There are a total of 2903 blood banks in the country i.e., less than 3 blood banks for every 10 lakh people. The annual blood collection in the country is less than the projected requirement. In states like Bihar, the annual collection is less than 20% of the projected requirement as per WHO norms.
In 2015-16, 10.9 million units of blood was collected across the country while the requirement as per the WHO norm of 1% of the population was 12 million units. While voluntary blood donation & awareness have improved over the years, we are still lagging in the collection of required blood units. As of July 2017, there are a total of 2903 blood banks in the country or less than 3 blood banks for every 10 lakh people.
Bihar has less than one Blood Bank for 10 lakh people
Of the 2903 blood banks in the country, Maharashtra has 328 of them, 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. 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.
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 of the states with more than a crore population. Telangana has 4.6 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 people compared to the national average of 2.4 blood banks. Bihar (0.7) is at the bottom of the list with less than one blood bank for 10 lakh people. West Bengal has only 1.4 blood banks for 10 lakh people while Uttar Pradesh & Jharkhand are at 1.5 blood banks. Overall, 5 big states of Bihar, West Bengal, Uttar Pradesh, Jharkhand & Rajasthan have less than 2 blood banks for 10 lakh people.
There are 74 districts in the country spread across 14 States/UTs that do not have a single blood bank.
Achievement of collection still less than requirement while wastage is more than 10%
As per WHO norms, the blood requirement in units is calculated at 1% of the population. As per this norm, the actual number of units of blood collection is still lagging the requirement. The number of units of blood collected has increased from 9.94 million in 2013-14 to 10.9 million in 2015-16. Even with this increase, annual collection is less than the projected requirement of 12 million units. Moreover, there are wide variations within the states. In Bihar for instance, the number of units of blood collected annually was less than 20% of the requirement. In Uttar Pradesh, it was less than 50% of the projected requirement. In some states, the collection is way above the projected requirement. For example, in Delhi, the annual collection of the number of units was more than 3 times the requirement in 2015-16. More units are collected than the projected requirement in states like Gujarat, Haryana, Telangana, Maharashtra, Karnataka, Kerala etc. It also has to be noted that the amount of blood collected annually is still less than that of the US while our population is more than 3 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 take 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, this number is more than 3% of the population. 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 recently 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