Development and evaluation of community-based approaches and donor care intervention models for improving availability and safety of blood for the management of severe anemia in Ghana

开发和评估基于社区的方法和捐助者护理干预模型，以改善加纳严重贫血管理的血液供应和安全性

• 批准号: 10200885
• 负责人: Lucy Asamoah-Akuoko
• 金额: $ 22.87万
• 依托单位: UNIVERSITY OF GHANA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10200885
• 关键词: Acute; Adolescent; Africa South of the Sahara; Age; Altruism; Anemia; Attention; Awareness; Back; Behavioral; Blood; Blood Donations; Blood Transfusion; Blood donor; Cardiovascular Diseases; Caring; Chronic; Clinical; Clinical Management; Collection; Communication; Communities; Community Health; Community Hospitals; Consent; Country; Development; Discipline of obstetrics; District Hospitals; Drama; Drops; Education; Emergency Situation; Ensure; Family; Female; Free Will; Frequencies; Fright; Future; Ghana; Goals; Health; Health care facility; Hematologist; Hemorrhage; Hospitals; Hypertension; Individual; Intervention; Iron; Iron deficiency anemia; Knowledge; Lead; Leadership; Legal; Maternal Mortality; Medical; Methods; Modeling; Motivation; Nutritional; Outcome Measure; Patients; Play; Policies; Population; Process; Public Health; Reaction; Recommendation; Risk; Role; Safety; Secure; Services; Sickle Cell Anemia; Source; Specialist; Supplementation; Surveys; System; Teaching Hospitals; Testing; Time; Transfusion; Vascular blood supply; Vasovagal; Visual; Whole Blood; World Health Organization; abortion; animation; base; blood product; commune; community based evaluation; design; efficacy evaluation; improved; iron deficiency; iron supplementation; mortality; multidisciplinary; nutrition; nutritional supplementation; payment; primary outcome; prospective; recruit; response; screening; sociologist; trend; volunteer

Summary This project is directed towards transforming the blood donor pool in Ghana from family replacement donations (FRD) to voluntary collections. In line with WHO recommendations, the national blood policy in Ghana aims at 100% voluntary blood donation pool to secure and sustain an adequate and safe blood supply, since voluntary blood donors are more likely to donate on a regular basis. The major challenge for blood transfusion services in sub-Saharan Africa (SSA) is the juxtaposition of an increasing clinical demand for blood and a historically insufficient supply of safe blood in the region. The inadequate and irregular supply of blood readily available for emergency transfusions play a cardinal role in the high mortality rates in obstetric haemorrhage. We have identified the system of blood donation in Ghana as the major barrier to providing adequate and regular blood to meet the transfusion needs of the country. Currently, over 70% of blood collection in Ghana is obtained in a Family Replacement Donor (FRD) system, which is associated with insufficient, unsustainable and relatively unsafe supply of blood for emergencies. In contrast with an average rate of 31 per 1000 population in countries with a 100% voluntary blood donor base, blood donation in Ghana remains at only 5 per 1000 population. As a direct result, blood supply is characterized by chronic inadequacy with frequent critical shortages, and represents a major developmental challenge. Our long-term goal is to secure a sustainable supply of adequate and safe blood in Ghana by establishing a new paradigm of blood donation in the country focused on a community-based volunteer system and nutritional donor enrichment. Anaemia accounts for up to 53% of voluntary donor deferrals and is, therefore, a major focus of the current application. In addition, fears associated with misconceptions about blood donation, and the lack of knowledge and information on blood donation contribute to the low number of blood donation volunteers in Ghana. The targeting of communities to donate blood not as individuals but as communities (communal collectivism), with a reciprocity model that ensures blood is available for future use by their own communities offers an attractive strategy to recruit new volunteers. Interventions based on communal collectivism and aided by communication strategies are culturally appropriate in SSA but have not yet been explored for increasing blood donation rates. Additionally, other modifiable causes of inadequate blood donation—motivation, access to donation facilities, nutrition—will be targeted using improved communication, behavioural change methods, and iron supplementation to improve overall donor recruitment and retention. We will evaluate the impact of increased availability of volunteer community-sourced blood on reduction of haemorrhage-related maternal deaths in community hospitals. Based on these ideas, we will test the OVERALL HYPOTHESIS “A community-based volunteer and nutritional donor enrichment model towards recurring blood donors will help to overcome the developmental challenge of blood availability in Ghana”.

总结 该项目旨在将加纳的献血者库从家庭替代献血转变为 (FRD)自愿募捐。根据世卫组织的建议，加纳的国家血液政策旨在 100%自愿献血池，以确保和维持充足和安全的血液供应，因为自愿献血 献血者更有可能定期献血。输血服务面临的主要挑战 在撒哈拉以南非洲（SSA），临床对血液的需求不断增加， 该地区安全血液供应不足。血液供应不足和不规则， 紧急输血在产科出血的高死亡率中起着至关重要的作用。我们有 确定加纳的献血制度是提供充足和定期血液的主要障碍 来满足国家的输血需求目前，加纳70%以上的血液采集是在 家庭替代捐助者制度，这与不充分、不可持续和相对 紧急情况下的不安全血液供应相比之下，有些国家的平均发病率为每千人31人， 尽管加纳拥有100%的自愿献血者基础，但献血率仍然保持在每1000人中只有5人。作为 直接结果是，血液供应的特点是长期不足，经常出现严重短缺， 是一个重大的发展挑战。我们的长期目标是确保充足的 通过在加纳建立一个新的献血模式， 以社区为基础的志愿者系统和丰富营养捐助者。贫血症占53%， 自愿捐助者推迟捐款，因此是目前申请的一个主要重点。此外，恐惧 与对献血的误解以及缺乏有关血液的知识和信息有关 献血导致加纳献血志愿者人数少。将社区作为目标， 献血不是作为个人，而是作为社区（社区集体主义），具有互惠模式， 确保血液可供自己的社区未来使用，这是一个有吸引力的战略， 志愿者以社区集体主义为基础并辅以沟通策略的干预措施， 在撒哈拉以南非洲，这种做法在文化上是适当的，但尚未探讨如何提高献血率。此外，本发明还 献血不足的其他可改变的原因-动机，献血设施的获得，营养-意愿 通过改善沟通、改变行为的方法和补铁， 改善捐助者的征聘和保留工作。我们将评估增加可用性的影响， 志愿者社区来源血液减少社区内与出血有关的孕产妇死亡 医院的基于这些想法，我们将测试“社区志愿者”的总体假设 对经常献血者的营养补充模式将有助于克服 加纳血液供应的发展挑战”。