Whether private or public, health services rely on donors, for everything from organs after the donors pass away, to assistance that can be given more regularly. Of these resources, the most highly sought after and frequently used is, almost universally, blood. National Blood Service Zimbabwe (NBSZ) looks after this need in the southern African country. The organisation has recently gone through a series of changes, as have Zimbabwe’s blood supply systems; we decided to investigate.
Until recently, units of blood had a price attached to them for any Zimbabwean patient, whether they were on the public or private health care system. In 2017, up until October, the price of blood was around $100 per unit of blood. At the end of the year, between November and December, this price was reduced to $80, and commencing 2018, from January to June, it was lowered again, to $50. In July that year, blood became completely free for all public health institutions. Private health institution fees currently remain at $120 per unit. These fees have always been set in consultation with the Ministry of Health & Child Care.
It is NBSZ’s job to meet this need. As predicted, removing the price tag from blood has led to a spike in demand, as more patients are able to access the healthy blood that they need where previously, they would not have been able to afford treatment. This spike represents lives that are being changed by the new system, but eyes are on NBSZ to keep up.
In response, the organisation has adjusted its targets, raising its previous annual goal of 80,000nits of donated blood to its adjusted 2019 target of 108,405 units. To reach this new target, the organisation has added new mobile collections teams in Harare, Bulawayo and Mutare, and has also held discussions with the government regarding the cost of blood collection, which the government has now agreed to subsidize.
In association with the World Health Organisation (WHO), NBSZ has a set of guidelines to make sure that donors are only giving blood if it is healthy and ethical for them to do so. For example, donors must be between the ages of 16-65 years old, need to weigh more than 50kgs and must be in good health. The charity is looking at ways to reach out to new donors, as over half of donations (68%) are currently given by students between the ages of 16-20. This group represents only around one tenth of the population, showing that there are many areas of the population who still need to be targeted and reached correctly.
To assist with this effort, NBSZ is also upgrading its website with a feature that will allow donors to book their donations online. This new system follows in the trend of many European blood services, and would allow NBSZ to gauge in advance the levels of donations it will receive in the coming months, which will allow it to plan accordingly and prevent any periods of low supply. The aim is for the website to be user-friendly, allowing donors to book their own appointments. The organisation is also starting to develop its social media engagement, a tool that it has previously under-exploited in terms of its ability to reach out to people.
All of these solutions should comfortably increase the number of donations that the blood service receives, and currently, it is not reporting any difficulties in meeting the new demand. However, in the wake of this positive change for Zimbabwe, there have been concerns raised. NBSZ ran into some media pressure in March this year when an article in the country’s Sunday Mail published an article titled, “Zim runs sort of critical blood stocks”. The article observed that the bank had five days’ worth of blood in its stocks and interpreted this as a sign that the banks were alarmingly low on supply. However, the NBSZ shot back in a statement from their Public Affairs Manager, Esther Massundah, explaining that whilst blood has a 42-day shelf life, keeping levels at a five-day stock avoids blood being allowed to expire from the bank being over-stocked. “The Blood Service confirms that the national blood bank currently has enough stocks for any procedures requiring blood transfusion at both government and private health institutions,” Esther stated publicly.
As well as issuing this statement, the blood service responded to the news report by apologising to both the public and to health institutions for any panic that the article had caused, and it plans to take proactive steps to assist the media in its health reporting to prevent such misunderstandings occurring again. The service therefore intends to host a series of workshops to educate health reporters and other members of the press on blood and blood-related issues.
In the recent past, concerns have also been voiced about NBSZ in regard to the organisation’s Board of Directors, many of whom had held office for several decades. The Board had come under scrutiny for not attracting as many investors and as much government assistance as desired, with some donors and supporters concerned that these leaders were not doing enough to develop NBSZ the way it needed. Following this unrest, in June 2018, the news was released that the organisation would appoint a new Board.
The organisation has five branches: Harare, Mutare, Masvingo, Bulawayo and Gweru. All five groups held AGMs and voted on their new leadership. Justice Leslie Smith, who had held his position for 38 years, retired as the Harare chairperson for the organisation. His deputy, Elliot Mugamo, also stepped down. From each branch, two people were elected to collectively form the new board, which came together in July last year.
A full year later, the change in NBSZ is clear, demonstrated in the various changes it is making to broaden its reach. These changes have not gone unnoticed, and in fact, the blood service received official recognition this May through the receipt of two awards from the Zimbabwe National Business and Leadership Council. Within the Health Sector segment of the awards ceremony, NBSZ’s CEO Lucy Marowa received the national ‘CEO of the Year’ award, and the blood service also received ‘Organisation of the Year’.
The organisation is also receiving acknowledgement from its peers; blood services from other countries have taken note of NBSZ’s changes and have reached out to them with the hope of learning from their progress. For example, a delegation from Sudan is set to visit NBSZ to familiarize themselves with their operations – both their long-established systems and the areas in which they have recently updated and grown. If anything is proof of faith, it’s this, and a clear sign that NBSZ is rising to the new bar set for it – fantastic news for the people of Zimbabwe, as they are finally able to access the care they need without a high cost, or any cost, attached to it.