Topics Covered :

Donor Recruitment & Retention
Patients’ right

Donor Recruitment

We will discuss here how to recruit, retain and recall the donors keeping in
mind that donor is a very important person in blood transfusion.

The cornerstone, of a safe and adequate supply of blood, is the motivation, recruitment, selection, and retention of nonremunerated repeat blood donors.

Universal principle of Donor recruitment and retention.

Firstly, Careful planning and organization.

Secondly, we should know the community well.
thirdly, We need to access what will motivate people in that very community. Strategies will differ for age groups, local organizations, political organizations, uniformed organizations, students, etc.
fourthly, Effective communication, and campaign.
fifthly, Good service, and support for donors.
sixthly, good support to the organisers when they require blood.
seventhly, Good public reputation of the organizer goes a long way in increasing the voluntary blood donations.

Milestones achieved so far, for the voluntary nonremunerative blood donors.

Regulations by Central Drug Standards and Control Organization regarding various aspects of blood donation which is safeguarding the rights of the blood donors.

There was a Public Interest Litigation Common Cause Versus Union of India and others-1994. The outcome was the landmark judgment of the honorable Supreme court came out on 4th Jan 1996. What did we get? What did the voluntary Blood Donors get? We got our rights. Our demands were established.

The court ordered to establish National Aids Control Organisation and support the blood transfusion of the country through National Blood Transfusion Council – NBTC, and SBTCs, in the states.

The court further ordered to Ban Professional Donors by Dec 1997. Thus India became a country with no professional donors, legally. No one can sell blood neither anyone can buy it. What we need to give to the blood centres, if our patient is in the private sector is only the processing charge.

Mandatory tests was introduced for safe blood transfusion.

Antibodies to HIV1&2, antibodies to hepatitis C, Hepatitis B surface antigen, Syphilis VDRL and RPR, and malaria was introduced in the system. This was a major win for the voluntary organisations.

NBTC under the directives of the honorable supreme court framed the National Blood policy in 2002. The national Plasma policy was also framed in 2003.

Thalassemia patients, Haemophilia, and sickle cell patients are the people who need a regular transfusion. The year 2014 was a year of a big victory for us. It was decided that these patients won’t need to give any processing fees while procuring blood from the government and even private blood centres. We have been campaigning these years but we feel sorry, that even many thalassaemia organizations don’t even know this and their patients are being looted by scrupulous blood centre. Through this chapter, we urge you all to spread the message that these patients will get blood free of cost.

Bulk Transfer of blood from one blood centre to the other was a major demand of the Federation of Indian Blood Donors Organisations – FIBDO, which came into effect in 2015. We LUCY, as an organisation is proud to be a member of FIBDO.

Any Hospital-based blood centre are also allowed to collect blood through outdoor camps now. It was also one of FIBDOs Major demands.

Type of blood donors.

Voluntary non remunerated blood Donors: A Voluntary NonRemunarative Blood Donor is a person who Donates Blood on their own and doesn’t expect anything in return. In our country, we have 64 percent of them and in our state, it’s 85 percent. These donors are the best form of donors and our target is to make our country 100 percent in voluntary donors.
Replacement Donors: This type of donor comes from within the patient’s own family or friends or office. Peer pressure remains on these types of donors and we aim to STOP Replacement Blood Donation as soon as possible. This can only be done by introducing more and more voluntary non remunerated blood donors.
Autologous Blood Donors: A patient who donates his/her own blood for self.
Apheresis Donors: Donation of blood components through the process of cell separation.
Professional Donors: They are legally banned in India. But they act as replacement donors in disguise on the patients relative. They are a threat to the blood transfusion system of the country.

An adequate supply of safe donors requires-
A donor recruitment program.A dedicated recruitment section with trained staff.Appropriate funding to support donor recruitment activities.Careful assessment of your needs and requirements.Realistic goals.
1st ly Number of units.
2nd ly Type of blood or blood components.
And finally Regular reassessment.

We need to concentrate on repeat donors after they are recruited in the system. This is because they are screened regularly and understand the importance of health and risk behavior factors. They Are well informed and committed. Have experience in giving blood and therefore can be dealt with more quickly. Regular Donors are dependable and willing to give blood in an emergency, as well as on a regular basis. They Provide a basic source of safe blood and very valuable to BTS.

Principle of Blood Donor recruitment

what a donor motivator or a donor organisation should aim at while recruiting a blood donor. Identification, education & motivation of potential donors in the community.Training & motivation of blood donor organizers and recruiters.Donor record maintenance and confidentiality. Highlighting the importance of voluntary non-remunerated donation. Continued motivation and education of potential donors. Involving important public figures and community leaders in the education program. Retention of safe donors. Organizing donor recruitment campaigns on a continuous basis.

Now, To motivate and recruit a donor or an organisation what will be our approach?

We have two ways to approach. One is the Direct approach and the other is indirect. Let us first discuss how we will make a direct approach. The direct approach can also be subdivided into two segments – one personal and second group approach.

We can use emails, personal WhatsApp, social media phone calls, and face to face discussion as a means of personal approach.

2ndly for the Group approach we need to go for -

• Awareness campaign in school and colleges.
• People at workplaces - factory workers.
• General population.
• Uniformed services - paramilitary, police.
• Religious and community leaders.

The indirect Approach will be much a Mass approach involving the -

Print media. Electronic media - TV, social media, FM Radio.

• Outdoor Banners and hoarding.
• Celebration of special days.
• Use of celebrities to convey a message.
• Posters and stall in local fair or exhibition.
• Slogans on a day to day items.

So, Now to approach the sections just mentioned what will be our messages to them. We need to be very much concrete on that because these messages and ways of communication from our side will be the deciding factor a person or an organizations involvement in blood donation. We will have to give stress on -Importance of voluntary blood donation.

Need for preventing transfusion transmissible infections and the risk associated with paid blood donors. Assuring harmlessness of blood donation & safety of blood donors. Community responsibility for blood donation. Emotional appeals for Thalassemia & Hemophilia patients. Information about collection, processing, storage, and distribution of blood
After all our effort we find that Many people after blood donation for the first time do not come again to donate blood. We need to find out WHY this happens. Repeat donors are our assets as they will be the best form of donors. Let us find out why this happens and find the remedies to it.
The reasons behind this are -

Lack of time and communication.
Unfavorable location or time of the blood donation.
Unhappy past experience.
Bad handling by the blood bank personnel.
Donor reactions at the time of blood donation.
Non-availability of blood in time of his / her need.
Failure to appreciate the efforts of blood donors.
The impression that blood is not being utilized properly.

How can we mend this and have the donors with us lifetime -The organizations can send

Appreciation and thanks letters.
SMS and WhatsApp appreciation.
Birthday greeting cards.
Special badges for regular donations.

We must take care of the Environment of the blood donation center with

Clean, pleasant environment.
Courteous, efficient, trained staff.
Providing Assurance of total confidentiality.
Foster a good relationship.
Absolute confidentiality of records.
Ensure donation is a good experience.
Keep donors informed & involved.
Encourage innovative ideas from donors.
Follow up of temporary and lapsed deferral.

The experience at the blood drive holds the first and the most important
key for retention of a blood donor.
So our main focus will be on

Relationship.
Recall.
Rewards.
And Recognition.

Donor Retention

To establish a transfusion service, dependent totally on voluntary blood donors to meet the entire blood need of the country or the region, a good donor base is absolutely necessary. Building up a good donor base is not an easy task and retaining the donor base is equally difficult. To maintain a donor base, recruitment of new donors and retention of the old donors are absolutely essential.

There are people who do not donate blood after their first donation and remain one time donor for the rest of their lives. Retention of old donors is equally important along with the recruitment of new donors. The reason is simple. These pool of eligible donors have already overcome superstitions, taboos and fear complex for donating blood and therefore, the dropping out of such donors weakens donor base. The entire work of donor motivators or organisers is lost if a donor donates blood once and then does not return for future donation. Further, if the reasons for the dropping out of donors are not taken care of, they may in the long run adversely affect the donor recruitment drives. Any whispering from such dropouts communicated to the non-donors is magnified and exaggerated and may strengthen the will of non-donors to remain non-donors for ever.

The reasons for dropping out generally are:

Illness/weakness/general health consideration
Lack of time
Lack of communication/information
Unfavourable location or time of the camp
Unhappy past experience
Bad handling by the blood bank personnel
Negative reactions of the blood donation e. g., dizziness, fainting, painful venipuncture, double puncture etc.
Non-availability of blood in time of his/her need
Wastage/improper utilisation of blood.

Donor retention is emphasised in the days of fatal blood communicable diseases not only because it significantly eases the work of donor recruiters but even more important is the fact that regular repeat donors are safer than new donors. Their blood was tested and transfused safely keeping all records with the transfusion service or the blood bank.

An active programme of donor retention is necessary. The most important is the care and handling of donors. Good public relations is the tool. Phlebotomy staff must ensure that the donation process is a pleasant experience for the donor. Scientific donor selection, proper examination and testing instil confidence in the mind of donors. Personal attention, smiling face, clean blood collection site, cheerful refreshment corner and show of sign that donors are wanted by the service help in donor retention. Pinning of donor badge, properly handing over blood group card with correct blood group written neatly speak about the effectiveness of the service. Careful avoidance of haematomas, bruises or double puncture of veins speaks highly about the competence of the blood collecting team. A single case of post donation fainting acts as a big damper at any camp with consequential loss of the donor on the day and also for the future. Donor of less than three donations may need special encouragement before during or after donation to come back again.

The regular donor who may be temporarily deferred for medical reasons should be handled carefully with encouragement to come back when fit to donate. Recognition of donors always plays an important role in retention.

Besides, the following activities help in donor retention:

Observing days of importance, days of joys and sorrows by different groups help in accepting blood donation drive as a part of annual activity of the organisation:
Outdoor blood collection drives at the same place on a fixed day every year help in retaining old donors:
Donors may be encouraged to become voluntary donor organisers through training programmes/workshops;
Formation of blood donors' club, society, pledge 25 groups, association, friends of blood bank society or group and guiding them with due recognition of their service also help in retaining old donors.

The best motivational efforts may go in vain if blood collection teams treat donors indifferently. On the other hand, they can convert one time donors to regular repeat donors.

In India it has been observed that:

Retention of old donors becomes easier if the task of donor motivation and recruitment are in the hands of one or more weII-organised voluntary organisations rather than on the transfusion service itself.

Such organisations may have separate identity but should work hand in hand with the transfusion service in a well co-ordinated manner with mutual respect for each other as an essential member of the team. Donor retention is a global problem. Motivators should keep in mind the following cardinal points to retain donors:

How do you keep Blood Donors as Regular Donors?

The short answer would be "to make the donors feel wanted and appreciated". To achieve this, the transfusion service or the organisations responsible for donor motivation should do several things.

Maintain accurate records:

Encourage donors to intimate change of address.

Treat donors courteously.

Each contact between the staff member of the blood bank or volunteers of social welfare organisations in the field of donor motivation and the donor, whether by letter, telephone, in blood

bank, at the camp or at the enquiry/blood distribution centre of the blood bank can either cement or strain the donor-blood bank relationship.

Try not to keep donor waiting:

Donors are busy people, and may have constraints on their time. Make sure that there are sufficient staff and volunteers available all the time to minimise the pre-donation waiting period.

Listen to complaints:

Every complaint, real or imaginary, merits investigation and prompt and polite response. A soft (prompt) answer 'take away wrath'.

Recognise the donor:

Thanks offered at each visit, together with tokens of honour (badges, certificates, and cards) will encourage donors and make them feel appreciated.

Inform the donor:

Keep the donors aware of the invaluable role they play and the use which is made of their gift of love. Donors are to be intimated and invited to camps when they are eligible to donate again.

Encourage donors to bring others:

A satisfied and committed donor is the best ambassador of recruiting other donors.

No blood centre, however well supported by its donors, can afford to become complacent about such support. The donors' support cannot be taken for granted forever. The transfusion service must be attentive to its donors, encourage them and inform them of the vital and unique support they are extending in supporting the health services of their community. Individual intimation retains donors.