Allain J-P
Emeritus Professor of Transfusion Medicine, University of Cambridge, Cambridge, UK.
Transfus Med. 2019 Oct;29(5):297-310. doi: 10.1111/tme.12629. Epub 2019 Aug 27.
Low- and middle-income countries (LMIC) suffer from chronic or seasonal blood shortage. The first review was published in 2007.
The review of literature since 2005 presented here uncovered a fairly large number of articles justifying the grouping of blood donation issues into five geographical areas sharing common background. These are Sub-Saharan Africa (SSA), Muslim countries, India, China/South East Asia and Latin America/Caribbean islands (LA&C).
SSA countries start collecting at 16-18 years of age in schools where female donors can be reached better than in other settings. Community-oriented culture favours family donors who need, similar to volunteer non-remunerated donors (VNRD), to be actively induced to repeat donation. Muslim countries share the contradiction of religion encouraging blood donation but restrain women from donating. The active involvement of religious leaders and the progressive easing of female participation are the keys to increasing blood donation. In India, 'social duty' is a major inducement to blood donation but also benefits and rewards. Ways of involving female donors by reducing the donation age to 16 years and providing donor education in schools need to be considered. In China and East Asia, the option of small-volume donation impairs blood collection without being justified by scientific evidence but is a concession to culture. Reducing the donation age would also help the supply. In LA&C, the concept of 'social capital' was developed as a complement or alternative to the theory of planned behaviour.
Strategies to improve blood donation and repeat donation should be innovative and adapted to local or regional culture and environment.
低收入和中等收入国家（LMIC）面临慢性或季节性血液短缺问题。首次综述发表于2007年。
本文对2005年以来的文献进行综述，发现大量文章支持将献血问题按共同背景划分为五个地理区域。这些区域是撒哈拉以南非洲（SSA）、穆斯林国家、印度、中国/东南亚以及拉丁美洲/加勒比群岛（LA&C）。
SSA国家在学校从16 - 18岁开始采血，在学校比在其他场所能更好地接触到女性献血者。以社区为导向的文化有利于家庭献血者，这些家庭献血者与志愿无偿献血者（VNRD）一样，需要被积极引导再次献血。穆斯林国家存在宗教鼓励献血但限制女性献血的矛盾。宗教领袖的积极参与和女性参与限制的逐步放宽是增加献血量的关键。在印度，“社会责任”是献血的主要诱因，但也有福利和奖励。需要考虑通过将献血年龄降至16岁并在学校提供献血者教育来吸引女性献血者。在中国和东亚，小剂量献血的选择在缺乏科学证据支持的情况下影响了采血，但这是对文化的一种让步。降低献血年龄也有助于血液供应。在LA&C，“社会资本”概念被发展为计划行为理论的补充或替代。
改善献血和再次献血的策略应具有创新性，并适应当地或区域文化及环境。
