Community-led initiative addresses blood donation shortages in rural Sierra Leone

The 'Gi4SaveLife' initiative, led by grassroots organisation Lifeline Nehemiah Projects with support from King's College London, places ownership of blood donation drives in the hands of the local community. Over an eight-month study period, the initiative collected 539 units from 376 donors, increasing from zero voluntary donations before the initiative began.

In the new study, published in BMJ Global Health to coincide with World Blood Donor Day, the team piloted Gi4SaveLife across the Kono and Kenema districts of Sierra Leone. Sierra Leone has critically low levels of voluntary blood donation, contributing to high rates of maternal mortality. Bleeding after childbirth (postpartum haemorrhage) is one of the leading causes of maternal death in the country. For blood transfusions, clinics often rely on blood donated by family members in emergency situations or paid donations.

Several barriers exist to voluntary blood donation, including a lack of public awareness and cultural myths and fears. Therefore, traditional blood drives driven by external health organisations often fail to generate long-term trust or commitment.

To address this challenge, Lifeline Nehemiah Projects developed the Gi4SaveLife initiative to flip this model on its head, shifting ownership directly to local community champions organised into community 'hubs'. All hub members were nominated by their local communities, based on their social standing and influence, and were responsible for leading monthly blood drives.

Over an eight-month trial period, the initiative generated 539 units of blood from 376 unique donors, increasing local baseline statistics from zero voluntary donations to a reliable, consistent supply. Importantly, 43% of these were repeat donations, demonstrating a crucial cultural shift toward regular giving. Key motivators for donating blood included altruism, with 71% of donors stating a 'desire to save lives,' and social recognition, with 52% of donors stating they 'enjoyed being known as a blood donor.' In addition, the initiative allowed the team to reduce the cost-per-unit of blood by 40% compared to standard hospital-led drives.

Dr Cristina Fernandez Turienzo, Senior Research Fellow at King's College London and lead author of the study, said: "There is an urgent need to champion local solutions to local problems when tackling global health challenges. Gi4SaveLife demonstrates the power of building local capacity."

Ms Lucy November, Midwife Research Fellow from King's College London and co-author added: "By empowering trusted community champions to dismantle deep-rooted myths with facts, Gi4SaveLife created a sustainable, cost-effective pipeline of voluntary donors and helped to bridge the gap between communities and health facilities."

Prince Tommy Williams, Executive Director of Lifeline Nehemiah Projects and co-author of the study, said: "We developed Gi4SaveLife as part of our mission to equip individuals and communities for sustainable development. By investing in local leadership and designing an approach rooted in trust, relationship-building, and mutual respect, our volunteers have transformed blood donation from a feared procedure into a meaningful, empowering, and community-driven act of solidarity that can strengthen the national blood transfusion service. A medical doctor can only save lives when blood is available, because doctors do not manufacture blood.''

One of the community stakeholders, Shek Osma Koroma, said: "I used to believe and say that blood donation was demonic until my wife was due to deliver twins and was severely anaemic. The blood donated by community volunteers was used to save the lives of my wife and our twins. That experience completely changed my mind set and perception about blood donation."

The initiative was funded by the UKRI through the Economic and Social Research Council (King's College London International Impact Fund).