When blood is missing: The silent gaps in Ghana’s lifesaving system

The call often comes at the worst possible moment. A mother is bleeding heavily after childbirth. A road crash victim has been rushed into surgery. A child with severe anaemia needs an urgent transfusion.

Then comes the message to relatives: “The patient needs blood. Find donors.”

Within minutes, family members begin making frantic calls, sending WhatsApp messages, and appealing on social media. Some race from one hospital to another in search of matching donors. Others simply pray that blood arrives before it is too late.

For many Ghanaians, this is their first encounter with a reality healthcare professionals know all too well-blood remains one of the country’s most critical and vulnerable healthcare resources.

Despite years of progress, experts say Ghana’s blood collection, storage, and transfusion system still faces significant gaps that affect access, quality, and safety. And in emergencies, those gaps can cost lives.

A system built out of necessity   

For decades, hospitals across Ghana collected blood however they could because patients needed it. There was no law governing blood services. There was simply the urgent need to save lives.

It was only in 2020 that Parliament passed the Blood Service Act (Act 1042), establishing the National Blood Service (NBS) as the agency responsible for ensuring safe and adequate blood supplies nationwide.

Charity and philanthropy

According to Dr. Shirley Owusu-Ofori, Chief Executive Officer of the NBS, the law marked a major shift toward a coordinated national system. But reforming practices that evolved over generations remains a challenge.

The blood that is not there

One of the biggest weaknesses is Ghana’s continued dependence on family replacement donors. These are relatives and friends who donate blood only when someone they know requires a transfusion.

The preferred option, experts say, is a strong pool of voluntary, unpaid donors who donate regularly, allowing blood to be available before emergencies occur.

“The blood should be waiting when the emergency happens, not the other way round,” Dr. Owusu-Ofori said.

The numbers reveal the challenge.

The World Health Organization recommends that countries collect at least 10 units of blood per 1,000 people.

Ghana currently collects about 6.6 units per 1,000 population, an improvement from previous years but still well below the recommended threshold. Yet demand continues to rise.

An estimated 80 to 85 per cent of blood requests in Ghana are for emergencies, leaving little room for delays.

More than a bag of blood

Many people assume donated blood goes straight to a patient. It does not. Every unit must first be screened for infections such as HIV, hepatitis B, hepatitis C, and syphilis. It must then be processed, stored under strict temperature conditions, and transported safely.

Blood itself is not a single product. Red blood cells, plasma, and platelets all require different storage conditions and handling procedures.

Maintaining those standards requires specialized equipment, trained personnel, and continuous monitoring.

And that is where another challenge emerges.

The infrastructure gap

Across the country, some hospitals lack adequate blood storage facilities and the specialized equipment required to operate fully functional blood banks. Others depend on nearby facilities for supplies when emergencies arise.

While healthcare workers often improvise to meet patients’ needs, experts warn that blood safety cannot depend on improvisation.

Storage conditions, transportation systems, and quality controls must work every time.

A breakdown anywhere along the chain can compromise blood quality and patient safety.

Unequal access

Geography presents another challenge. For years, Ghana relied on three major blood centres in Accra, Kumasi, and Tamale to serve the entire country. The arrangement made blood collection and distribution across vast regions difficult and expensive.

To address this, the National Blood Service has established five regional blood centres in the Greater Accra, Ashanti, Northern, Volta, and Central regions.

More are planned.

But with 16 regions nationwide, large areas still remain underserved.

The result is uneven access to blood and blood products, particularly for facilities located far from regional centres.

Closing the regulatory gaps

The Food and Drugs Authority (FDA) says recent assessments have uncovered compliance challenges across the blood sector.

According to Dr. Edwin Nkansah, Director of Vaccine Vigilance and Clinical Trials at the FDA, gaps exist across the entire transfusion chain, from donor recruitment and testing to storage and transfusion practices.

To strengthen oversight, the FDA is embarking on a programme to regulate and license selected blood facilities across the country. The aim is not punishment, he stressed, but improvement.

Facilities will undergo audits, receive technical support, and be guided to meet approved standards.

The goal is simple: ensuring that blood transfused in any hospital meets the same safety requirements.

The missing link

For all the discussions about infrastructure, regulation, and accreditation, experts agree that the biggest solution lies with ordinary citizens.

Every unit of blood starts with a donor. Yet voluntary blood donation remains far below what the country requires.

Health officials estimate that if just one per cent of eligible Ghanaians donated blood regularly, shortages could be dramatically reduced.

That would mean fewer desperate appeals from hospital wards and fewer families scrambling for donors during medical emergencies.

A race against time

Ghana has made important strides in strengthening blood services. Collection rates are improving. Regulatory oversight is expanding. New regional centres are being established. Yet significant gaps remain.

And for the mother experiencing postpartum haemorrhage, the accident victim on the operating table, or the child awaiting a transfusion, those gaps are not statistics. They are the difference between life and death.

Until safe blood is available whenever and wherever it is needed, Ghana’s blood system will remain a critical work in progress—one whose success depends not only on regulators and hospitals, but also on the willingness of citizens to roll up their sleeves and donate.

Because when blood is missing, every second matters.- GNA