For thousands of Kenyans who require blood transfusions each year, accessing life-saving blood is often a race against time, distance and an overstretched health system.
A landmark study published in The Lancet Global Health has found that the country’s blood crisis is driven by far more than a shortage of donors, exposing deep structural weaknesses that delay care and put patients at risk.
Globally, the World Health Organisation estimates that about 61 per cent of countries do not have an adequate blood supply, contributing to an annual shortfall of roughly 102 million units of red blood cells.
The burden is heaviest in low and middle-income countries, particularly in sub-Saharan Africa, where demand remains high due to maternal bleeding complications, childhood anaemia, trauma, surgery and infectious diseases.
Kenya reflects this wider reality, but the new evidence suggests its challenge is not only about how much blood is collected, but how the system itself functions from donor to patient.
The study, conducted across Siaya, Nakuru and Turkana counties, draws on the experiences of nearly 200 healthcare workers, donors, patients, administrators and government officials. It was led by Strathmore University in partnership with the University of Pittsburgh and the Centre for Public Health and Development, and in collaboration with the Kenya Blood Transfusion and Transplantation Service.
Researchers describe the situation as a fragmented “blood transfusion continuum’, where every step from donation, testing, storage, transport and transfusion is affected by gaps in coordination.
The findings reveal a system under pressure on multiple fronts. The study identifies seven major challenges affecting blood availability. These include persistent shortages, mismatches between where blood is stored and where patients need it, heavy reliance on family replacement donors, delays in patient care, strain on healthcare workers, mixed attitudes toward donation and transfusion, and inadequate resources for collecting, testing, storing and transporting blood.
In practice, these weaknesses translate into dangerous delays. Patients waiting for emergency transfusions often lose precious time while families are asked to mobilise relatives to donate. In some cases, surgeries are postponed.
Healthcare workers, already stretched, spend hours searching for blood across facilities instead of focusing on clinical care. The study notes that some staff even resort to personally calling nearby hospitals, organising transport or using informal networks to secure blood for patients in critical condition.
While these efforts highlight commitment within the health system, the researchers warn that reliance on individual effort is not sustainable. It masks deeper system failures and places emotional and logistical pressure on frontline workers who are already operating in high-stress environments.
The consequences are especially severe in counties where infrastructure is limited, and distances between facilities are large. When blood is stored in one location but urgently needed in another, delays become unavoidable. This mismatch between supply and demand is one of the most persistent barriers identified in the study.
Despite these challenges, the research also points to areas of resilience and innovation. Community blood drives have shown success in increasing donations when properly organised. Some facilities have built stronger ties with local communities, improving awareness and participation.
In addition, emerging digital tools are beginning to help connect donors with patients and improve visibility of available blood stocks, although these systems are still developing.
Similar findings have been echoed by other global health organisations. The WHO has long emphasised that strong blood systems depend not only on donors but on efficient coordination, reliable infrastructure and public trust. Without these, even countries with willing donors struggle to meet clinical demand.
The study introduces an important concept called collective stewardship. This approach calls for shared responsibility among government agencies, blood banks, hospitals, community organisations, donors and patients. Rather than treating blood supply as a series of disconnected tasks, it views it as one integrated system where each part must function in harmony with the others.
Researchers argue that strengthening Kenya’s blood system will require investment in local collection and testing capacity, improved transport networks and better real-time tracking of supplies. It will also require sustained public education to shift attitudes and encourage voluntary donation, reducing reliance on family replacement systems that often slow down emergency response.
The findings offer a timely warning as Kenya continues to pursue universal health coverage. Ensuring blood is available when and where it is needed will not be achieved through technology or infrastructure alone. It will depend on trust between communities and health systems, coordination across institutions and a shared commitment to treating blood as a public resource rather than an emergency scramble.
The study ultimately reframes the conversation around blood shortages. It is not simply about scarcity, but about systems that struggle to move a vital resource efficiently through every stage of care. Fixing these gaps could mean the difference between life and death for patients across the country.
