Spotlight Blood Safety and Availability

Blood Safety and Availability is one of the core competencies of the Swiss Red Cross (SRC), both in Switzerland and abroad. The SRC supports its Sister National Societies in low- and middle-income countries so that they can mobilise blood donations for the blood transfusion system or even provide full blood bank services. In several countries, it also supports government blood transfusion services. Promoting voluntary, non-remunerated blood donation is a key element of the SRC’s engagement.

In 2023, the SRC supported activities in eight countries: El Salvador, Moldova, Lebanon, Malawi, South Sudan, Togo, Bhutan and Laos. Whereas the blood services it supported in African countries had to deal with serious shortages of blood, the focus in other countries, for example in Moldova, was on quality management and achieving the highest standards of blood safety.

Key cumulative data

In 2023, the SRC’s Blood Safety and Availability work helped reach 91’318 people with the message «Save a life by donating blood.» As a result, 233’265 people made voluntary non-remunerated blood donations. These donations from «the heart to a stranger» accounted for on average 65% of all blood donation types, which also include family replacement and paid donations. In 43% of cases, the voluntary non-paid donations were made by people who had donated before and continue to give blood to people in need.

Learn more about our impact in healthÖffnet ein neues Fenster.

The examples given provide snapshots of our work in the programme countries and highlight specific outputs from 2023. The impact of the different country programmes on Blood Safety and Availability are highlighted in the Programme Domain HealthÖffnet ein neues Fenster.

Lebanon: Blood availability in time of disaster

The Lebanese Red Cross blood service, supported by a longstanding partnership with the SRC, has steadily expanded and is currently the largest provider of blood in Lebanon. Its growth has nevertheless been impeded by multiple crises and disasters: the 2006 war, the Beirut port explosion in 2020, economic hardship, financial breakdowns and COVID-19 all worsened the situation in a country that has hosted over 1 million Syrian refugees for a decade.

These crises and disasters differed in scale, duration and impact, whether they were man-made, natural or complex, and the blood service reacted accordingly. In the wake of a sudden mass casualty event like the Beirut explosion, it had to collect, test, process and distribute huge amounts of blood in a very short time, whereas the country’s economic collapse disrupted and at times even blocked operations, as staff, electricity and medical materials all ran short. In either case, the consequences for health service delivery, disaster victims and hospital patients could have been devastating if the blood services were not able to cope with the challenges.

Lessons learned for preparedness

The Lebanese Red Cross learned useful lessons from these crises, enabling it to prepare for future events and in general to boost the blood service’s resilience. Preparedness plans and processes were defined, personnel and volunteers trained, and emergency stocks positioned in decentralised locations. This helped the Lebanese Red Cross review and update its contingency plans should the recurrent conflicts in the region spill over into its territory.

Lebanon: Key data 2023

Togo: Mobilising young blood donors

In Togo, the Swiss Red Cross (SRC) has been supporting Blood Safety & Availability since 2017 in a partnership with the Togolese Red Cross and governmental blood services. Shortages of blood often lead to death, especially among infants and women with postpartum hemorrhages. Two strategies have been used to improve production capacity, as illustrated in the video.

• Young volunteer blood donors are mobilised through school-based Club 25s. On joining a Club 25, the young people commit to adopting a healthy lifestyle and making at least 25 blood donations before the age of 25. They are a crucial source of blood throughout the country.

• The regional blood transfusion centre's capacity to collect, qualify, prepare and distribute blood products has been reinforced by acquiring equipment and consumables and by strengthening its quality assurance skills.

In 2023, the SRC, the Togolese Red Cross and the regional blood transfusion centre in Sokodé (Central Region) jointly developed an intermediary project that seeks to consolidate the gains made by setting up Club 25 and strengthening the centre’s mobile blood collection capacity.

The partnership’s long-term objective is to make the Sokodé centre self-sufficient in blood products and to encourage the clinics that receive the products to comply with the haemovigilance system in place.

Togo: Key data 2023

El Salvador: Improving quality, obtaining certification

Since 2021, the SRC has provided technical and financial support to the Salvadoran Red Cross for the implementation of quality management in blood services. The ultimate goal is to obtain ISO certification.

Investing in quality gives blood service users, clinics, doctors and patients greater confidence in the way blood is taken, tested, processed and distributed. The focus on quality has also generated a culture of continuous improvement in the Salvadoran Red Cross blood service.

Hard work that paid off

The hard work paid off: blood donor satisfaction rose by 37% compared to 2022. National Society staff members further developed their skills and competencies. Blood donor recruitment went up 32%. Innovations were introduced, the legal framework was updated, risks were better managed and process opportunities were identified.
As a result, in 2023 the Salvadoran Red Cross blood service obtained ISO 9001:2015 certification, the first blood provider in the country to do so. The Salvadoran Red Cross intends to continue developing its quality management system and position itself as the leading humanitarian organisation in El Salvador.

El Salvador: Key data 2023

South Sudan: From paper to digital – new ways to manage donors

Access to safe blood is a huge challenge in South Sudan. The Swiss Red Cross (SRC) has been helping the South Sudan Red Cross to improve the availability of safe blood since 2014, including by boosting the capacity of the National Blood Transfusion Services.

Problematic manual data management

The National Blood Transfusion Services used to record and manage all blood donor information manually. Donations were recorded by hand on paper and later typed into Excel spreadsheets. This made data management – delivering up-to-date information on the number of frequent donors, identifying rare blood groups, generating timely reports, contacting blood donors in time of need, entering data after blood drives – a challenge.

New digital tool

With financial support from the SRC, the South Sudan Red Cross provided computers and installed the Blood Safety Information System (BSIS). Staff at the National Blood Transfusion Services were trained to use the software. An officer recalls, “It used to be difficult to trace donors manually because it takes time and there were errors in recording. Then we installed the BSIS and workflows became easy. There is no duplication of donors through Donor Identification Number. Reporting is easy, and we now have excellent up-to-date records."
The installation and efficient use of the BSIS has improved workflows and the generation of timely reports. It has allowed the National Blood Transfusion Services to adhere more closely to strict blood safety rules: only labelled blood units that have passed all blood safety criteria are now distributed to health facilities for transfusion.

South Sudan: Key data 2023

Moldova: Learning from errors

The Swiss Red Cross (SRC) started supporting the National Blood Transfusion Centre in Moldova in 2014, along the entire blood transfusion chain, from the collection of sufficient, safe blood to the production of quality blood products and their safe delivery to patients throughout the country. National protocols were developed for rational use of blood and the haemovigilance system, hospital haemovigilance committees established and medical staff trained. Reporting of adverse reactions and post-transfusion events nevertheless remained weak.

Study conducted

A knowledge attitude and practices (KAP) study was conducted to understand why haemovigilance tools were not much used to report post-transfusion reactions. The study showed that 92% of health care workers believe it is important to report adverse post-transfusion reactions, but 26.7% fail to do so because they fear repercussions or are unsure about the symptoms observed.

Based on the KAP results, steps were taken to adapt training and build capacity. In 2023, 808 health care professionals were trained and the capacity of hospital haemotransfusion committees was significantly increased.

Results achieved

The percentage of hospital transfusion committees working in line with protocols and standards rose from 34% in 2020 to 84% in 2023. Of the 122,811 transfusions performed in 2023, only 2,464 (2%) did not meet national clinical protocols. The National Blood Transfusion Centre’s capacity to audit transfusion facilities increased from 40% in 2022 to 100% in 2023. There were 63 recorded post-transfusion reactions, representing 0.5 reactions per 1,000 transfusions. The number of adverse reactions reported increased by 273%. This sharp increase is not a sign of deteriorating clinical practice, but the improved capability of medical practitioners to detect and report incidents, which enables learning and further quality improvement.

Moldova: Key data 2023

Laos: Taking blood donation on the road

Since 2021, the SRC has been working with the Lao Red Cross (LRC) Blood Service to address the country's persistent undersupply of blood products by introducing effective strategies to recruit enough blood donors. Together, the LRC and the SRC have devised and implemented various donor recruitment strategies and training programmes, while working with the government and private sector to recruit donors from diverse groups.

More outreach activities

In 2023, the Lao Red Cross launched several impactful mobile outreach campaigns targeting specific groups and organisations. It directly engaged factory workers at their workplaces, making blood donation accessible and convenient for 847 individuals. It strengthened its emergency-response capacity by building a reliable network of emergency blood donors (“Walking Blood Banks"). It organized awareness-raising sessions for young people that were attended by 984 students and other young people from government offices, high schools, universities, and military and police bases. The participants gained the knowledge and skills needed to become blood donor recruiters and Youth Donor Club volunteers, ensuring a sustainable future for blood donation efforts.

Media campaign

To maximise the campaigns’ reach and encourage blood donation, the Lao Red Cross also adopted innovative communication strategies. It worked with Medlao, a private company, to develop information, education and communication materials for the "Give Blood Save Life" campaign. Leaflets, banners, and targeted messages were distributed via social media, SMS, telephone and the Medlao mobile application to private sector workers and the general public. The campaigns made 38 mass media broadcasts and posted 489 messages on social networks, effectively raising awareness and increasing total blood donations by 30% in just two years.

Laos: Key data 2023

Malawi: Donors recruit donors

Limited access to safe blood at Malawi’s hospitals contributes to the country’s high maternal and under-5 mortality rates. And while the Malawi Blood Transfusion Service has increased the number of blood units collected from 4,000 in 2004 to 102,960 in 2023, it is still far from meeting the annual target of 120,000 units. As a result, hospitals collect blood directly from patients’ friends and relatives through a family replacement blood donation system. This is less than ideal: it is a burden on the patient’s family, may involve hidden payments and thus poses a threat when donors are not fully honest about their own health or risk behaviour.

Mobilising donations

In recent years, the Malawi Red Cross, with support from the SRC, has cooperated with the Blood Transfusion Service to mobilise voluntary blood donations. National Society volunteers play a key role in their respective communities, as do open days, radio/TV jingles and celebrities as role models. It can nevertheless be much more effective to have trusted friends, rather than unknown recruiters, mobilise blood donors. With the “Donor recruits donor” approach, regular or repeat donors bring someone they know to donor clinics.

Myths and rumors

The myths and rumors associated with blood donation (e.g. witchcraft, supernatural powers, blood-sucking creatures) are a recurrent obstacle. The Malawi Red Cross uses various strategies, including community education campaigns, local leader engagement, personal testimonials and donor training, to provide comprehensive information about the process and dispel misconceptions.

The village of Kabudula organized an open session where community members witnessed the blood donation process firsthand. This multi-faceted approach, combining education, community involvement and cultural sensitivity, played a crucial role in debunking rumours, quelling fears and building trust among potential donors. The result is a community that is positive and informed about blood donations.

Malawi: Key data 2023

Bhutan: Enhancing the National Society’s auxiliary role

Thanks to Swiss Red Cross support for its activities and development, the Bhutan Red Cross Society organized 10 blood donation camps at seven branch offices in 2023. In cooperation with district hospitals, it collected 491 voluntary non-remunerated blood donations.

On World Blood Donor Day (14 June), National Society branch volunteers organized festivities to mark the occasion. At the Thimphu branch, for example, 27 regular blood donor volunteers were honored by the presence of the Bhutan Prime Minister and Health Minister. World Blood Donor Day serves as a reminder of the crucial role that donors play in maintaining a reliable blood supply.

The Bhutan Red Cross Society is currently assessing how it can better play its role as an auxiliary to the government, specifically the National Blood Bank, by stepping up its activities to mobilise blood donations.

Bhutan: Key data 2023

In the face of persistent large differences in Blood Safety and Availability between low- and high-income countries, the SRC will pursue its engagement around the globe. It will work with its Sister National Societies to promote voluntary non-remunerated blood donation.

Based on needs and contextual factors, it will help blood services strengthen their operational processes, leadership, support functions and legal foundation. It will also help its partners meet ambitious milestones, such as having their quality and safety procedures endorsed by an international accreditation/certification body.

The SRC bases its engagement on the principles and standards of the International Federation of Red Cross and Red Crescent Societies and the Global Advisory Panel on Corporate Governance and Risk Management of Blood Services in Red Cross and Red Crescent SocietieÖffnet ein neues Fensters.