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”.

概括 该项目旨在将加纳的献血者库从家庭替代献血转变为 （FRD）自愿收集。根据世界卫生组织的建议，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、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，而历史上 该地区安全血液供应不足。随时可用的血液供应不足且不规律 紧急输血在产科出血的高死亡率中发挥着重要作用。我们有 认为加纳的献血系统是提供充足和定期血液的主要障碍 满足国家输血需求。目前，加纳 70% 以上的血液采集是在 家庭替代供体（FRD）系统，与不足、不可持续和相对相关 紧急情况下的血液供应不安全。相比之下，各国的平均发病率为每 1000 人 31 人 加纳拥有 100% 自愿献血者基础，但每 1000 人中只有 5 人献血。作为一个 直接结果是，血液供应的特点是长期不足且经常出现严重短缺，并且 是一个重大的发展挑战。我们的长期目标是确保充足的可持续供应 通过在该国建立新的献血模式，重点关注加纳的安全血液 基于社区的志愿者系统和营养捐赠者充实。贫血占53% 捐助者自愿延期，因此是当前申请的一个主要重点。此外，还有恐惧 与对献血的误解以及缺乏血液知识和信息有关 捐赠导致加纳献血志愿者人数较少。社区的目标 不是以个人而是以社区（公共集体主义）的形式献血，并采用互惠模式 确保血液可供他们自己的社区将来使用提供了一个有吸引力的策略来招募新人 志愿者。基于社区集体主义并辅以沟通策略的干预措施是 在 SSA 文化上适合，但尚未探索如何提高献血率。此外， 献血不足的其他可改变的原因——动机、使用献血设施、营养——将 有针对性地使用改善沟通、行为改变方法和补铁来 改善捐赠者的整体招募和保留。我们将评估增加可用性的影响 志愿者社区血液可减少社区内与出血相关的孕产妇死亡 医院。基于这些想法，我们将测试总体假设“基于社区的志愿者 针对经常性献血者的营养献血者丰富模式将有助于克服 加纳血液供应的发展挑战”。