What, according to you, are the major gaps in India’s blood transfusion system?
Dr Bharucha: A National Blood Policy has been defined but it is not legislated to provide authority to National Blood Transfusion Council (NBTC), which is charged with the responsibility to implement the policy, and hence, remains a toothless assembly of wise men.
There is a multiplicity of control involving many agencies without coordination. National Health Mission has state and district blood cells, National Institute of Biologicals runs haemovigilance programme and National Accreditation Board of Hospitals (NABH) accredits blood banks. The regulatory function remains under the Drug Control Authority. The amendments in drug rules are not in pace with technology. According to the World Health Organisation, all countries should have a single standard, but in India besides Indian standards, there are drug rules, DGHS standards, NABH standards and others.
There are over 3,000 blood banks in India, and the regulators are unable to cope with inspections due to shortage of staff. Blood centres operate in total isolation, their standards vary from one centre to another. Only 62 per cent of blood undergoes component preparation. Non-availability of components and inappropriate use increases scarcity. Access to safe blood in remote and rural areas where 70 per cent of the population lives, is poor. Demand is increasing due to increasing population and development of medical systems, but supply is lacking due to difficulties in creating stable base of donors, increased donor deferral and inappropriate use of blood, lack of trained staff as well as improper finance management.
Why is voluntary blood donation important? Is family replacement donation inadequate to meet the country’s needs?
Dr Bharucha: Voluntary blood donation is reported as 84 per cent but many report family donors as voluntary. Regular donors vary from zero to 30 per cent in various states. Though national policy recommends that hospitals should be responsible for blood requirement, many hospitals ask relatives to get replacement donors. Recently, some apps using GPS, enable users to connect with registered blood donors in their area.
Blood should be waiting for the patient and not vice-versa as at times it may be too late before a donor is found. The insistence is on voluntary blood donors as we get correct answers to the questions on medical and lifestyle history and the regular blood donors who donate every three months are safer as their blood is tested every three months.
How can community awareness be created on the need for voluntary blood donation?
Dr Bharucha: To improve community awareness regarding voluntary blood donation, Information Education and Communication IEC materials are developed by NBTC and State Blood Transfusion Council SBTC in various languages using educational, informative and motivational material with emotional appeal need to be distributed.
Texting reminders, appointments, and urgent needs using mass SMS can also increase the show rates. School education programmes help as a long-term campaign. Messages from President/Prime Minister and advertisements with well-known actors can be promoted through TV, radio and newspapers. Social media, especially Facebook, is also supporting donor recruitment in India.