Predicted future blood demand and donor recruitment strategy in Japan
2011; Wiley; Volume: 6; Issue: 2 Linguagem: Inglês
10.1111/j.1751-2824.2011.01533.x
ISSN1751-2824
Autores Tópico(s)Blood donation and transfusion practices
ResumoThe number of annual supply units of blood products was 7 010 000 units in 1979, and gradually increased along with the increase of population and development of medical treatment to the utmost 18 780 000 units in 1996, then decreased to 16 000 000 units by the promotion of appropriate use. But from 2006 it turned to increase again up to 18 473 000 units in 2010 mainly due to the expansion of senior generation by baby boomers. Here, one unit corresponds to the content of 200 ml whole blood. The utmost number of blood donors in Japan was about 8 700 000 in 1985 when we had only 200 ml whole blood donation. The number decreased gradually to about 4 940 000 in 2007 owing to introduction of 400 ml whole blood donation and apheresis donation with the aim of decreasing donor exposure, while maintaining almost the same amount of blood collection. However, with the increase of the demand for blood products, we had to increase the number of donations from 2008 up to about 5 320 000 in 2010 to meet the demand of blood. Although the total number of donors increased, the number of young donors declined more steeply than the decline of the corresponding population. The number of young donors (16–29 years old) decreased from about 2 250 000 in 2001 to about 1 370 000 in 2010, a decrease of 40% during the 10 years. In 2010, Blood Service Headquarters of Japanese Red Cross Society estimated by the future demand–supply simulation that we would lack 1 010 000 donors in 2027 when the demand for blood products marks its peak, if the ageing society with fewer children gets more serious with the current blood donation rate (5·9% of possible blood donor population) (Fig. 1). Future forecast of demand and supply gap. Considering the current situation, to ensure the system for a stable blood supply into the future, we must promote blood donation by far the more. The promotion for young donors is especially needed. Japanese Red Cross Society set medium term aims of blood donation promotion along with ‘Blood Donation Promotion 2014’, which the national government decided in 2010. The aims are shown in Table 1. The three main categories shown in Table 1 are the key targets to promote blood donation effectively. Table 2 shows the aim year by year. The number of donations by teens and twenties donors has been tremendously decreasing for these 10 years. The current ratio of 400 ml blood donation is almost 90% of the total number of whole blood donations. It is considered that the transition from 200 to 400 ml donation has reached its limit. Furthermore, the number of supply units has been increasing recent years. Therefore, what is important with the current future simulation is to increase the number of donors itself. Japanese Red Cross Society has promoted blood donation so far, but with the cautious future forecast, we need to strive to promote more and more. For achieving the aims along with the blood demand, Japanese Red Cross Society keeps taking various measures more effectively and will take new approaches as follows. We believe that what enhance people’s motivation for blood donation is to help them understand deeply the meaning of blood donation and the usage of donated blood for medical treatment. Not many people know that there are people who need blood transfusion regularly because of their disease. Therefore, we will put strong emphasis especially on the ‘voice’ of the patients who were/are saved by blood transfusion as well as tell people about the basic information about blood donation and transfusion. It was mentioned in a guidebook of health and physical education class for teachers of high school students to teach about ‘blood donation’ in a class. Therefore, from 2011 to 2013, we try to visit as many schools as possible, not only high schools but also junior high schools, and will give lectures called ‘blood donation seminar’ for them. Although junior high school students cannot donate blood yet, they will be good donors if they realize the importance of blood donation at their early age. We have prepared ‘seminar-oriented short movie’ which enables blood donation centres’ staff all over Japan use in the seminar. The content of the movie is not only about blood donation, but also the message for students about the importance of lives, including Red Cross’s various activities around the world. After 2013, we will evaluate the effectiveness of the movie and will revise it if needed. We strengthen the advertisement with the internet, mobile site, radio programme, etc. as most effective PR. Since a continuous project focusing on especially young-orientated events like impactful music concerts is very attractive to them, we have been conducting a project named ‘LOVE in Action’ for over these 2 years. In this project, famous and popular musicians, athletes, actors, comedians, etc. have supported us. The voice of famous people which encourage blood donation is especially effective for young people. To cooperate with students volunteers for blood donation promotion is another very important way to enlighten young people. The organizations of volunteer students were established in each region and the number of the organizations is about 200, the total number of the students all over Japan is about 5000 in 2011. And National Student Blood Donation Promotion Executive Committee (association of student volunteer groups) was established and holds a national conference annually. They discuss blood donation from the view point of young people, and they have regional and areal meetings as well. In addition, they carry out various kinds of campaigns like ‘Giving blood at twenty’s Campaign’, ‘Summer Donation Campaign’, ‘Valentine’s Donation Campaign’, etc. every year. Among them, ‘Students Christmas Blood Donation Campaign’ is the biggest event held by students all over Japan every year (Fig. 2). The photo of one of the Christmas Campaigns held by student volunteers. Based on the ‘Blood donation facility Guideline’ which was established in 2010 by Blood Service Headquarters of Japanese Red Cross, we are improving the environment of blood donation facilities to have donors relieved when they donate blood. For example, large spaces, bright lighting and clean atmosphere are one of the key factors for ‘a good environment’. We also think that it is important to establish facilities which meet the demand of each region. We are also building donation rooms according to the needs of each generation and gender. For example, Twenties to thirties women are busy bringing up babies and children, and they hardly have opportunities to donate blood even though they have donated before. Therefore, we are constructing blood donation rooms with ‘playroom for kids’ where staff members or volunteers in the room take care of the children during the parents’ donation, so that offer them opportunities to come to donate blood with their children. We are also improving the amenity and function of mobile buses, and trying to make mobile buses with favourable impression. We will make some research about new model bus, and will introduce it according to the needs (Fig. 3). The photo of one of the new blood donation rooms in Japan. Blood donation eligibility criteria were revised in April 2011. What was changed greatly was ‘age criteria’ with the aim of expanding the eligible population in case of the shortage of blood in the near future. Lower age limit of 400 ml whole blood donation was changed from 18 to 17, and higher age limit of platelet aphaeresis donation from 54 to 69, both only for men. Although a study has shown occurrence rate of vasovagal reaction (VVR), the most common adverse reaction associated with blood donation, is not significantly different, we need to take care of such new donors more carefully. For this aim, we have prepared leaflet and short movie which first donors must read and watch before donation. And when blood donation is held at a high school, a nurse for taking care of young donors is assigned. To increase the number of donors who donate more than twice a year, we will offer special designed card as incentives for them. Addition to the original card design, we are preparing two new designs. (We will start this from 3 October 2011.) The current original design is very simple and normal with Red Cross symbol mark in red and gold colour. And one of the new designs is a very cute card with blood donation promotion character in vivid red colour. And the other one is a very cool card with a world map in black colour. The donors who donate more than twice a year can choose which card to take according to their taste. The number of corporations and organizations that cooperate in blood donation has been favourably increasing these years. To increase more along with the aim mentioned above, blood donation seminars or conferences are held in each region. Recently, with these approaches, we could take an attention and gain understanding for blood donation of each generation, mainly young generation. As a result, the donation rate of teens stopped to decrease in 2010 despite the fact that the number and the donation rate of teens had been tremendously decreasing, and the decline of the donation rate of twenties got more gradual in 2010. The number of donors who donate more than twice a year is gradually increasing every year. Therefore, we believe the approaches are very effective and important. We need to evaluate the approaches correctly and to keep carrying out what are very effective with stronger emphasis. Especially, it is very important to take more strategic measures to promote donations based on the future forecast of demand along with the defined aims. No potential conflict of interests to declare.
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