Defining blood deserts and access to blood products for 660 million people: a geospatial analysis of eight states in Northern India.

INTRODUCTION: Blood transfusion is crucial, but low-income and middle-income countries like India face a severe shortage of banked blood. This study focuses on the Empowered Action Group (EAG) states in India, where healthcare is limited, and health outcomes are poor. Our objective was to assess the blood banking infrastructure and access to blood products in these states.

METHODS: We used e-Rakht Khosh, an online platform for blood availability data. We collected data on blood bank locations and stocks from 18 January to 9 February 2022 and used ArcGIS to determine the population residing within 30-60-90 min of a blood bank. Availability ratios were calculated by dividing available blood products by population in these catchment areas. Descriptive analysis characterised availability, and statistical tests evaluated differences across states and over the 4-week period.

RESULTS: 806 of 824 blood banks reported data on blood stocks. Our analysis showed that 25.72% of the EAG states' population live within 30 min of a blood bank, while 61.45% and 92.46% live within 60 and 90 min, respectively.

CONCLUSION: Blood availability rates were low in the EAG states, with only 0.6 units per 1000 people. Additionally, only 61% of the population had access to blood-equipped facilities within an hour. These rates fell below the standards of the Lancet Commission on Global Surgery (15 units per 1000 population) and the WHO (10 donations per 1000 population). The study highlights the challenges in meeting demand for blood in emergencies due to inadequate blood banking infrastructure.