Motivation Recruitment and Retention of Blood Donors

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Blood cannot be manufactured. For continuous supply of blood
and its products, blood has to come from generous donations
from blood donors. To ensure a safe and adequate supply of
blood and blood products motivation, recruitment, selection
and retention of voluntary non-remunerated blood donors are
of at most importance. The first step towards blood safety is to
encourage blood donations from voluntary and non-
remunerated low-risk blood donors. Blood from a voluntary,
repeat and regular donor is the best. A regular donor is one
who donates blood two to three times a year and continues
to donate at least once a year. Voluntary non-remunerated
regular blood donors who donate blood out of self sacrifice
are considered safe blood donors. In many countries, conti-
nuous efforts are needed to achieve 100% voluntary blood
donation. It is well established that paid donors constitute a
group with high-risk behaviour leading to greater chances of
transfusion-transmitted infections in the recipients. If the blood
replacement system is in use, it is necessary to impose strict
vigilance to identify paid donors.
Donor Motivation
While planning donor education and motivation campaign,
the following should be kept in mind:
• People do not donate blood unless they are asked to donate.
• There are sufficient potential donors available.
• There are several myths and misconceptions about blood
donation in the public.
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Motivation, Recruitment and
Retention of Blood Donors
182

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Motivation, Recruitment and Retention of Blood Donors 183
Education therefore is an important bridge between aware-
ness and recruitment. Donor education is essential to ensure
recruitment of safe donors.
Essential Steps in Donor Motivation
This is done by the following ways:
• Appeal for blood donation through lectures and focused
group discussion.
• Continued motivation and education of potential donors.
• Involving important public figures and community leaders
in blood donation education programmes.
• Retention of safe donors.
• Organizing donor recruitment campaigns on a continuous
basis.
• Developing messages: A clear and simple message
conveyed in a local language is most effective. All health
education or communication materials, e.g. posters, leaflets,
flip charts, etc., once prepared, should be field-tested among
a subset of target population and suitably modified based
on the feedback from the field test. Educational material
suitable for the target group should then be prepared and
used for the purpose of motivating potential donors.
Traditional media, such as songs, folk dance, street plays,
puppetry, etc. can prove valuable, especially in rural settings.
The local community groups and youth groups can
participate actively in preparation as well as in the use of
such promotional material.
• Communication approaches: Methods and approaches to
be employed for communication or awareness programme
could include the use of mass media—newspapers, radio
and television; interpersonal communication through
person-to-person interaction; group educational workshops,
e.g. lectures, exhibition—posters and banners; use of cele-
brities to convey messages; regular contact with potential
donors through greeting cards, phone calls, blood donation
drives on important national days, recognition of regular
blood donors, etc.

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Essentials of Blood Banking and Transfusion Medicine
Proper and effective communication strategy can help to
motivate potential donors to become donors, encourage
suitable donors to be regular donors, and discourage
unsuitable individuals from donating blood, thus reducing
the chances of transmitting infections through blood trans-
fusion.
The main messages which the communication programme
should highlight include the following:
• Target populations to be addressed may include:
– Youth above the age of 18 years in colleges
– People at workplaces, i.e. factory workers, office workers,
etc.
– General population
– Organizers of blood donation campaigns
– Religious and community leaders
• Need for preventing transfusion-transmitted infections and
risk associated with blood collected from paid blood donors.
• Assuring harmlessness of blood donation, safety of blood
donors through their pre-donation medical checkup and use
of disposable equipment for blood collection.
• Community responsibility for blood donation.
• Information about collection, processing and supply of
blood.
• Blood as a life savior to the needy and emergency cases.
• Blood donation through organized group or individual
recruitment.
• Organizing and providing infrastructure.
Donor education and information materials, donor
questionnaires and consent forms should be prepared in simple
language and translated for use according to regional varia-
tions. Picture presentations or flip charts can be used to educate
donors who cannot read printed educational material.
For satisfactory donor recruitment, the first essential step is
to initiate knowledge, attitude and practice studies among a
sample of donors and non-donors. The objective is to under-
stand donor demographic profiles as well as the prevailing
misconceptions, beliefs and fears leading to a negative attitude

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Motivation, Recruitment and Retention of Blood Donors 185
towards blood donation. This should also cover socio-economic
and cultural factors relating to blood donations, such as asking
donors how they decided to donate or learnt about the dona-
tion centers. The information so obtained could be helpful in
developing appropriate messages to be used during recruit-
ment of campaigns, creating and strengthening positive
attitudes towards blood donation, and developing and
implementing focused awareness programmes for target
populations.
Planning of education and motivation campaigns should
take into consideration the profile of the target audience in
terms of socio-economic and cultural background, age group,
sex, level of education as well as physical, environmental and
other factors.
Retaining Donors
To increase the number of voluntary blood donors and retain
them as regular donors, efforts are being made by most of the
blood banks. This is important because the prevalence of
infections in regular donors is known to be much lower than
in new donors. Recruiting regular blood donors will help in
increasing the yield of plasma for therapeutic and fractionation
purposes. The regular donors are tested each time they donate,
which further increases the safety of blood. For an effective
donor retention programme, building a long-term relationship
with donors is crucial. Following are some of the measures
that may help in donor retention:
• To have a clean and easily accessible location for blood
donation.
• Time schedule convenient to most of the donors.
• Donors should be given personal attention.
• They should not be made to wait long.
• Staff behaviour is perhaps the most important factor. The
staff should therefore be courteous, trained and experienced
in providing proper donor care.
• The staff should make the procedure of blood donation a
pleasant and comfortable experience.

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Essentials of Blood Banking and Transfusion Medicine
• The donors must be appreciated and thanked for their contri-
bution and assured of total confidentiality.
• Appropriate follow-up and medical support would go a long
way in donor retention.
According to blood transfusion safety department of
essential health technologies of World Health Organization,
high priority should be given to the elimination of family/
replacement and paid blood donor systems, which are associa-
ted with a significantly higher prevalence of TTIs. Voluntary
non-remunerated blood donors from low-risk populations who
give blood regularly are the foundation of a safe and adequate
blood supply. Important activities include:
• Appointment of an officer responsible for the national blood
donor programme.
• Establishment of a BTS unit responsible for donor education,
motivation, recruitment and retention.
• Appointment of a designated blood donor recruitment
officer.
• Preparation of SOPs in accordance with BTS guidelines.
• Training of staff in the blood donor unit.
• Identification of donor populations at risk for TTIs.
• Development of educational materials.
• Establishment of a register of voluntary non-remunerated
blood donors.
• Assurance of safe blood collection procedures, including
donor selection and deferral, donor care and confidentiality.
Ensuring Safety during Blood Donations
During blood donation campaigns, it is crucial to ensure the
safety of the donors. The donor should willingly consent to
donate blood without being pressurised. The organizers of
donation campaigns should be discouraged from offering
expensive incentives to blood donors. Information and
counselling are essential for enhancing donor awareness,
perception, motivation, self-deferral and recall. The donor
should be assured of absolute confidentiality. Moreover, the

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Motivation, Recruitment and Retention of Blood Donors 187
procedure for blood collection should be made completely safe,
e.g. by using disposable needles, syringes and blood collec-
tion packs to instill confidence in the donors about their own
safety.
Donor Record Maintenance
A well-maintained donor record, kept in strict confidentiality,
is an essential part of the programme. It is helpful in donor
retention as well as in tracing the donor for any specific needs,
such as requirement of rare blood group, donor recall in case
of post-transfusion infection, confirmation of test results and
counseling.