Considering equity during guideline development: the Belgian Red Cross’ example on blood donor recruitment in sub-Saharan Africa

Article type
Authors
Avau B1, De Buck E2, Jennes M1, Laermans J3
1International Cooperation Department, Belgian Red Cross, Mechelen, Belgium
2Centre For Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium; Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium
3Centre For Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium; International Cooperation Department, Belgian Red Cross, Mechelen, Belgium
Abstract
Background:
In sub-Saharan Africa, blood donation rates are too low to meet the demand, due to weak donor recruitment programs, cultural hesitance, and lack of education. Belgian Red Cross assists other Red Cross National Societies in supporting blood services through blood donor recruitment activities.

Objectives:
To develop an evidence-based guideline on blood donor recruitment in sub-Saharan Africa, while considering and fostering equity throughout

Methods:
A guideline panel was composed and evidence was gathered systematically. Health equity aspects were considered at various levels and stages of guideline development. Members of the public and consumers were indirectly involved.

Results:
As evidence was expected to be limited in quantity and quality, the guideline panel would have to formulate good practice points and contextualize evidence from other settings. Therefore, we ensured sufficient panel diversity and inclusiveness with regard to, eg, country, area of expertise, and interaction levels with blood donor recruiters. We selected 11 experts from academia, national blood services, and Red Cross Societies from 6 African countries. Their input was collected individually to ensure equitable collaboration.
Equity was also embedded in the research questions. For example, the panel stressed the need for clear recommendations on addressing misconceptions and cultural/religious beliefs as obstacles for donation. As certain populations may be more susceptible, they advised searching for evidence on motivators and deterrents for blood donation in Africa and charting the populations’ characteristics. Hence, sometimes, searches were focused on identifying evidence from African or low- and middle-income countries. While reviewing the evidence, we carefully documented population and intervention characteristics.
Currently, the experts are reviewing the draft guideline. During a panel meeting in May 2024, the applicability and generalizability of the evidence to populations experiencing inequities will be considered in developing final recommendations and good practice points. Moreover, the panel will help identify equity issues in guideline implementation.

Conclusions:
This guideline will be used to train blood donor recruiters in sub-Saharan Africa. It will help blood services in focusing their efforts efficiently, particularly in resource-constrained contexts. It might facilitate equitable access to safe and sufficient blood in sub-Saharan African, which is highly relevant to the general public.