Understanding urgent blood-donor mobilisability: a cross-sectional online survey of digitally reachable adults in Ghana
This cross-sectional survey of digitally reachable adults in Ghana reveals that while digital reachability and general willingness to donate are high, actual mobilisability for urgent blood requests is significantly lower and is primarily driven by trust in the health system, digital readiness, and prior donation experience, while being hindered by gender, work schedules, and travel barriers.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of a preprint that has not been peer-reviewed. It is not medical advice. Do not make health decisions based on this content. Read full disclaimer
In many parts of the world, a sudden need for blood can be a matter of life and death. When a mother suffers severe bleeding after childbirth, or a child is injured in an accident, the difference between survival and tragedy often depends on whether a unit of safe blood is available within minutes. In low-income countries, where hospitals frequently face shortages, the challenge is not just finding people willing to give blood, but finding them quickly enough to act. For decades, health officials have hoped that digital tools—smartphones, text messages, and apps—could solve this by instantly connecting hospitals with potential donors. The logic seemed sound: if a person owns a phone and has internet access, they should be able to receive an urgent request and rush to a clinic.
However, owning a phone is not the same as being ready to act. A person might be reachable by a digital message but still be unable to leave their job, might not trust the source of the message, or might simply not have the time to travel to a hospital in an emergency. This gap between being digitally reachable and being truly available is the central question researchers set out to explore. They wanted to understand what actually happens when an urgent request for blood is sent to a large group of people. Is the pool of available donors as large as the number of phone users suggests, or are there hidden barriers that stop people from responding even when they are willing?
To answer this, a team of researchers conducted a large survey across Ghana, a country with high mobile phone usage. They reached out to over a thousand adults through social media and online networks, asking them to imagine a scenario where they received an urgent, trusted request for blood. The researchers did not just ask if these people would donate; they broke the process down into four specific steps. First, would the person be willing to give blood in the future? Second, would they be willing to download a specific, trusted app for this purpose? Third, if they received a message from a trusted source like a hospital, would they agree to respond? And finally, the most critical step: if they said yes to all the above, would they actually be able to stop what they were doing and travel to a clinic right now?
The results revealed a significant drop-off at the final step. While nearly everyone in the survey said they were willing to donate in the future, and most said they would install an app or answer a call from a trusted hospital, only about half of the participants felt they could actually leave their current activities to make the donation. This finding suggests that simply counting how many people have smartphones or how many say they are willing to help greatly overestimates the number of people who can actually show up in an emergency. The study showed that digital reachability does not equal mobilisability.
The researchers found that certain factors made a person much more likely to be truly ready to act. Trust was the most powerful driver. People who trusted the formal health system—hospitals and clinics—were far more likely to say they would respond to an urgent request. Similarly, those who had previously donated blood or who knew a lot about the donation process were more confident in their ability to act. On the other hand, practical barriers were the main reason people said they could not help. If a person had a rigid work schedule, or if it took them more than thirty minutes to travel to the nearest hospital at night, they were significantly less likely to be considered "mobilisable," even if they wanted to help. Women were also less likely to be mobilisable than men, largely due to these practical constraints and family responsibilities.
The study also looked at how people reacted to different types of requests. It found that people were more willing to respond if the request came with a clear, emotional explanation of why the blood was needed, such as a message about a pregnant woman in danger, rather than a generic call for anonymous donors. This suggests that while technology can deliver the message, the content of that message and the trust behind it are what turn a digital notification into a real-world action.
Ultimately, the research paints a clear picture for health officials and technology developers. Building a blood donation app or sending out thousands of text messages is not enough if the people receiving them cannot physically get to a clinic or do not trust the sender. The study suggests that future efforts should focus less on just expanding the digital network and more on removing the practical hurdles that stop willing people from acting. This means ensuring that requests come from clearly identifiable and trusted sources, checking if a donor is actually free at that moment, and perhaps even providing transport support for those who live far away. By understanding that a "yes" on a screen does not always mean a person can arrive at a hospital, health systems can design better strategies to ensure that when the urgent need arises, the right people are not just reachable, but ready.
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