Blood transfusion services always play a consolidate role in healthy system, according to World Health Organization (2012) definition, Voluntary Non-remunerated blood donation (VNRBD) is meaning that donor gives blood, plasma or cellular components with his/her own wills and receive no payment for it, either in the form of cash, or in kind which could be considered a substitute for money. VNRBD first published by The League of the Red Cross (IFRC), to encourage national societies take actions on blood issue (Global Advisory Panel,2017).
Since 1952, blood donation programme operated in Hong Kong exclusively on a non-remunerated basis ,this programme has been managed by the Hospital Authority from 1991 and the Hong Kong Red Cross Blood Transfusion Service (BTS) is the only public agency to supply blood in Hong Kong nowadays (Hong Kong Red Cross,2017).According to Hong Kong Red Cross (2017), there has been a continued increase in blood product demand, demand from 2006-2016 increased from 180,754 to 242,379 .Only 3 % of the total population of Hong Kong donate blood (HKRCBTS,2003). Due to structural change in population, increased in population and aging issues, in addition of factors such as, teenage group reluctant to donate blood, Chinese traditional reason. It shown that the blood stock is being challenged (Hong Kong Red Cross,2017). As this review will discuss the existing policy’s advantages, disadvantages and the challenges in Hong Kong.
Challenges of running VNRBD in Hong Kong
As usual for developed countries, aging population is a challenge on blood donation, according to Census and Statistics Department (C&SD,2016), the total number of elderlies is 1,163,153 Comparing to data in 2006, its population increased 310,357. The blood donor in HK are mainly distributed in middle age group or above, it takes 44.45% form the whole number of donor (HKRC,2018). Showing that the supply is mainly supported by senior citizen. Since there is an age limit for blood donors which over 66-year-old are not suitable for give blood (Red Cross,2019). Underling that the number of blood donor will drop continuously, while the needs of blood will increase accumulatively due to the main demand are came from elderly.
According to HKRC (2017), the clinical usage of red blood cell collected from VNRBD are majorly used in Medical & Geriatric Department, up to 51.5% of blood cell used in this department. It has been proven that in 2033, 27% the population will be over 65-year-old, also there will be a steep decline in birth rate (Hong Kong Young People’s Donation Behaviour,2008).With the low fertility leads to the number of students decrease, usually BTS gain blood from teenage group through donation station in school (HKYPDB,2008). But according to Red Cross(2017),except low birth rate, change in academic structure is also a factor leads to teenagers reluctant to donate blood, from 2012, government first published “3-3-4 Scheme” which decreased the number of secondary school students, beside, the student also need to attend supplementary classes and on leave for prepares for Hong Kong Examination (HKDSE), in which lost some opportunity to participate in blood donation.(HKRC,2017). With the aging population increased, low birth rate and educational factors, it is a challenge for running VNRBD in Hong Kong which needs to maintain a stable support of blood to Hong Kong Citizen.