20 - Blood Transfusion in Resource-limited Settings

Abstract

Abstract The issues of blood safety, availability, access, and rational use continue to be major challenges in many parts of the world, especially in resource-limited countries. Blood supply is inadequate to meet global needs, and blood availability and accessibility are highly inequitable. High-income countries collect 47% of the 112.5 million annual global blood donations, although they account for only 19% of the global population. Low- and low-middle-income countries have 24% of the global blood supply for 48% of the world's population. Annual blood donation rates vary from 33.1 donations per 1000 people in high-income countries to 4.6 donations per 1000 people in low-income countries. This discrepancy is due to many factors, including high levels of anemia and transfusion-transmitted diseases in the general population, which reduces the pool of healthy potential blood donors. There are also cultural and spiritual factors that may impede willingness to donate, and the infrastructure for collecting, processing, and distributing blood to where it is needed is often weak and ineffective. In addition to constraints in achieving an adequate blood supply, resource-limited settings face considerable demand-side challenges, including a predominance of emergency rather than elective transfusions, high demand for pediatric transfusions, and temporal and spatial variation in demand.