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Club 25... where
blood donors
love life!




World Health
Organization
Introduction
    The spread of HIV in the 1980’s caused blood services across
the world to seek new strategies to collect the safest blood possible.
A variety of strategies have been implemented and in some cases
costly and sophisticated advertising campaigns have resulted in
dismal failures, while others have had limited success. Countries
across the world are continually evaluating their blood donor
recruitment and motivation strategies in the light of current
demands for blood and blood products and in some cases a
reduction in available eligible donors: this being due to the
stringent criteria in place to protect blood safety.
    With this as a very brief backdrop to the challenges facing
those tasked with the collection of the safest blood possible it is
fascinating to find that often the best solutions can also be the
cheapest!
         Introducing… “Club 25” where young
      blood donors indeed love life and are happy
      to share their time, their blood, their energy
                     and their ideas!
    In 1989, Zimbabwe started targeting a previously untapped
pool of low-risk donors and one such school-age blood donor at
the time suggested it might be a good idea if young people pledged
to give 25 blood donations by age of 25 years. Very soon many stu-
dents started committing themselves to this idea and the forma-
tion of the first “Pledge 25 Club” took place. Now around 70% of
blood collected in Zimbabwe is donated by school students and
Pledge 25 Club members.
    The accompanying video and this leaflet provide an overview
of how this initiative is now having appeal to teenagers across the
world. It is interesting that the initiative has been particularly suc-


2   Club 25... where blood donors love life!
cessful in keeping young people protected from HIV and other
infections because part of their pledge is that they will maintain
healthy life-styles in order to provide the safest blood. Indeed in
Zimbabwe the HIV infection rates among blood donors fell from
4.45% in 1989 to 0.61% in 2001, in a country where infection
rate in the sexually active population was 33.7% at the time.
    Elsewhere, such as in neighboring South Africa the results are
just as impressive: young people aged 16-25 years are providing
about 24% of the national blood supply. This video will introduce
you to various Club 25 programmes and examine their progress in
three different countries, South Africa, the Philippines and
Malawi.
    In preparation for World Blood Donor Day 14 June 2005,
where we will again acknowledge the role of all voluntary blood
donors, it seems appropriate to introduce an approach to blood
donor motivation and HIV/AIDS education which may provide
guidance to other organizations wishing to introduce similar pro-
grammes. The philosophy behind the Club 25 Programmes is to
be open and honest with young people, providing clear guidelines
about blood donation criteria and similarly facts about the best
HIV/AIDS protection based on the evidence available, and then
allowing young people to make their choices based on this evi-
dence.


          One very important consideration in
            setting up a Club 25 Programme
       is that on no account is the Blood Service
           used as the place to find out if one
            is HIV positive. This would only
            be counter productive and attract
               the wrong target population.


                         Club 25... where blood donors love life!   3
In summary it appears that Club 25 Programmes are using an
evidence based approach to stimulate youth to take responsibility
for their own actions. This ultimately has an impact in the com-
munity in which they live and so far the impact in maintaining
blood supplies and in stopping the spread the HIV/AIDS is prov-
ing to be significant, at least in some parts of the world.


         Club/pledge 25…worldwide activities
                as at November 2004
                   Zimbabwe                              Botswana
                   Zambia                                South Africa
                   India                                 Indonesia
                   Malawi                                Uganda
                   Haiti                                 Philippines
                                        Togo
        Pilot programmes are also underway elsewhere and with
                YOUR help this list will be extended before
                 World Blood Donor Day 14 June 2005.
     Start now and establish a Club 25 programme in your country!


1 Stoneburner and Low-Beer, Population-Level HIV Declines and Behavioral Risk Avoidance
   in Uganda, Science 2004 304: 714-718 Science Journal




4   Club 25... where blood donors love life!
Overview
with country examples:
    Models of various kinds exist but generally they follow a simi-
lar structure as per this very simple example:

   Models of various kinds exist but generally they follow a
   similar structure as per this very simple example:
   1. The Club elects a national and provincial administra-
      tive committee to organize activities, for example a
      National Youth Blood Donor Day.
   2. Peer promoters are elected to assist the Blood Service in
      the recruitment of voluntary, non-remunerated blood
      donors from low-risk populations and in turn the
      Blood Service supervises and supports the Club.


    Operationally the Club functions according to local needs but
the following example from South Africa helps to illustrate the role
of the Blood Service and the responsibilities of Club Members:

                Adapting Pledge 25
                Club to South Africa
    The idea started in Zimbabwe. In the late 1990s, the blood
service there revealed some interesting data and strategies in the
overall context of reducing the HIV rate and retaining young
donors. The service had reduced the HIV rate among Zimbabwe
blood donors from about 21 per cent to 1.1 per cent including
new donors (in a country where 20-26 per cent of people aged
between 15-49 years were living with HIV/AIDS, and with rates
climbing). They had identified young people as a low-risk group


                         Club 25... where blood donors love life!   5
but they had also observed they ceased donating after they left
school. So the first Pledge 25 Club was established, for school
leavers who pledged to donate 25 times in their lifetime.
    As part of the pledge, the young people had to remain sero-
negative in order to achieve their objective and within a short peri-
od there was a significant increase in both club membership and
blood donor retention among school leavers.
    Some time afterwards the “club concept” was then introduced
in South Africa under the title of Club 25, and in general it oper-
ates as follows:
    Approximate age of Club members: 18-25 years
        Recruitment for Club 25 is aimed at current donors
        who are leaving school or who have left school and
        already donated three or more units..
        Donors (21 years or younger) who are no longer at
        school can also join the programme as long as they have
        previously given three units of blood.
        Club 25 members must ensure they lead a safe lifestyle
        in order to remain safe blood donors and meet the cri-
        teria for donor eligibility.
        Club 25 members must commit to donate a minimum
        of two units per year with the aim of donating 20 units
        by the end of their twenty-fifth year (ie all donations
        must be made before they reach 26 years.

Teamwork
    In South Africa Club 25 is very much a team exercise, involv-
ing various elements within the blood service. In involves the
donor staff in recruiting new members, the Corporate Public
Relations/Donor Marketing Department in special efforts to
retain members as donors and to educate them to commit to
healthy lifestyles and a Club 25 newsletter to reinforce education



6   Club 25... where blood donors love life!
and to remind donors of their commitment. Finally, telerecruiters
also play a key role by contacting the young donors and remind-
ing them about their first donation during the January-March
period and again for subsequent donations later in the year.

The process
    After blood donors leave school they sign up as Club 25 mem-
bers and give their first donation as part of the club. They receive
a bag from the Blood Banks of South Africa as token of their
appreciation for their support and commitment. On their 20th
donation, a Club 25 member receives a nationally recognised Club
25 medal and there is also a quarterly Club 25 newsletter to keep
all members informed about blood donation drives and activities.
One of the primary functions of this newsletter is to remind these
donors of their commitment and to continually provide them with
information on risk behaviour: the focus is on the importance of
donating blood regularly and living a safe lifestyle.

Results
     The launching of Club 25, conducted on National Youth
Blood Donor Day, 4 December 1999, involved twenty branches of
SANBS and all centres reported that Club 25 was well received.
Despite the cultural diversity of South Africa the National Blood
Service (SANBS) has been successful in creating a concept that
appeals to a target age group across all ethnic boundaries.
     SANBS has had some years to develop the concept and watch
the programme grow. Latest statistics indicate that Club 25 is cer-
tainly making an impact on the quality and quantity of the coun-
try’s blood supply. Moreover, it is also clear that the Blood Centre
is playing a significant role in educating young people about risk
behaviour and ensure they remain free of the HIV/AIDS scourge
that has taken hold of the continent.



                         Club 25... where blood donors love life!   7
Latest data
    In 4 years:
        35,193 active donors on Club 25 donor panel.
        177,426 donations from Club 25 members.
        Increase in 18-25 year old donors on SANBS donor
        panel from 6% to 15%.
        Decrease in HIV prevalence of Club 25 panel to
        0.04%: SANBS donor panel to 0.07%: South Africa
        country 26 – 28%.



A similar model
in the Philippines
    “Pledge 25” has recently become a project of the Philippine
National Red Cross (PNRC)-Red Cross Youth Department (RCY)
in support of the drive on voluntary blood donation. It consists of
a group of young blood donors who pledge to regularly donate
blood 3 to 4 times a year starting the age of 18 until they reach 25
years old. After this period, they will be joining other blood donor
groups for their regular blood donations.

Objectives
        To organize a youth group as a link with Red Cross to
        tap the youth sector as regular donors of the PNRC.
        To create a group of young blood donor recruiters.
        To interface the youth program with the NBS.
        To promote the participation of women in voluntary
        blood donation.
        To instill into both young and old alike, the value of
        saving others’ lives by voluntary blood donation.



8   Club 25... where blood donors love life!
Representation
    Members mostly represent various youth groups, either gov-
ernment or non-government. But also accepted are young people
who do not belong to any youth organization. There are thou-
sands of active members nationwide, and these young people are
also actively participating in other various worthwhile Red Cross
Youth activities. Each member receives an attractive ID card after
their second donation, and a pin is given after the third donation.
A regular Pledge 25 blood donor will receive a different design of
pin every year after the third donation.

Results
Pledge 25 memberships
for year 1999, 2000, 2001, 2002:

                      Nationwide membership
 Year                  Luzon    Visayas  Mindanao Total
 1999                   1,038     353       960    2,351
 2000                   1,249     624       555    2,428
 2001                    815      913       271    1,999
 2002                   1525      605       820    2,950
 January-June 2003       266      386       120     772
 Over – All total      4,893     2,881     2,726  10,500




                         Club 25... where blood donors love life!   9
HIV/AIDS prevention:
 it is your choice!
     Based on current evidence available there are three broad cate-
 gories of risk concerning HIV/AIDS (No Risk, Low Risk and
 High Risk) and the chart opposite tries to identify these categories
 to enable young people especially make their choice in terms of
 appropriate protection where sexual relationships are concerned.

     Generally Club 25 Programmes include guidelines for young
 people to ensure they remain eligible as blood donors by leading
 healthy life-styles and the Blood Service can play an important role
 in providing HIV/AIDS education materials. In this way young
 people themselves become “HIV/AIDS” peer educators and their
 role in the community is even more significant than “saving lives
 by blood donation”... they now also play a vital role in health pro-
 motion as well!

     The Club 25 Programme, though only just beginning in some
 cases, appears to be a most economical model in terms of public
 health care. With young people playing such valuable roles in help-
 ing to secure a safe and adequate blood supply, and in creating a
 culture of healthy lifestyles among their peers, World Blood Donor
 Day, 14 June 2005 seems be a good opportunity for governments,
 policymakers and blood programmes to include them in their mes-
 sage of thanks to all blood donors.


               Thank you to all
           Pledge/Club 25 members!

10   Club 25... where blood donors love life!
Club 25... where blood donors love life!   11
Further information,
see World Blood Donor Day website




www.wbdd.org

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Club25

  • 1. Club 25... where blood donors love life! World Health Organization
  • 2. Introduction The spread of HIV in the 1980’s caused blood services across the world to seek new strategies to collect the safest blood possible. A variety of strategies have been implemented and in some cases costly and sophisticated advertising campaigns have resulted in dismal failures, while others have had limited success. Countries across the world are continually evaluating their blood donor recruitment and motivation strategies in the light of current demands for blood and blood products and in some cases a reduction in available eligible donors: this being due to the stringent criteria in place to protect blood safety. With this as a very brief backdrop to the challenges facing those tasked with the collection of the safest blood possible it is fascinating to find that often the best solutions can also be the cheapest! Introducing… “Club 25” where young blood donors indeed love life and are happy to share their time, their blood, their energy and their ideas! In 1989, Zimbabwe started targeting a previously untapped pool of low-risk donors and one such school-age blood donor at the time suggested it might be a good idea if young people pledged to give 25 blood donations by age of 25 years. Very soon many stu- dents started committing themselves to this idea and the forma- tion of the first “Pledge 25 Club” took place. Now around 70% of blood collected in Zimbabwe is donated by school students and Pledge 25 Club members. The accompanying video and this leaflet provide an overview of how this initiative is now having appeal to teenagers across the world. It is interesting that the initiative has been particularly suc- 2 Club 25... where blood donors love life!
  • 3. cessful in keeping young people protected from HIV and other infections because part of their pledge is that they will maintain healthy life-styles in order to provide the safest blood. Indeed in Zimbabwe the HIV infection rates among blood donors fell from 4.45% in 1989 to 0.61% in 2001, in a country where infection rate in the sexually active population was 33.7% at the time. Elsewhere, such as in neighboring South Africa the results are just as impressive: young people aged 16-25 years are providing about 24% of the national blood supply. This video will introduce you to various Club 25 programmes and examine their progress in three different countries, South Africa, the Philippines and Malawi. In preparation for World Blood Donor Day 14 June 2005, where we will again acknowledge the role of all voluntary blood donors, it seems appropriate to introduce an approach to blood donor motivation and HIV/AIDS education which may provide guidance to other organizations wishing to introduce similar pro- grammes. The philosophy behind the Club 25 Programmes is to be open and honest with young people, providing clear guidelines about blood donation criteria and similarly facts about the best HIV/AIDS protection based on the evidence available, and then allowing young people to make their choices based on this evi- dence. One very important consideration in setting up a Club 25 Programme is that on no account is the Blood Service used as the place to find out if one is HIV positive. This would only be counter productive and attract the wrong target population. Club 25... where blood donors love life! 3
  • 4. In summary it appears that Club 25 Programmes are using an evidence based approach to stimulate youth to take responsibility for their own actions. This ultimately has an impact in the com- munity in which they live and so far the impact in maintaining blood supplies and in stopping the spread the HIV/AIDS is prov- ing to be significant, at least in some parts of the world. Club/pledge 25…worldwide activities as at November 2004 Zimbabwe Botswana Zambia South Africa India Indonesia Malawi Uganda Haiti Philippines Togo Pilot programmes are also underway elsewhere and with YOUR help this list will be extended before World Blood Donor Day 14 June 2005. Start now and establish a Club 25 programme in your country! 1 Stoneburner and Low-Beer, Population-Level HIV Declines and Behavioral Risk Avoidance in Uganda, Science 2004 304: 714-718 Science Journal 4 Club 25... where blood donors love life!
  • 5. Overview with country examples: Models of various kinds exist but generally they follow a simi- lar structure as per this very simple example: Models of various kinds exist but generally they follow a similar structure as per this very simple example: 1. The Club elects a national and provincial administra- tive committee to organize activities, for example a National Youth Blood Donor Day. 2. Peer promoters are elected to assist the Blood Service in the recruitment of voluntary, non-remunerated blood donors from low-risk populations and in turn the Blood Service supervises and supports the Club. Operationally the Club functions according to local needs but the following example from South Africa helps to illustrate the role of the Blood Service and the responsibilities of Club Members: Adapting Pledge 25 Club to South Africa The idea started in Zimbabwe. In the late 1990s, the blood service there revealed some interesting data and strategies in the overall context of reducing the HIV rate and retaining young donors. The service had reduced the HIV rate among Zimbabwe blood donors from about 21 per cent to 1.1 per cent including new donors (in a country where 20-26 per cent of people aged between 15-49 years were living with HIV/AIDS, and with rates climbing). They had identified young people as a low-risk group Club 25... where blood donors love life! 5
  • 6. but they had also observed they ceased donating after they left school. So the first Pledge 25 Club was established, for school leavers who pledged to donate 25 times in their lifetime. As part of the pledge, the young people had to remain sero- negative in order to achieve their objective and within a short peri- od there was a significant increase in both club membership and blood donor retention among school leavers. Some time afterwards the “club concept” was then introduced in South Africa under the title of Club 25, and in general it oper- ates as follows: Approximate age of Club members: 18-25 years Recruitment for Club 25 is aimed at current donors who are leaving school or who have left school and already donated three or more units.. Donors (21 years or younger) who are no longer at school can also join the programme as long as they have previously given three units of blood. Club 25 members must ensure they lead a safe lifestyle in order to remain safe blood donors and meet the cri- teria for donor eligibility. Club 25 members must commit to donate a minimum of two units per year with the aim of donating 20 units by the end of their twenty-fifth year (ie all donations must be made before they reach 26 years. Teamwork In South Africa Club 25 is very much a team exercise, involv- ing various elements within the blood service. In involves the donor staff in recruiting new members, the Corporate Public Relations/Donor Marketing Department in special efforts to retain members as donors and to educate them to commit to healthy lifestyles and a Club 25 newsletter to reinforce education 6 Club 25... where blood donors love life!
  • 7. and to remind donors of their commitment. Finally, telerecruiters also play a key role by contacting the young donors and remind- ing them about their first donation during the January-March period and again for subsequent donations later in the year. The process After blood donors leave school they sign up as Club 25 mem- bers and give their first donation as part of the club. They receive a bag from the Blood Banks of South Africa as token of their appreciation for their support and commitment. On their 20th donation, a Club 25 member receives a nationally recognised Club 25 medal and there is also a quarterly Club 25 newsletter to keep all members informed about blood donation drives and activities. One of the primary functions of this newsletter is to remind these donors of their commitment and to continually provide them with information on risk behaviour: the focus is on the importance of donating blood regularly and living a safe lifestyle. Results The launching of Club 25, conducted on National Youth Blood Donor Day, 4 December 1999, involved twenty branches of SANBS and all centres reported that Club 25 was well received. Despite the cultural diversity of South Africa the National Blood Service (SANBS) has been successful in creating a concept that appeals to a target age group across all ethnic boundaries. SANBS has had some years to develop the concept and watch the programme grow. Latest statistics indicate that Club 25 is cer- tainly making an impact on the quality and quantity of the coun- try’s blood supply. Moreover, it is also clear that the Blood Centre is playing a significant role in educating young people about risk behaviour and ensure they remain free of the HIV/AIDS scourge that has taken hold of the continent. Club 25... where blood donors love life! 7
  • 8. Latest data In 4 years: 35,193 active donors on Club 25 donor panel. 177,426 donations from Club 25 members. Increase in 18-25 year old donors on SANBS donor panel from 6% to 15%. Decrease in HIV prevalence of Club 25 panel to 0.04%: SANBS donor panel to 0.07%: South Africa country 26 – 28%. A similar model in the Philippines “Pledge 25” has recently become a project of the Philippine National Red Cross (PNRC)-Red Cross Youth Department (RCY) in support of the drive on voluntary blood donation. It consists of a group of young blood donors who pledge to regularly donate blood 3 to 4 times a year starting the age of 18 until they reach 25 years old. After this period, they will be joining other blood donor groups for their regular blood donations. Objectives To organize a youth group as a link with Red Cross to tap the youth sector as regular donors of the PNRC. To create a group of young blood donor recruiters. To interface the youth program with the NBS. To promote the participation of women in voluntary blood donation. To instill into both young and old alike, the value of saving others’ lives by voluntary blood donation. 8 Club 25... where blood donors love life!
  • 9. Representation Members mostly represent various youth groups, either gov- ernment or non-government. But also accepted are young people who do not belong to any youth organization. There are thou- sands of active members nationwide, and these young people are also actively participating in other various worthwhile Red Cross Youth activities. Each member receives an attractive ID card after their second donation, and a pin is given after the third donation. A regular Pledge 25 blood donor will receive a different design of pin every year after the third donation. Results Pledge 25 memberships for year 1999, 2000, 2001, 2002: Nationwide membership Year Luzon Visayas Mindanao Total 1999 1,038 353 960 2,351 2000 1,249 624 555 2,428 2001 815 913 271 1,999 2002 1525 605 820 2,950 January-June 2003 266 386 120 772 Over – All total 4,893 2,881 2,726 10,500 Club 25... where blood donors love life! 9
  • 10. HIV/AIDS prevention: it is your choice! Based on current evidence available there are three broad cate- gories of risk concerning HIV/AIDS (No Risk, Low Risk and High Risk) and the chart opposite tries to identify these categories to enable young people especially make their choice in terms of appropriate protection where sexual relationships are concerned. Generally Club 25 Programmes include guidelines for young people to ensure they remain eligible as blood donors by leading healthy life-styles and the Blood Service can play an important role in providing HIV/AIDS education materials. In this way young people themselves become “HIV/AIDS” peer educators and their role in the community is even more significant than “saving lives by blood donation”... they now also play a vital role in health pro- motion as well! The Club 25 Programme, though only just beginning in some cases, appears to be a most economical model in terms of public health care. With young people playing such valuable roles in help- ing to secure a safe and adequate blood supply, and in creating a culture of healthy lifestyles among their peers, World Blood Donor Day, 14 June 2005 seems be a good opportunity for governments, policymakers and blood programmes to include them in their mes- sage of thanks to all blood donors. Thank you to all Pledge/Club 25 members! 10 Club 25... where blood donors love life!
  • 11. Club 25... where blood donors love life! 11
  • 12. Further information, see World Blood Donor Day website www.wbdd.org