Prevalence and determinants of unmet blood needs among patients at Jinja Regional Referral Hospital in Eastern Uganda

Abstract

Access to safe blood is critical for healthcare delivery, especially in resourcelimited settings. Uganda requires 450,000 units annually but consistently falls short by over 30%. In the Eastern Region, which has the highest maternal mortality ratio nationally, 34% of maternal deaths are linked to a lack of blood. Despite shortages, inappropriate use and wastage occur, and there is limited data quantifying unmet blood needs and their determinants. The study determined the prevalence of unmet blood needs and their determinants among patients at Jinja Regional Referral Hospital in Eastern Uganda. Methods: A convergent mixed-methods design was employed at Jinja Regional Referral Hospital, Uganda, in July 2025. Quantitative data were obtained via a census of 987 blood transfusion orders from the hospital’s electronic A-LIS system to estimate the prevalence of unmet blood needs. Qualitative data were collected through 25 key informant interviews and 17 in-depth patient interviews, purposively sampled to explore systemic, institutional, and socio-cultural factors influencing unmet blood needs. Quantitative analysis used descriptive statistics while qualitative data underwent hybrid thematic analysis, with findings triangulated across sources to ensure validity. Results: A total of 987 blood transfusion orders at Jinja RRH were analyzed; the majority, 66.7% were for females, while 33.3% were for males, and the mean patient age was 32 years (SD 19). Most orders were for blood group O+ (42.2%). Overall, 68.3% of orders were unmet, highest among females (69.6%), patients aged 20–30 years (39.9%), and those with blood group O- (83%). Qualitative findings revealed institutional factors influencing unmet blood needs, such as high demand, stock-outs, off-site screening for TTIs, inadequate storage capacity, staffing shortages, and community barriers, including low donations, mistrust, and religious beliefs. Conclusion: The high proportion of unmet blood transfusion orders (68.3%) at Jinja RRH, especially for blood group O-, warrants action and solutions to target both institutional and community factors. Inefficiencies in the blood supply chain and low voluntary donation hinder timely access. Targeted blood donation drivers should be considered for high-demand blood groups. Strengthening supply chain management and community mobilization is critical to ensuring adequate and safe blood availability