Taking blood from a baby can be a bit more difficult than taking candy from a baby. Especially when parents, grandparents, and community members have their say.

One of the responsibilities of the fieldwork coordinating team is to meet with any participants who have repeatedly refused to allow the fieldworker to take the babies’ blood. We encountered some interesting reasons for refusals that relate specifically to blood.

Fieldworker drawing peripheral blood from a study baby under a tree as children watch

Many of the children are anemic, so some parents believe the blood samples for the study (1 mL) contribute to the babies’ anemia or make them more susceptible to illness. One father reasoned the blood samples caused his baby to fall sick three times afterward. Another mother suggested her baby wouldn’t be as strong as an adult because of the blood samples.

Fieldworker at the passives clinic preparing Malaria Rapid Diagnostic Tests (RDTs)

Others take issue with study’s policy on blood transfusions. In Ghana, it’s required for anyone who receives a blood transfusion to replace the blood or arrange for a friend or relative to do so. If they cannot find someone, they must pay the hospital twenty-five cedis per unit to cover the cost of the hospital recruiting a donor. However, it’s also illegal to buy blood. Some parents of children who required transfusions for their anemia expected the study to pay for the cost of the blood when they were unable to find a replacement and reasoned the blood samples led to the need for transfusion. The study pays for the cost of processing blood, but not for blood itself because that’s illegal.

This is a particularly difficult issue to address when participants don’t understand that the small amount of blood required for the study would not necessitate transfusion. Some of the supervisors donated blood for especially desperate families who needed to replace the transfused blood. The fieldwork coordinator also visited families to explain the reasons for the study’s policy. Organizing blood drives in the community to replace transfused blood was suggested as another potential solution.

Most interesting was the belief that the study was selling the blood or using it in rituals.  It’s possible the study may hold a community discussion at this town to inform its inhabitants about the use of blood to the study. In some cases, parents have been brought to the lab to show them how the children’s blood samples are processed. Also, I recently attended a KHRC presentation about an upcoming small qualitative study on reasons for blood draw refusal which should help the centre identify and resolve these issues.

The majourity of the participants we spoke with agreed to resume blood sampling. Communication really is key.

OJ, fieldwork coordinator, bonding with a study child

Category: Ghana, On location // Add Comment »