City of Blood – a Surprisingly Simple Way to Address the Shortcoming of Blood Donations

Nigeria accounts for the second highest rate of maternal mortality in the world. 26% of these deaths are due to postpartum hemorrhaging – i.e., excessive blood loss after child labour. In addition, over 50,000 deaths from road accidents are due to excessive blood loss. Nothing more to say: solving this problem would help many many people. As many sub-Saharan countries, Nigeria has a huge problem with their emergency blood system. Unlike in many other countries, there is a general lack of voluntary blood donations (almost zero) and at the same time Nigeria has a problem to allocate the right type of blood to the right hospital when needed. With a population of 180 million, Nigeria has a blood need of about 1.5 million pints per annum. Currently less than 500,000 pints are collected and distributed, leading to avoidable deaths.

Today the existing blood collection system is mainly based on family replacements – about 60%, when family members give blood to someone within their family. About 40% of the collected blood is through commercial blood donors, who get paid for their “philanthropic” action. However, the percentage of voluntary blood donations, the major source of blood pints in many countries, is negligible.

On the other hand, not only the supply side of blood is missing the crucial element of blood donations, but also the management and allocation of the collected blood has some shortcomings. At the moment, there are many private blood banks that buy, sell and distribute blood. However, as there is no single repository or database that gives an overview of the blood on stock, it’s oftentimes hard for hospitals in need for blood to find the blood they need. Moreover, as there is a general shortage of blood, one can observe prosperous black markets for blood, which rather serves the ones who can pay for it, rather than the ones that are in most need.

 

Why are people not donating?

Although people would be open to donations, there are some circumstances that hold them back. Foremost, Nigerians are concerned about the health security when donating blood. The fear that needles are reused and infect the donor is one of the major issue. Moreover, potential donors fear that their donation is not given for  good, but rather sold to a private blood bank or on the black market. Next to that, the blood donation needs to be hassle-free without long ways to donation stations, registrations and fixed dates and times.

Why is it hard to allocate the blood?

In general, there is an insufficient transparency about blood demand and supply (hospitals, blood banks) as the blood bank landscape is scattered and processes are mostly based on pen and paper. It is usually the case that the hospital staff call several blood banks to find out if they have the required blood type on stock (and for the right price). On the other hand, it is very hard to plan the supply of blood. There are only little regularly recurring blood donors and even if you have their contact details to communicate the next date of blood donations, there is no certainty they will show up.

Currently there is an attempt to increase the supply of blood through incentives such as money or food. However, although many Nigerians respond to these incentives, this procedure ultimately increases the price for blood as well as creates an expectation that one needs to get paid for giving blood.

Bloodlines through vans and cooperation

Alright, this rather sounds like an unsolvable issue, especially as people mostly start caring about blood donations only when they are affected themselves. So let’s make it as little about blood donation as possible. A solution to the described problems would start as a combination of donation vans that come to the donor, local businesses that would get additional customers, businesses or practice and a digital basis such as RFIDs or just QR-Codes for tracking the blood, as well as the donors.

The idea is simple. First, if donors don’t come to you, you need to go to the donors! The core of this true ‘bridging model’ are vans driving through a city such as Lagos. Through their smart route based on donors database, the van automatically informs potential donors, via sms or feature phone, about the location and time of possible donations. The van works as a small steril donation room, which includes cooling for the daily storage of blood donations. A side aspect: next to function as a donation spot, it could serve as logistics system between hospitals and blood banks as well.

Second, based on the already established digital contact to donors, as well as clear labeling of blood pints, a tracking and proactive information to donors of the blood and its use would be possible.

However, the real trick comes when including local businesses to address the remaining  pressing issues: the fear of used needles and financing the van’s operations and even creating a sustainable business out of it. The idea is to establish a circular system, where the donors get vouchers for local shops that are tailored to identified needs. These needs can be identified, for instance, through analysis of their blood and potential shortcomings or sickness or just through the short conversations in the van itself.  A voucher could be for the local pharmacy, grocery store, clothes, etc. Next to the voucher itself, that gives recutions or has a monetary value for the respective product or a service, a voucher ALWAYS includes the offer to pick up a fresh needle at the respective business. Thus donors bring their ‘own’ one-time needle every time to the donor station (van) and can much better control the hygienic security. This mechanism increases also the value of vouchers for the issuing businesses: the likelihood that people show up in the store increases, even if it is only for the needle. Next to issuing the vouchers, the included businesses pay to the operators of the van for each person picking up a needle and therefore financing the core operations of the donation vans. They are willing to do so because they get very targeted customers.

In addition, in the long run, the system could create a rich database on blood donors but also on preferences and needs. It could also become a very valuable data source for other players such as the government, doctors, pharmaceutical companies and all local business e.g. for health interventions or understanding local habits or trends in nutrition.

  • Donors: having the possibility of picking their needles, donors feel and are in a safer environment. They also get regular blood checks and vouchers for products and services they specifically need. Thanks to the smart routing of the vans, they can pick the closest spot for blood donation, making it more convenient time wise.
  • Local business: they are the preferred partners of the vans and increase their sales through recurring customers. Also their planning (e.g. of stock) could be improved when harmonized with the van’s routes as they know when customers would come (after getting their vouchers)
  • Vital Vans: they can benefit from hospitals and government that need their service. It is mostly based on a self-sustaining model, by using the information they gather on donor profiles and include local businesses who pay for that information. In the long run, the van service could offer other services such as to blood banks to run their stocks on the created platform and increase their efficiency through a value-based pricing.
  • [Option:] For the blood distribution a non-obvious logistics partner such as CocaCola could be included. CocaCola delivers cooled drinks to even very remote places and has many empty routes on the way back – which could be leveraged.

Open questions

  • Is it acceptable for the donors to bring together very sensible (blood) data with promotions other customer data?
  • Is it possible to find enough contributors on both sides: local business as well as donors?

We would like to thank Bukola Bolarinwa, who is trying to set up such a service in Nigeria, for her valuable insights and comments.

Icons from Till Teenck, hunotika, Thijs Rentier, Viktor Vorobyev, emma mitchell, Vectors Market, EBDRU DESIGN, mello, Nook Fulloption, Lawyer Collection, The Noun Project

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