Implementing suggested recommendations and potential challenges

The motivational speeches given in schools and religious institutions prior to mobile sessions are a good tool through which future donors can be educated on the donation process. Posters and pamphlets with information on how to prepare for donation (e.g.

recommend that donors eat prior to donating) and frequently asked donor questions and concerns can be distributed prior to mobile sessions. These can also be provided to replacement donors prior to their donation visit. However, given that nearly 30% of the Ghanaian population is not literate (UNICEF, 2013), this method of delivering information may not be appropriate for everyone. An alternative would be to provide patients, when possible, with the necessary information and request them to pass it on to any replacement donors they secure, though this is not ideal given the burden it places on patients.

Additionally, a video, in Twi, on the blood donation process could be played on the TV in the donor clinic on loop, which would provide donors with information while they wait without adding to staff workload.

Special efforts should be directed at minimising donor fears (e.g. fear of pain), particularly for first time donors. Staff should ask donors prior to pre-screening whether there is any additional information they would like to be given and donors should be reminded and encouraged throughout the process to ask questions.

Pamphlets, with explanatory illustrations (to address the needs of the non-literate population) on the donation process and post-donation care should be distributed to donors.

Pamphlets should be specific and include details regarding each step of the donation process, information on how the blood is processed, which foods donors should consume, what types of liquids and what amount, the amount of rest required post-donation, potential signs of an adverse event and where to seek care should they experience any symptoms. These pamphlets could serve dual purpose as they provide donors with information and may also aid in donor recruitment as current donors may share the pamphlets with friends, colleagues

and family which may motivate non-donors to donate blood.

When appropriate, successful and deferred donors should be given personal written advice regarding their personal health and lifestyle habits, reassuring donors that their health is staff’s primary concern.

5.5.5.1 Potential challenges

There may be insufficient human resources to consistently provide donors with such detailed information, particularly during peak donation periods. Pamphlets may help reduce staff workload, but may also prove costly. However, it important to maintain donor satisfaction and efforts should be made to secure the necessary resources to ensure donors receive adequate counselling and their needs are met.

5.6 Limitations

During the study period, there were few mobile sessions in religious institutions (e.g. church and mosque), thus I was unable to conduct interviews there and have a limited perspective from those donating at a faith based event (except for a focus group at mosque), and may not have a complete list of factors that motivate donors.

Lack of HCA participants

In some cases, there were logistical issues and donors were interviewed in close proximity with donor clinic staff - this may have had an impact on the results as donors may have been unable to speak freely. It is also possible that some information was lost or misinterpreted in translation - follow up questions, however, were useful in detecting this and limiting such problems.

A major limitation was the implementation of focus groups. Two attempts were made to hold

a focus group with replacement donors, with refreshments as a motivator. The aim was to hold discussions with 5-10 replacement donors. After attempting to recruit fifteen participants, only one returned. This was likely due to the fact that it is difficult for many donors to find time off work to attend and there is the added financial cost of transport. In fact, some of the participants approached declined stating work or school commitments.

Weekends were considered, however, Ghanaians generally have many engagements during the weekends (e.g. funerals, church, family visits) and according to local staff would not be convenient.

The student focus group was much more dynamic than the discussions held in mosque, largely I believe because the students knew each other and had a comfortable rapport with one another, something that was lacking in the focus groups held at mosque, where despite attending the same mosque, it did not appear as if everyone knew each other. This limited the discussions between participants.

5.7 Conclusion

Donor counselling is a commonly recommended policy, but there are limited details on how it should be implemented. Increased research at local levels is required to better understand donor needs so that donor counselling can be appropriately tailored to the donor population and improve donors’ experiences. Based on the qualitative data collected in this study, donors are overall satisfied with their donation experience and most are willing to return again under any circumstance provided they have the time and resources. However, quicker processing times and more information, particularly relating to donors’ health, are still desired. Donor counselling can be used to provide donors with this information, and perhaps a better understanding of the donation process will help donors appreciate longer processing times.