1000 population per year.
In many countries, family members are often pressured to donate blood or find a replacement donor in an emergency situation. This causes emotional and financial stress and significant delays in obtaining suitable blood, and also puts women at risk of bloodborne infections as there is often no time or facilities to properly screen the donated blood.
June 14, 2014 was yet another day to commemorate World Blood Donor Day. It is celebrated annually around the world to provide opportunity to highlight the life saving role of voluntary unpaid blood donors and also thank those donors who give this precious gift, with no incentive to them, to save millions of lives every year. The theme of this year’s celebration is: “Safe blood for saving mothers’’
As Nigeria joined the rest of the World to mark World Blood Day, there is a wide spread shortfall between blood requirements and blood supplies. This was seen during the April 14, 2014 Nyanya bomb blast, as the hospitals where the bomb blast victims were rushed to, were short of blood from their blood banks and had to appeal to people to go and donate blood to save the lives of the bomb blast victims. Shortage of this life-saving fluid has become a recurrent problem in the delivery of medical care in Nigeria.
The general availability of blood in the country shows 0.2 units of whole blood per 1,000 population in Nigeria as against WHO recommendation of 10 units of whole blood per 1,000 population to meet clinical demand in resource-limited settings.
While some countries have well-established systems of voluntary blood donation, majority are still dependent to varying degrees, on family/replacement donors and sometimes on paid donors. At Nigeria’s current level of healthcare delivery, about 1.3million units of blood annually are required. However, a National Baseline Data Survey on blood transfusion indicates that only about half a million units of blood are collected from private and public sources with paid donors accounting for over 90 percent of the blood donated.
While marking the 2014 World Blood Donor Day, the Minister of State for Health, Dr. Khaliru Alhassan disclosed that Nigeria needs about 1,336,000 units of blood annually to save the lives of the vulnerable population amongst which are women and children.
The Minister explained that “only 0.08 percent of Nigerians need to donate the required blood unit to save the lives of those who need it.
“The greatest need for donated blood is for pregnancy related complications, severe childhood anaemia and victims of trauma especially road traffic accidents and more recently causalities of bomb blasts.’’
The minister who encouraged Nigerians to voluntarily donate blood added that, ‘’this year’s campaign focuses on the value of safe blood to women, not only in saving her life but also in improving her life expectancy and quality of life.
“Timely access to safe blood and blood products is essential for all countries as part of a comprehensive approach to preventable maternal deaths.’’
The Director of Health Services of the ministry, Dr. Patience Oshunubi also noted that severe bleed during delivery and after childbirth accounts for prevalence of mortality, morbidity and long-term disability adding that voluntary blood donors could come from all works of life, religions and backgrounds.
Speaking with Blueprint, the Managing Director, Pahlycon Hospital Bauchi, and National Public Relations Officer (PRO), Guild Of Medical Directors, Dr.Hassan Garba, said “we have bloodbanks from where screened blood is accessed while new donors are screened, but the blood stored is used up too quickly.’’
Dr. Garba added that the thinking of the average nigerian to donate blood, is mostly when it is needed by family or friend.
WHO has however called on countries to improve access to safe blood for saving the lives of mothers. The organisation reported that every day, almost 800 women die from causes related to complications of pregnancy and childbirth. Severe bleeding during pregnancy, delivery or after childbirth is the single biggest cause of maternal death and can kill a healthy woman within 2 hours if she is unattended. Urgent access to safe supplies of blood for transfusion is critical to saving these women’s lives.
According to the Organisation’s report, in many low- and middle-income countries, blood supply is critically inadequate, adding that Sub-Saharan Africa, which has the highest maternal mortality rate in the world of 510 deaths per 100 000 live births, also has the lowest blood donation rates.
“If all obstetric facilities provided safe blood for transfusion, many of these mothers lives could be saved.
“When a new mother dies, not only does her baby face greater risk of death, malnourishment and lifelong disadvantage, but the whole family’s wellbeing is affected,” WHO Director-General, Dr Margaret Chan, was quoted saying.
WHO further reported in their survey that the safest source of blood is from regular, voluntary unpaid donors whose blood is screened for infections, adding that World Health Assembly resolution adopted in 2010 highlights that a secure supply of safe blood components, based on voluntary, non-remunerated blood donation, is an important national goal to prevent blood shortages.
“Safe blood transfusion is one of the key life-saving interventions that should be available in all facilities that provide emergency obstetric care.
“Yet in 2014, equitable access to safe blood for obstetric care stil remains a major challenge, contributing to high maternal mortality in many countries,’’ the Director of Service Delivery and Safety at WHO, Dr Edward Kelley, was quoted saying.
WHO maintains that providing safe and adequate supplies of blood and blood products should be an integral part of every country’s efforts to improve maternal health.
