Blood, donors and dollars: Rethinking financial sustainability of safe blood services in Tanzania

Abstract

Introduction: Collection, processing and distribution of safe blood in Tanzania occurs within a free-for-service context, that is, a collection from non-remunerated blood donors and distributing freely to the needy people through health facilities. The safe blood services in the country appear to be crippled with many challenges and cannot meet the demand for blood and its products. As such, a need for rethinking collection methods, financial models and possible mechanisms for donor remuneration is evident. Methods: In this paper, we venture on multi-stakeholder meetings and ongoing discussions regarding the internal mechanisms of safe blood transfusion financing. The intent is to offer a perspective on the considerations for self-sustaining safe blood services in the country and the extent to which they may be implemented or not. Results: We suggest that despite huge demand, the external donor dependent financing mechanisms for safe blood services in the country are ineffective. Therefore, we discuss two potential ‘internal’ financing mechanisms that have been identified in recent shareholders forums 1) introducing a blood processing fee accompanied by policy change to allow direct charging of either recipients or hospitals or 2) influencing the introduction of ‘blood services’ within the current insurance schemes. Conclusion: We conclude that there is a need for constructing alternative financial mechanisms to sustain the demand of safe blood in the country. We discuss two cost recovery mechanisms, blood processing fee and insurance schemes; however, warning is noted that their implementation warrants structural adjustments, massive community sensitization and optimum stakeholder engagement to maximize acceptability within the country.