Blood donation is a critical component of healthcare systems worldwide, yet access to safe and sufficient blood varies significantly across regions. While high-income countries (HIC) get a substantial portion of global blood donations from citizens, low-income countries (LIC), including many in Africa, face severe shortages. Sub-Saharan Africa grapples with some of the lowest blood donation rates, globally, with Nigeria being a significant contributor to this trend. In Nigeria, the demand for blood transfusions far exceeds the available supply, leading to preventable deaths and compromised healthcare outcomes. In this report, GBENGA SALAU delves into factors contributing to Nigeria’s blood donation challenges, the implications, and what can be done to change the narrative.
In 2021, Oloyede Adebola’s eight-year-old daughter fell ill and required a blood transfusion at a hospital in Ibadan. The hospital insisted on a “family replacement” policy, demanding that a family member donates blood before the child could be discharged.
Unable to provide a suitable donor, Adebola resorted to a network of middlemen who connected her to a commercial blood donor. This practice, though illegal, is prevalent owing to the country’s severe blood shortage and lack of regulation in private blood banks.
Also, Ruth Benjamin’s father was having two dialysis weekly at Lagos University Teaching Hospital (LUTH). After the first three dialyses, the hospital demanded a family replacement of at least two pints before the fourth dialysis is done. As a result, they rally round among family members to get two people to donate.
Before her father died, all members of the nuclear family had donated while a number of the extended family members and friends have come forward to donate blood under the family replacement.
And when he died, the family still needed to replace about two pints of blood. So, while grieving about the lost of her dad, Ruth was still running around getting part of the blood his father used replaced as the hospital insisted that without the blood being replaced, the family cannot complete its clearance to claim her father’s corpse.
Similarly, in 2019, Clement Okechukwu, faced a life-threatening situation when his wife, diagnosed with placenta previa, required 15 pints of blood during childbirth at a general hospital in Lagos. The hospital provided only the initial pint, compelling Ejimbe to source the remaining blood.
He managed to gather eight pints from relatives but struggled to obtain the remaining six. Eventually, he purchased a pint from a private blood bank, plus an additional fee for screening. Despite these efforts, the hospital’s refusal to provide the necessary blood without replacement nearly cost his wife her life.
Nigeria stands as one of the youngest nations globally, with over 70 per cent of its population under 30 years of age. This demographic advantage positions the country to harness its youth for various developmental initiatives.
With a median age of just 18 years and a significant portion of the population under 30, the country has a ready and able blood donor base.
Surprisingly, despite this vibrant youth base, Nigeria faces a significant challenge in meeting its blood donation requirements.
The National Blood Transfusion Service reports that the country collects only about 500,000 pints of blood yearly, falling short of the 1.8 million pints needed to adequately serve its population.
This is despite the availability of a large, healthy, and eligible donor pool, only 10 per cent of Nigerians donate blood voluntarily.
The majority of donations is either from family members or paid donors, raising concerns about the safety and reliability of the blood supply.
African countries, including Nigeria, according to the World Health Organisation (WHO), collect only 5.2 units of blood per 1,000 people, which is below WHO’s recommended minimum of 10 donations per 1,000 people.
WHO states that in HICs, it is 31.5 donations per 1,000 people, while in upper middle-income countries (UMIC), it is 16.4 donations per 1,000 people.
Many in developed countries are donating, voluntarily, probably because they understand the health benefits.
Speaking on the health benefits of donating blood, a medical doctor, Adebayo Akintayo, stated that donating blood has not have several health benefits for individuals, including free health screening because before donating blood, individuals undergo a mini-physical examination to check vital signs, which can help detect potential health issues like high blood pressure or heart arrhythmias, irregular heartbeats.
Akintayo added that donating blood could lead to healthier heart and vascular system because regular blood donation may lower blood pressure and reduce the risk of heart attacks as it decreases blood viscosity and clots.
He also said that donating blood assist in reducing risk of cancer and other diseases. He noted that some research suggests that regular blood donation helps to reduce the risk of certain cancers and diseases, although more research is needed to confirm this.
“Weight Management: Donating blood can burn up to 500 calories per donation, which can aid in weight management. Mental Health Benefits: Donating blood can give individuals a sense of satisfaction and happiness, potentially reducing stress and anxiety levels.”
Donating blood, Akintayo said, could increase sense of community, as the blood donation fosters social connection, which is essential for overall well-being.
On how often could blood be donated, he stated the frequency varies depending on the type of donation. “Whole blood donation: Every 56 days, up to six times a year, while Power Red Donation is every 112 days, up to three times a year.”
He further said that Platelet Donation is every seven days, and up to 24 times a year while Plasma Donation is every 28 days, and up to 13 times a year.
According to him, men can typically donate blood more frequently than women, with men eligible to donate every 12 weeks, while women every 16 weeks.
Also speaking, Director of Policy, Private Sector Health Alliance of Nigeria, Dr. Anne Adah-Ogoh, stated that donating blood is a selfless act that not only saves lives but also comes with some amazing health benefits to the donor.
She listed the health benefits of donating blood to include reduced harmful iron stores, as donating blood helps reduce excess iron in the body, lowering the risk of conditions like hemochromatosis.
According to her, donating blood lowers heart attack risk because regular blood donation depletes excess iron stored and improves blood flow.
She also said that it reduces cancer risk. “Some studies suggest that regular blood donation may lower cancer risk, particularly in individuals with conditions like hemochromatosis.”
Adah-Ogoh stated that donating blood could reduce stress and increase feelings of happiness, thereby, boosting mental health.
But the CEO, LifeBank, Temie Giwa-Tubosun, said the gap is driven by multiple systemic and cultural challenges.
“First, the majority of blood donations in Nigeria come from replacement donors — typically family members are required to donate during emergencies—or commercial donors, who give blood in exchange for money.
“This means very few people donate blood voluntarily, without being prompted by a crisis or financial need. Cultural misconceptions, religious concerns, and fear about the health effects of donation also reduce willingness to give blood.
“Additionally, infrastructure challenges, such as limited cold chain capacity, obsolete screening capabilities, and under-resourced health facilities, make it difficult to maintain safe, ready-to-use blood reserves even when blood is available.”
She, however, said that the shortfall is a solvable problem, but it requires systemic reforms, grassroots mobilisation, and partnerships for sustained investment.
To encourage and mobilise young people to donate, Adah-Ogoh suggested integrating blood donation awareness into school curricula including educating students about the importance of blood donation.
She also suggested government and critical stakeholders to utilise social media to raise awareness and promote voluntary blood donation.
She added that incentives should be provided to motivate people to donate through offering rewards like free medical check-ups or recognition to encourage donations.
On her part, Giwa-Tubosun noted that with Nigeria having one of the largest youth populations in the world is a demographic advantage, and if harnessed, it could transform the nation’s blood supply system from one that is crisis-driven to one that is consistent, safe, and sustainable.
Commenting on the way out of the crisis, Giwa-Tubosun stated: “The first step is to demystify blood donation. Many young people abstain owing to myths, misinformation, or a lack of opportunity. Tailored education campaigns (delivered in local languages) through social media, and peer networks, are critical to reshaping perceptions and making donation feel like a normal, noble act.
“Educational institutions play a vital role. Universities, polytechnics, and colleges of education can integrate donation awareness into their health and civic curricula. More importantly, they can create blood clubs, organise student-led donation events, and embed blood drives into campus life.”
She maintained that with deeper partnerships with corporate partners and student organisations as well as stronger institutional support, youth-driven blood donation could become a cornerstone of Nigeria’s blood systems.
The global standard is a 100 per cent voluntary, non-remunerated donor system, but it is the other way round in Nigeria. This is because data on the donation rate in Nigeria shows that about 80 to 90 per cent of blood collected is from family replacement and commercial blood donors, which experts argued may pose safety concerns due to potential undisclosed health risks, especially those by paid donor.
The Coordinating Minister of Health and Social Welfare, Prof Muhammad Ali Pate, speaking recently on blood donation, argued that the situation around blood donation in Nigeria could improve if only 1 per cent of the country’s adult population commits to voluntary non-remunerated blood donation on a regular basis.
The minister also said empirical evidence shows that the most reliable and safest source of blood comes from a stable base of regular, voluntary, unpaid blood donors rather than from commercial sources.
Giwa-Tubosun stated that relying on commercial donors creates a twofold risk: health safety and equity.
She added that commercial donors often do so for financial reasons and may conceal health risks that could compromise the safety of the blood system.
“This increases the likelihood of transmitting infections like HIV, Hepatitis B, and syphilis especially with weak testing systems. It also shifts blood away from a health-driven system to a transactional one; placing vulnerable patients at even greater risk and reducing the long term capacity to build a voluntary blood system.
“Additionally, this practice disproportionately harms low-income patients who may not be able to afford commercial blood or who face longer wait times due to lack of access.”
Adah-Ogoh stated that in contrast to commercial donation, voluntary blood donation ensures a safer and more sustainable blood supply.
The National Blood Service Commission attributes 80–90 per cent of maternal mortality to bleeding complications, which are often exacerbated by inadequate blood supply.
In Lagos, a shortage of 44 per cent in blood supply yearly means that many women with complications such as placenta previa or uterine rupture may not receive timely transfusions, increasing the risk of death.
Additionally, the WHO revealed that 14 million women hemorrhage during childbirth every year and timely access to safe blood transfusion is crucial for appropriate response and saving lives.
Also, the number of voluntary, unpaid blood donors has been on a steady decline since 2017, dropping from 42,384 in 2017 to 20,839 in 2021.
Commenting recently, the Executive Secretary of the Lagos State Blood Transfusion Service (LSBTS), Dr. Bodunrin Osikomaiya, emphasised the critical importance of voluntary blood donation.
“Blood is a precious and irreplaceable resource that cannot be manufactured. Every day, countless lives depend on the generosity of voluntary, non-remunerated donors. Unfortunately, cultural myths and limited awareness have hindered the growth of this lifesaving culture in Lagos State,” she stated.
Akintayo stated that the unavailability of blood and blood components can indeed lead to preventable deaths, affecting individuals across various demographics and situations, including:
“Pregnant women and new mothers may require blood transfusions due to complications during pregnancy, childbirth, or postpartum hemorrhage.
“Babies and children may need blood transfusions due to anemia, cancer, or other medical conditions. Road traffic accidents, injuries, or other traumatic events may require immediate blood transfusions to save lives.
“Patients undergoing surgery may require blood transfusions due to blood loss or other complications.”
Akintayo, therefore, stated that the lack of access to safe blood and blood components can have devastating consequences, emphasising the need for increased voluntary blood donation to meet the demand for blood and blood components as well as strengthening blood banking systems to ensure the safe collection, testing, storage, and distribution of blood and blood components.
Giwa-Tubosun noted that the human cost of inadequate blood supply is devastating stating that Nigeria has one of the highest maternal mortality rates globally, with postpartum hemorrhage being a leading cause.
“Many women die simply because safe blood is not available when they need it most. Children with sickle cell disease, which affects over 150,000 babies born annually in Nigeria, often require regular transfusions. Without a reliable blood supply, these children face preventable crises and fatalities.
“The economic cost is also steep. Households are often forced to pay out-of-pocket to procure blood or lose income caring for a sick loved one. Care centres and ultimately healthcare systems also suffer as emergency cases get delayed, hospital efficiency drops, and trust in care delivery erodes. We cannot achieve health equity without addressing the blood supply crisis.”
Pate also stated that: “Every blood donation is a precious gift. Each donation has the potential to save up to three lives, making blood donors true heroes among us. Blood donation is a powerful symbol of community and compassion.”
To strengthen Nigeria’s blood transfusion services, Adah-Ogoh suggested the establishment of a National Blood Policy that will provide a comprehensive policy for a safe and sustainable blood supply including increasing funding to support blood transfusion services and promote voluntary donation.
She also suggested increasing public awareness through launching campaigns to promote the importance of voluntary blood donation
On legislative measures or policy reforms necessary to strengthen Nigeria’s blood transfusion services and ensure a sustainable and safe blood supply, Giwa-Tubosun stated that ensuring a sustainable and safe blood supply in Nigeria requires all hands on deck.
“While the government has taken meaningful steps; such as establishing the National Blood Service Commission (NBSC), there is still room for expanded collaboration, smart investment, and supportive policy to bridge the significant gap in blood access.
“We envision a future where every Nigerian who needs blood can get it safely, affordably, and without delay.
“To make this a reality, we recommend the following: Increased funding for the NBSC to expand its reach and strengthen its infrastructure nationwide.
“Incentives for healthcare facilities to champion voluntary donation programmes instead of relying on emergency-based systems.
“Support for blood banks through capital investment to help scale their screening and storage capabilities.
“Partner with innovative organisations delivering financially sustainable systems that deliver safe blood quickly and consistently.”
On his part, Akintayo stated that many lives have been saved and rescued from death when blood and blood components were readily available for therapeutic purposes.
