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understanding any questions, for example, due to low literacy levels, and to explain the questions and facilitate the process for donors to provide accurate responses. A donor selection questionnaire takes considerable time to develop and should be piloted and validated as fit for purpose to ensure that all ambiguity is removed and that it yields the expected results. The questionnaire should be reviewed at frequent intervals to ensure that it is effective and should be revised in accordance with changes in the selection criteria in the national guidelines (26). Revised versions should be introduced and used uniformly in all blood donation settings. An example of a donor questionnaire is included as Annex 2. 2.3 PUBLIC INFORMATION AND DONOR EDUCATION Effective public information and donor education are the first steps in the process of donor selection. The dissemination of information on donor suitability through public awareness campaigns and donor information and education materials will help to ensure that individuals who volunteer as blood donors are well-informed and likely to be accepted. Informing potential donors about the health conditions and risk behaviour that would make them unsuitable as blood donors and the screening tests that are performed on donated blood enables prospective donors to assess their own suitability and provides an opportunity for them to self-defer (27,28). It should be made clear that there is no discrimination in donor selection on the grounds of gender, race or religion, and neither the donor nor the recipient has the right to require that any such discrimination be practised (29). Towards 100% voluntary blood donation: a global framework for action (4) provides guidance on strategies to foster a culture of voluntary blood donation, including donor information and education, for building a safe, sustainable voluntary donor base. Information materials on the donor selection process and criteria should be developed, including an explanation of their rationale and objectives. These materials should be simple and easy to understand, and written in languages suitable for the donor population. 2.4 INFRASTRUCTURE AND FACILITIES It is essential that suitable infrastructure and facilities are made available in which blood donor selection can be performed in a friendly and conducive environment. Whether it is carried out in a fixed location or mobile setting, the venue for donor selection should provide adequate privacy and confidentiality. A pleasant atmosphere for blood donation will encourage donors to relax and help to reduce anxiety. Space used for donor selection should be arranged to maximize the opportunities for confidential discussion between BTS staff and donors. 26 Sufficient, suitable and well-maintained equipment for donor health assessment should be available. This may include equipment for haemoglobin screening, sphygmomanometers, weighing scales and essential consumables, such as disposable sterile lancets, disinfectants and stationery. 2.5 FINANCIAL AND HUMAN RESOURCES A system of adequate and sustainable finances is imperative for a stable and sufficient supply of safe blood and blood products. The cost of public information programmes, donor education and donor selection is an important component of the BTS’s operating costs. A dedicated budget should therefore be allocated for training of staff, the development of information, education and communication materials, and the supply of equipment and consumables required for assessing donor suitability. Effective donor education, recruitment and selection contribute to minimizing the collection of blood from unsuitable donors, thus reducing the wastage of blood, consumables, and donor and staff time. The responsibility for donor selection and care lies with a physician or registered nurse in attendance at the donation session. An adequate number of staff should be employed to ensure proper donor assessment and selection. Staff involved in donor selection should be appropriately qualified, well-trained and skilled in providing information, advice and counselling in order to assess donor suitability for blood donation. Staff working in donor selection should have an understanding of the principles and basis for donor selection criteria and have the technical and clinical skills required to perform the health and risk assessment. The key skills, knowledge and competencies required for staff involved in donor selection include: n Understanding of the donor selection criteria n Pre-donation information and counselling n Interview and assessment based on a standardized donor questionnaire n Ability to explain questions in the donor questionnaire, ensure understanding and allay donors’ apprehensions n Basic health check, including haemoglobin screening n Counselling of deferred

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