Five year follow -up of a university initiated national voluntary non remunerated blood donation programme in a developing country

International bodies continue to recommend blood services based on voluntary non remunerated blood donation as an essential prerequisite for blood safety and adequacy. Trinidad and Tobago is a multi-ethnic, multi-religious, high income developing country with a long history of family replacement and remunerated blood donation. Delivery of blood services is fragmented across five autonomous Regional Health Authorities and policy is established by the National Blood Transfusion Service in the Ministry of Health. A voluntary non remunerated blood donor programme initiated by The University of the West Indies at one blood donation centre collected 1.8 % of the annual donations in its first three years and was accepted for national extension in 2018. The COVID-19 pandemic delayed implementation of this plan. The programme to achieve exclusive voluntary non remunerated donation nationally was launched by the Ministry of Health on World Blood Donor Day, June 14th 2022. Knowledge, attitude and practices surveys were done to gather information for communication and interventional strategies. Voluntary non remunerated blood donation was linked to restructuring of blood transfusion services across all Regional Health Authorities. Fifteen surveys identified misconceptions, knowledge gaps and socially acceptable methods of intervention. Voluntary non remunerated donations accounted for 10.8 % of the national collection in the first full year of implementation (p < 0.05). A voluntary non remunerated blood donation programme based on research, education and action has been successfully extended nationally.