Blood donation barriers and facilitators of Sub-Saharan African migrants and minorities in Western high-income countries: a systematic review of the literature.
OBJECTIVES
The present study aimed to gain more insight into, and summarise, blood donation determinants among migrants or minorities of Sub-Saharan heritage by systematically reviewing the current literature.


BACKGROUND
Sub-Saharan Africans are under-represented in the blood donor population in Western high-income countries. This causes a lack of specific blood types for transfusions and prevention of alloimmunisation among Sub-Saharan African patients.


METHODS/MATERIALS
Medline, EMBASE, PsycINFO and BIOSIS were searched for relevant empirical studies that focused on barriers and facilitators of blood donation among Sub-Saharan Africans in Western countries until 22 June 2017. Of the 679 articles screened by title and abstract, 152 were subsequently screened by full text. Paired reviewers independently assessed the studies based on predefined eligibility and quality criteria.


RESULTS
Of the 31 included studies, 24 used quantitative and 7 used qualitative research methods. Target cohorts varied from Black African Americans and refugees from Sub-Sahara Africa to specific Sub-Saharan migrant groups such as Comorians or Ethiopians. Main recurring barriers for Sub-Saharan Africans were haemoglobin deferral, fear of needles and pain, social exclusion, lack of awareness, negative attitudes and accessibility problems. Important recurring facilitators for Sub-Saharan Africans were altruism, free health checks and specific recruitment and awareness-raising campaigns.


CONCLUSION
The findings of this review can be used as a starting point to develop recruitment and retention strategies for Sub-Saharan African persons. Further research is needed to gain more insight in the role of these determinants in specific contexts as socioeconomic features, personal histories and host country regulations may differ per country.
['Klinkenberg|E F|EF|https://orcid.org/0000-0001-5800-0060', "Huis In't Veld|E M J|EMJ|", 'de Wit|P D|PD|', 'van Dongen|A|A|', 'Daams|J G|JG|', 'de Kort|W L A M|WLAM|', 'Fransen|M P|MP|']
D017954:Africa South of the Sahara D000533:Altruism D044383:Blacks D001782:Blood Donors D019049:Developed Countries D006801:Humans D008913:Minority Groups D014171:Transients and Migrants
African migrant blood type Africa south of the Sahara ethnic minorities inheritable blood disorder motivators needle fear personal discrimination