In Focus
Strengthening donor connections: A Forward path for 2026
Insights from the Indian subcontinent
In India, blood donation remains deeply rooted in community values, social responsibility, and the belief that "daan" (donation) is the highest form of service.
Across South Asia, including India, blood donation is woven into community values, collective responsibility, and the belief that helping others is a shared duty. Yet donor behaviour is evolving as lifestyles become more demanding, young people migrate for education or work, and seasonal illnesses strain health systems. In low- and middle-income countries, donor engagement requires approaches that reflect local realities, cultural norms, communication preferences, and resource constraints. This article brings together observations relevant to the region, focusing on practical ways to strengthen donor relationships and retention.
In many LMICs, there are many challenges that exist while recruiting and retaining sufficient donors, like fast-paced lifestyles, rising clinical needs, population ageing, and the after-effects of pandemic disruptions. Donor engagement begins long before the act of donation. People respond best when communication is simple, timely, and respectful. Many donors prefer short, bilingual SMS reminders or WhatsApp notifications, which they find accessible and familiar. These gentle nudges, especially those reminding donors of their next eligible date, are often more effective than long, formal messages. Personal acknowledgement also matters. Donors who receive sincere, personalised appreciation frequently express a stronger emotional connection4 with the system, a trend reported across LMICs where altruism and community-oriented motivations dominate.
One of the biggest challenges in the region is the decline in youth participation. Academic pressure, travel, parental hesitancy, and irregular schedules interrupt donation habits. Youth-focused outreach that uses relatable visuals, peer-to-peer encouragement, and group donation experiences tends to resonate more strongly. Studies from India show that young donors respond positively to motivational messaging and structured awareness initiatives, which significantly improve their willingness to donate again1. When donation feels like a shared, community-driven activity, participation improves. Motivations also vary widely; many donate out of gratitude for care received by a family member, some out of civic responsibility, and others because cultural values encourage service. Recognising these motivations and reflecting them in communication helps deepen trust4,5.
Donor safety and comfort remain the foundation of retention. In regions with warm climates or limited infrastructure, small improvements, cool waiting areas, hydration availability, or comfortable seating make the experience more reassuring. Streamlining pre-donation steps, such as simplifying questionnaires or offering multilingual assistance, reduces anxiety. After donation, a brief message asking about the donor’s well-being reinforces confidence and signals respect.
Sustained community education helps address misconceptions and encourages regular participation. Deferrals must be handled with empathy. A donor deferred for low haemoglobin, borderline vitals, or recent infection may feel discouraged if not counselled well. A calm explanation, a clear timeline for return, and simple suggestions, such as incorporating common iron-rich foods, can transform a negative moment into a positive, hopeful interaction.
Building a strong repeat-donor base in LMICs poses distinct challenges. High proportions of first-time or replacement donors, seasonal deferrals, and irregular working hours make consistency difficult. Evidence from North India shows that voluntary donors are far more likely to return compared to replacement donors, emphasising the importance of cultivating repeat voluntary donors2.
Community trust is strongly influenced by local leaders. In many towns and villages, teachers, youth volunteers, neighbourhood representatives, and spiritual figures hold significant persuasive power4. When such individuals donate publicly or endorse donation during community gatherings, it dispels myths and encourages hesitant first-time donors. Their involvement often creates a ripple effect where entire groups participate.
Ethical and inclusive practices remain essential to preserving trust. Donors appreciate transparency about what tests are performed, why screening is important, how blood is used, and why certain deferral policies exist3. When eligibility updates, such as those related to travel, behavioural risk screening, or tattoos, are communicated respectfully and in local languages, donors respond positively. Culturally sensitive messaging is especially important in diverse areas where language and symbolism influence how health information is perceived5.
Data and simple digital tools also contribute meaningfully to donor retention. Even basic trend analysis, monitoring seasonal shortages, identifying areas with repeated deferrals, or noting peak donation periods, helps services plan better outreach. Appointment scheduling tools, eligibility checkers, and chat-based donor support platforms reduce confusion and empower donors to navigate their own eligibility confidently. When implemented responsibly, such innovations improve communication consistency and donor satisfaction5.
As 2026 approaches, the path forward for donor engagement in LMICs lies in balancing compassion with practicality and innovation with cultural sensitivity. Donors return not because of technology or reminders alone, but because they feel respected, understood, and valued. Strengthening donor relationships means anticipating their concerns, simplifying their journey, and acknowledging the social worlds they come from. When communication is clear, safety is prioritised, and community identity is honoured, donor communities become more resilient and more committed.
By grounding global best practices in local contexts, countries across the region can continue building strong, dependable donor bases that ensure every patient receives safe blood on time. The focus must remain on human connection, because behind every unit of blood lies a person who chose to give, and a life waiting to be saved.
References
- Sinha R, Sinha P, Patil V. To study the effect of motivational lectures on voluntary blood donations among young blood donors. Global Journal for Research Analysis. 2025
- Dubey A, Sonker A, Chaurasia R, Chaudhary R. Knowledge, attitude and beliefs of people in North India regarding blood donation. Blood Transfus. 2014
- NACO: National blood policy of India.
- Borsato BA, Miranda CBS, Bizotti HS, et al. Motivational factors in blood donation: a systematic review. J Blood Disord. 2024
- Monteiro TH, Fernandes C, et al. Barriers and motivations for blood donation: a review. Transfusion Medicine and Hemotherapy. 2024.
