Blood Collection increases by 12% in 4 years, still 15% short of requirement
Sai Krishna Muthyanolla
March 26, 2018
There are a total of 2903 blood banks in the country i.e., less than 3 blood banks for every 10 lakh population.  The annual blood collection in the country has increased by about 12% between 2013-14 and 2016-17, but is still less than the projected requirement by 15%. In states like Bihar, the annual collection is less than 20% of the projected requirement as per WHO norms.
In 2016-17, 11.09 million units of blood was collected across the country, about 2% more than the collection in 2015-16. Though the collection has increased by about 12% between 2013-14 and 2016-17, it is still short of the requirement, as per the WHO norm of 1% of the population, by 15% . While voluntary blood donation & awareness have improved over the years, the situation in some states is alarming.  As of March 2018,as per the data shared by the government, there are a total of 2903 blood banks in the country or less than 3 blood banks for every 10 lakh population.
Bihar has less than one Blood Bank for 10 lakh population
Of the 2903 blood banks in the country, Maharashtra has 328, the highest for any state. Uttar Pradesh,Tamil Nadu and Karnataka are the only other states with 200 or more blood banks. There are 12 states with more than 100 blood banks each. There are 10 States/UTs with less than 10 blood banks each. Only Uttar Pradesh, the most populous state has more than 100 government blood banks. Six (6) other states have more than 50 government blood banks each.
When normalized with the population, North-Eastern states like Mizoram, Arunachal Pradesh & Sikkim rate higher because of their lower population. Of the bigger states, Kerala has 5 blood banks for every 10 lakh people, the highest  for any state with more than a crore population. Telangana also has about 5 blood banks per 10 lakh, second only to Kerala of the big states. A total of 10 States/UTs have fewer blood banks per 10 lakh population compared to the national average of less than 3 blood banks. Bihar is at the bottom of the list with less than one blood bank for 10 lakh people. West Bengal, Uttar Pradesh, Jharkhand and Rajasthan are the four other states  with less than 2 blood banks for 10 lakh population.
There are 74 districts in the country (spread across 14 States/UTs) that do not have a single blood bank.
Achievement still less than requirement while wastage is more than 10%
As per WHO norms, it is estimated that blood donation by 1% of the population is generally the minimum needed to meet a nation’s most basic requirements for blood.  The number of units of blood collected has increased from 9.94 million in 2013-14 to 11.09 million in 2016-17, an increase of about 12%. Even with this increase, annual collection is less than the projected requirement of 13 odd million units. The blood collection is almost 15% less than the required number of units.
Collection in 5 States is less than 50% of the projected requirement
Moreover, there are wide variations within the states. In Bihar for instance, the number of units of blood collected annually is less than 20% of the requirement in each of the last 4 years. In Uttar Pradesh, it is less than 50% of the projected requirement. Jharkhand, Meghalaya & Arunachal Pradesh are the three other states with less than 50% collection. In 12 states, the collection is above the projected requirement. For instance, in Delhi, the annual collection is close to 3 times projected requirement. Collection is more than the projected requirement in states like Gujarat, Haryana, Telangana, Maharashtra, Karnataka, Kerala, Tamil Nadu etc. The collection is more than the projected requirement in all the South Indian states except Andhra Pradesh. It also has to be noted that the amount of blood collected annually in India is still less than what is collected in the US while India’s population is almost 4 times the population of the US.
Wastage of the collected blood has been consistently more than 10%. While there seem to be no global markers for such wastage, India has a fairly high rate of wastage especially when the collection is less than requirement. More than 1 million units of collected blood has been discarded in each of the years 2014-15, 2015-16 and 2016-17.  Reactivity for infections, expiry, bacterial contamination, not meeting quality standards etc. have been stated as reasons for discarding the collected blood units.
Regulation & Awareness are key
Though the National Blood Transfusion Council (NBTC), the apex body for all issues relating to the operation of blood banks, was established in 1997, the regulation was weak. The National Aids Control Society (NACO) and NBTC are now primarily responsible for blood transfusion services. At the state level, the SACO & SBTC perform that role. Going forward, greater transparency & stronger regulation are needed for improved functioning of the blood banks. Disposal of complaints within a short time frame and hefty penalties for violations are the way forward. The e-RaktKosh portal envisaged to provide real-time information of blood availability is a step in the right direction. The portal has to be expanded to ensure real-time & accurate availability of information.
For a large country like India, voluntary blood donation is still not popular. Less than 0.5% of the population are voluntary blood donors in India. In the west, more than 3% of the population are voluntary blood donors. According to an assessment report of NACO supported blood banks, more than 80% of the donations in such blood banks are voluntary in nature. To achieve WHO’s goal of 100% voluntary blood donation, there is still a lot of work to be done in the country. The rules governing the operation of the blood banks were also modified in 2016 to allow transfer of blood between registered blood banks to avoid wastage. Detailed guidelines have been issued in this regard. Hopefully, this step would help reduce the wastage.
Featured Image: Number of Blood Banks in India