Alternative strategies to promote voluntary blood donation in secondary schools in Malawi: Enhancing participation and impact—Malawi BLOODSAFE program

BACKGROUND AND OBJECTIVE: Adequate blood supply remains a challenge in sub-Saharan Africa (SSA). Malawi has a 13% shortfall in required blood supplies. Innovative recruitment and retention strategies are crucial to ensuring a sufficient number of donors and blood supply. We explored alternative approaches to enhance blood donation in Malawi to bridge the gap. METHODS: A qualitative exploratory design was utilised with a sample of 135 participants purposively selected in eight districts, in the Northern, Central, Southern and Eastern regions of Malawi. Data were collected using in-depth interviews with 20 participants (first-time and repeat donors, lapsed and non-donors), 20 key informant interviews with community, policy-level stakeholders, Malawi Blood Transfusion Service (MBTS) staff and 16 focus group discussions (involving 95 participants). Thematic content analysis was used to categorise the strategies, and a qualitative software data package (NVivo version 12) was used to organise the qualitative data. RESULTS: Donor education emerged as a key strategy for donor recruitment and retention. Other strategies included the formation of blood donor clubs in secondary schools and for post-secondary students, accountability mechanisms related to blood: its collection and management of blood and blood products, the provision of incentives and youth-friendly motivation strategies, including school competitions (quizzes and sports) and entertainment. CONCLUSION: The study emphasised the significance of blood donor education in encouraging blood donation. Participants' views suggest that developing innovative approaches for education to increase awareness and understanding of blood-donation processes may help motivate more individuals to donate. In addition, participants suggested other youth-friendly approaches to support blood donor recruitment, including providing incentives preferred by young people, introducing intra-school competitions and incorporating entertainment activities. These insights point to the potential value of developing innovative strategies to support blood donor recruitment efforts.