Systemic barriers to donation for African, Caribbean and Black communities: A qualitative key informant study

BACKGROUND AND OBJECTIVE: For many blood collection agencies (BCAs), meeting the transfusion needs of people living with sickle cell disease, a genetic condition that causes sickling of red blood cells, is a priority but also a challenge because of a lack of diversity in the donor base. To help address this challenge, this study aimed to understand systemic barriers to donation from the perspectives of African, Caribbean, and Black (ACB) community leaders. METHODS AND MATERIALS: A qualitative study informed by a community-based participatory research approach was conducted with 10 ACB community leaders across Canada. Semi-structured interviews were conducted with key informants from February to March 2023. Topics explored included community involvement and priorities, perspectives on racism and discrimination, and perspectives on blood and other forms of donation including challenges to donation and recommendations for addressing challenges. Interviews were audio-recorded with participants' consent, transcribed, and uploaded to NVivo for analysis. Data analysis was guided by an interpretive descriptive and thematic analytic approach. RESULTS: Our analysis demonstrates how differing sociocultural views on blood donation, mistrusting BCAs as an extension of healthcare systems, and experiences of deferral criteria as exclusionary are constructed as barriers to donation for some ACB people and communities. CONCLUSIONS: Easing deferral criteria was recommended by key informants as a necessary step towards addressing a significant barrier to donation; however, even with the removal of a permanent deferral, its legacy and impact on affected communities may remain. Recommendations include that BCAs collaborate with ACB community groups to address these barriers.