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Ghana collects half the blood it needs – digital approaches can improve that

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Ghana collects only about half of the blood units it needs for its healthcare system, with the National Blood Service’s 2024 collection of 187,280 units falling far short of the World Health Organization’s recommended 308,000 units. This persistent shortfall affects emergency care, surgeries and maternal health, often forcing families to find donors at critical moments. This article by Michael Head, Honghui Shen and Markus Brede, highlights structural challenges such as inadequate collection infrastructure, heavy reliance on replacement donors (family and friends), and a lack of regular voluntary donors.

Infinite Photo/Shutterstock.com

Michael Head, University of Southampton; Honghui Shen, University of Southampton, and Markus Brede, University of Southampton

It is late, the ward is crowded, and the clock is moving faster than everyone would like. A doctor has stabilised the patient as best they can, but one thing is missing – blood.

A relative is asked to “try somewhere else”, and within minutes, the family is on the phone, calling friends, contacting church groups, posting in WhatsApp chats, hoping that someone nearby is eligible, willing and able to reach the hospital in time.

In that moment, healthcare stops being only about medicine. It becomes about networks, trust and whether a lifesaving resource can be found quickly enough.

This is not an unusual drama in Ghana. It is a recurring reality, quietly shaping outcomes in emergencies, childbirth, surgery and severe illness. Ghana has made progress, but the gap between what is needed and what is available remains wide.

In 2024, Ghana’s National Blood Service collected 187,280 units of blood. This falls far short of the World Health Organization recommended annual stock requirement of 308,000 units. The consequences are tangible, including delays to surgery, difficult clinical decisions, and families carrying the burden of searching for blood at the worst possible time.

One way to gauge the scale is the “blood collection index”, defined as donations per 1,000 people. Ghana’s index increased from 5.9 in 2023 to 6.1 in 2024, but it remains well below the ten per 1,000 level that is often cited as a basic benchmark by the WHO.

The contrast is stark. The WHO’s global figures show an average (median) donation rate of 31.5 per 1,000 in high-income countries, compared with 6.6 per 1,000 in lower- and middle-income countries and 5.0 per 1,000 in low-income countries. Ghana is a low-income country, yet its donation level remains below average for this group of countries, underscoring a persistent gap between demand and supply.

Why does this matter so much? Because blood availability is not a niche issue. It underpins everyday healthcare and becomes decisive in emergencies.

Few examples are more urgent than childbirth. Postpartum haemorrhage (severe bleeding after delivery) can escalate rapidly, and survival often depends on timely transfusion.

In 2025, the WHO highlighted that bleeding following childbirth causes nearly 45,000 deaths globally each year. When anaemia is common, the danger increases further: women have less physiological “buffer” against blood loss.

Women who enter labour with severe anaemia have around seven times higher odds of dying or becoming critically ill from heavy bleeding after childbirth, compared to those with moderate anaemia. In plain terms, they start with less room for error, and without fast access to transfusion, things can spiral quickly.

So why is Ghana’s blood supply so difficult to secure? Part of the answer is structural. Blood services require investment in collection, testing, transport at the right temperature and distribution networks.

These systems must work reliably every day, not only during crises. Yet the demand is rising with population growth and expanding clinical services, while resources remain constrained. The result is a system that is often stretched, especially outside major urban centres.

Another part of the story is how donations are sourced. In many settings, a stable supply depends on a large base of regular voluntary donors. Ghana is still working towards that goal.

In 2024, voluntary donations nationwide decreased from 40% to 29%, even as regional blood centres saw some improvement. That matters because heavy reliance on replacement donors (family members or friends recruited at the point of need) creates unpredictability. Emergencies do not wait for someone to finish work, travel across town and pass eligibility screening.

Then there is trust. People don’t donate in a vacuum; they donate into a system they believe in.

In our ongoing national survey in Ghana on people’s blood donation experiences, trust is clearly concentrated in familiar and formal sources. Around nine in ten respondents report trust in requests coming from a family member or close friend, and similarly high trust in requests issued by an official hospital or clinic.

Trust drops as the source becomes more distant or less verifiable, with markedly higher scepticism towards non-hospital community donation groups and, most of all, unknown people.

Yet high trust in hospitals does not automatically translate into action. When people are unsure how blood is used, whether it reaches patients fairly, or whether it might be diverted or sold, willingness can stall.

Even when people want to help, uncertainty can lead to hesitation: “Will this really go where they say it will?” In a high-stakes context, doubt is costly.

This gap points to a transparency problem, where confidence depends not only on who makes the request, but also on whether the system can credibly show where the blood goes.

Finally, communication channels shape outcomes. When a hospital lacks a rapid, reliable way to reach suitable donors, it falls back on what is available: phone calls, personal networks and social media posts.

But social feeds are noisy, messages get buried, and not everyone has the same connectivity or social reach. The ability to mobilise donors becomes uneven, depending on who you know, where you live, and how quickly information travels.

None of this means Ghana lacks goodwill. In fact, the opposite is often true: communities respond generously when they understand a need and feel confident their help will make a difference. The challenge is that goodwill alone cannot compensate for gaps in infrastructure, coordination and trust.

Telling people to “donate more” is not a strategy if the system cannot consistently reach donors, support them and show them that their contribution mattered.

The solution?

What would meaningful progress look like? It starts with stronger hospital services and blood-bank capacity, so that safe collection, testing and storage can happen consistently.

Alongside that, Ghana needs a more organised digital way to mobilise donors: a channel that can reach the right people quickly, rather than relying on broad social media appeals that get buried, skimmed past, or spread too widely without finding eligible donors nearby.

A well-run system could also keep clear, traceable records for each donation and request, making it easier to show where blood goes and to coordinate fast, accountable responses when an emergency hits.

That is exactly the gap our research is tackling. We’re developing a hospital-linked digital platform designed for Ghana’s realities. Here, urgent requests can be sent quickly to nearby eligible donors through a trusted channel, with location-aware matching and follow-up rather than blanket posts. It also builds in transparent, auditable donation-to-use tracking, helping hospitals coordinate emergencies more efficiently while giving donors clearer reassurance about where their blood goes.

Because, in the end, the story of blood in Ghana is not only about shortages. It is about a simple question with life-or-death consequences: when someone is bleeding, will help arrive in time?

This article was commissioned in conjunction with Prototypes for Humanity, a global initiative that showcases and accelerates academic innovation to solve social and environmental challenges. The Conversation is the media partner of Prototypes for Humanity 2025.

Michael Head, Senior Research Fellow in Global Health, University of Southampton; Honghui Shen, PhD Candidate in Computer Science, University of Southampton, and Markus Brede, Associate Professor, Mathematical Modeling, Statistics and Data Science, University of Southampton

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Commentary

‘The Sahel Juntas and the Crisis of Legitimacy’ by Joseph McCarthy

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Between 2020 and 2023, military juntas seized power across Mali, Burkina Faso and Niger, promising to defeat jihadist insurgencies that civilian governments had failed to contain. Years later, the security situation has deteriorated rather than improved, with insurgents breaching heavily fortified installations and expanding territorial control. Meanwhile, elections have been indefinitely postponed under the pretext of insecurity, and military rulers have deepened their alignment with Russia to escape external pressure for democratic transitions. This analysis examines the legitimacy crisis facing the Sahel’s juntas, arguing that governments which justify their rule solely through security outcomes cannot survive when those outcomes fail to materialize. This article explores the fragility of military authority in the absence of electoral mandate, the geopolitical calculations driving alignment with Moscow, and the consequences for millions of citizens living with displacement, closed schools and expanding insurgent control.

The Sahel Juntas and the Crisis of Legitimacy

By Joseph McCarthy

When soldiers seized power across the Sahel between 2020 and 2023, they offered strikingly similar justifications. Civilian governments, they argued, had failed to protect their citizens from the advancing threat of Jama’at Nusrat al-Islam wal-Muslimin (JNIM) and the Islamic State Sahel Province (ISSP), despite years of support from France, the United Nations, the European Union and the United States. Military rule, the argument went, would succeed where democratic politics had not: it would restore state authority, defeat the insurgents and, only then, return power to civilians. Years later, the region’s security landscape raises an uncomfortable question. Has military rule delivered on that promise, and what happens to a government’s legitimacy when it has not?

The pattern of coups was remarkably consistent. In Mali, Assimi Goïta removed President Ibrahim Boubacar Keïta in August 2020, citing the army’s inability to control large parts of the north and centre. In Burkina Faso, Paul-Henri Sandaogo Damiba overthrew President Roch Marc Christian Kaboré in January 2022 on similar grounds, only to be removed himself eight months later by Ibrahim Traoré, who argued that Damiba’s own counterterrorism record was too slow. In Niger, Abdourahamane Tiani deposed President Mohamed Bazoum in July 2023, insisting that a new approach to security was needed despite Bazoum having achieved relative gains against jihadist groups. In each case, the message was the same: only military leadership could act with the speed and decisiveness that civilian rule could not.

L-R: Leaders of Mali, Niger and Burkina Faso

The record since then complicates that claim. In June 2026, JNIM fighters breached Diori Hamani International Airport in Niamey. This is one of Niger’s most heavily fortified installations, housing the air force, military drones, the headquarters of the Alliance of Sahel States’ joint force, and Russian personnel. In April, coordinated attacks across Mali, including in Kati, revealed an insurgency that has grown more sophisticated rather than less, even as military governments have intensified their campaigns. Large swathes of northern and central Mali, eastern Burkina Faso and western Niger remain outside effective state control. Millions of people are displaced, schools and clinics have shut down across rural areas, and food insecurity continues to rise. Perhaps most tellingly, JNIM has moved beyond pure military operations in parts of the territory it contests, reportedly collecting taxes, mediating local disputes and enforcing its own rules, functions that amount to governance. For juntas that justified their rule by promising to restore the state’s authority, this is a difficult reality to reconcile.

None of this has produced elections. Goïta has repeatedly extended Mali’s transition, arguing that voting while the country remains insecure would undermine its credibility. Traoré has pushed Burkina Faso’s elections back to 2029. Tiani has likewise announced a prolonged transition in Niger, citing the need for stability before any return to civilian rule. In each case, insecurity, the very problem the juntas promised to solve, has become the justification for indefinitely postponing the democratic process that was meant to follow.

This is where the deepening alignment with Moscow matters. Russian foreign policy in the region, delivered first through the Wagner Group and now the Africa Corps, has emphasised sovereignty, executive authority and non-interference rather than electoral timetables. Unlike France and other Western partners, who after the 2020 and 2021 coups pushed for sanctions and rapid transitions back to constitutional rule through ECOWAS, Russia has attached no such conditions to its military assistance. That gives the juntas diplomatic cover and security backing without the external pressure that once accompanied Western partnerships, making prolonged military rule more sustainable in the short term.

But sustainability is not the same as legitimacy. Governments that seize power through force cannot draw on the ballot box or constitutional continuity to justify their authority. Instead, they rely on a narrower and more fragile bargain: deliver security, and the question of legitimacy can wait. That bargain depends entirely on results. It is not clear that the juntas are delivering them.

This is the vulnerability now facing Goïta, Traoré and Tiani. The argument that brought each of them to power, that civilian rule had failed to stop the violence and military leadership would not, is the same argument that can be turned against them if the violence continues to escalate under their watch. A partnership with Russia may insulate these governments from external pressure to hold elections. Still, it cannot insulate them from the judgement of their own citizens, who continue to live with displacement, closed schools and expanding insurgent control. If security remains the sole justification for indefinitely concentrating political power, then the failure to secure it becomes the sole justification for questioning that power. The Sahel’s juntas are not simply fighting insurgents. They are running out of time to prove that their original argument for seizing power still holds.

Joseph McCarthy is an analyst and researcher specialising in governance, security and political transitions in the Sahel. He writes on geopolitics, development and African diplomacy. joecarthy30@gmail.com

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What Ghana’s World Cup ‘juju man’ tells us about sport and spirituality in Africa

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a large ground of people at a football stadium cheering, a man in the crown blows white powder into the air
A Ghana fan blows white powder into the air during the Ghana-England match at the FIFA World Cup on June 23, 2026. (Thogden/YouTube)

Ayodeji Ogunnaike, McGill University

One of the most notable figures of the 2026 FIFA World Cup emerged during Ghana’s first match of the tournament: the “juju man,” Kailani Ibrahim Kpa, who was famously seen blowing white powder into the air during the game.

Another Ghanaian, Nana Kwaku Bonsam, went viral just before the match for claiming to have placed a curse on England’s captain, Harry Kane. Bonsam is a particularly media-savvy Twi traditional priest and one of the most recognizable faces of what is commonly called “witchcraft” or “juju” in African soccer.

Juju quickly became a topic of conversation and fascination for millions of soccer fans around the world, particularly after Kane failed to score and the match ended in a draw.

Although it may seem strange to westerners, soccer and esoteric rituals go hand in hand in Africa. One infamous video from Rwanda that regularly circulates on African group chats shows a striker failing to score, snatching a “charm” from inside the goal and subsequently scoring.

Ghanaians in particular have a long history of leveraging the spiritual side of sports. Former captain André Ayew scattered a ritual powder on the pitch in 2012, and Bonsam himself announced he cursed Portugal’s Cristiano Ronaldo ahead of the 2014 World Cup.

This blending of spirituality and sport can be easy for westerners to misinterpret or dismiss as simple superstition. This is particularly true when spiritual fraudsters try to make money by promising to help teams win and their predictions do not come true.

However, Africans are not backwards or simple-minded. Foreign academics and even colonial officials with first-hand experience with African spiritual arts have been surprised by how effective they are at achieving their intended results.

Fortunately, we also now have excellent written accounts from Africans about the power and logic behind Indigenous knowledge and ritual systems.

African knowledge systems

Western society has developed in a context that often seeks to define and establish separate religious and secular aspects of life. However, African knowledge systems generally treat what we might call science, religion, medicine and art as parts of a unified whole.

What westerners may call “religion” is often integrated into every aspect of African life, and it is more helpful to reconceptualize its relationship to sport as the reasonable engagement with the physical and metaphysical world toward a desired end.

When I studied with a priest and diviner in Nigeria, I helped him prepare many òògùn (a Yoruba term meaning simultaneously medicine, charm and technology) to heal and prevent injuries and harm.

Because all facets of their lives have a spiritual dimension, many Black and African players and teams regularly pray together before and after matches. Germany’s Jonathan Tah and Felix Nmecha made news by joining Curaçao’s team in prayer after their match.

From this perspective, a priest offering services to a team is just as legitimate as a sports psychologist, nutritionist or physiotherapist. Each draws on a long-standing tradition of experimentation, training and the application of different technologies to support favourable results.

For example, the Senegalese wrestling sport Laamb integrates marabouts (Muslim clerics) and amulets into competitions. The marabouts function much like boxing coaches, just also with power over immaterial forces.

Unlike in Laamb, spiritual intervention in soccer was not initially conceptualized as integral to the game, but it has, sometimes covertly, been integrated into the sport in Africa. https://www.youtube.com/embed/XvNIR0AIrPs?wmode=transparent&start=0 A clip about marabouts and Senegalese Laamb wrestling (Vice Media)

Accessing a nonphysical reality

A fundamental principle of Indigenous African spiritual systems is that all materials also have a nonphysical reality, and they can be used to effect change on that nonphysical level.

Powders, like those scattered by Ayew or Kpa seemed to blow, frequently contain dried, ground or burned natural substances with some characteristic related to the desired outcome.

These substances can be placed on or in a body, or important places such as a door frame or goal, to prevent things from entering. This is why the striker in the Rwandan example I mentioned removed the charm from his opponents’ goal while his opponents desperately tried to get it back.

Other common approaches include reciting incantations or soaking the body in ritual baths. Some also involve using flames to burn away or scatter dark and malevolent forces, like those I saw in a pot on the head of a Ghana fan at the 2010 World Cup.

Mischaracterization and prejudice

Europeans have often mischaracterized African ritual and knowledge systems as “black magic,” “witchcraft,” or “superstition” to justify a sense of religious, cultural and racial superiority over Black people. African religious practices and experts are also still frequently and pejoratively called “fetishism” and “witch doctors.”

The prejudice toward and dismissal of these practices and practitioners has driven many underground, but they are still ubiquitous in African society. Such pejorative attitudes were evident during Bonsam’s recent interviews in western media.

While I worked with the Nigerian diviner, people who might be considered “modern” and operating in secular spheres from a western perspective — such as university students, prominent business people and even politicians — regularly came for spiritual and professional help, which they understood as one and the same.

Athletes are particularly aware that talent and hard work are not always enough to ensure victory. Africans and non-Africans alike generally recognize that there are forces beyond their control at play, even if some might generically conceptualize those forces as “luck.” And even spiritual services are no guarantee of victory if the other side has access to them too.

It is unclear if Kpa’s powder was actually ritual material or simply a demonstration of cultural heritage, like Norway’s Viking row. However, after the goalless Ghana match, Kane did go on to score against Panama once Bonsam said he had “released” the Englishman.

Kpa and Bonsam unsurprisingly captivated African and non-African soccer fans, even if their actions may have been less legible to some. Beyond the World Cup, what may be more interesting is how both men represent an ancestral knowledge tradition that is thousands of years old, and they are merely a visible part of the invisible spiritual dimension of sport in Africa.

Ayodeji Ogunnaike, Assistant Professor of African Religions; Canada Research Chair (Tier 2) in the Globalization of African Religions and Yoruba Mythology, McGill University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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The Sahel is Burning, and West Africa Cannot Look Away

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JNIM now strikes at capitals and governs territory, and the bet that Mali, Burkina Faso, and Niger placed on Russia as their sole security guarantor has failed. Analyst and researcher Joseph McCarthy writes that the fire will not stop at the Sahel’s borders, and Ghana stands directly in its path.


The Sahel is Burning, and West Africa Cannot Look Away

By Joseph McCarthy

At dawn on 18 June 2026, fighters stormed Diori Hamani International Airport in Niamey, the most heavily guarded site in Niger’s capital. It is not merely an airport. The complex houses the air force, most of the country’s drones, the headquarters of the Alliance of Sahel States’ joint force, the Russian personnel meant to help crush the insurgency, and even uranium stocks the state hopes to sell. JNIM claimed the assault, which killed eleven soldiers and two civilians. It was the second strike on that complex this year; the Islamic State’s Sahel Province claimed a January raid. Both of the region’s jihadist franchises have now breached the defences of a capital. This was not just another attack. It was a strategic signal.

It was also no act of opportunism. Hitting a fortified installation in a capital demands months of surveillance, intelligence on shift changes, the logistics to move fighters and weapons over long distances, and the ability to slip past layered security. It implies networks operating close to, or inside, the capital itself. As the Armed Conflict Location and Event Data project noted, the Sahel’s insurgents have moved from localised rural fighting to coordinated strikes on vital national infrastructure. The pattern is everywhere. In Mali, JNIM has throttled Bamako with a fuel blockade since September 2025, destroying hundreds of tankers; in April, it overran the garrison town of Kati and killed the defence minister in his own home; it has since placed a bounty of two million euros on the head of Mali’s junta leader, Assimi Goïta.

More troubling than the firepower is the governance. A Reuters investigation found that JNIM now arbitrates land disputes, collects taxes, enforces rules and imposes a rough order in territories the state has vacated. Forged from the merger of four groups, it increasingly presents itself not as a militia but as an alternative authority, building legitimacy among populations long neglected by distant governments. History is unkind here: from Afghanistan to Somalia, insurgencies that learn to govern outlast those that only fight. The contest is no longer simply about defeating armed men. It is about whether the state, rather than an armed movement, remains the most credible source of authority, justice and security.

Against all this, the juntas made a bet. Mali, Burkina Faso and Niger expelled Western forces, walked out of ECOWAS, and rebuilt their security around a single guarantor: Russia, first through the Wagner Group, then the Africa Corps. On 26 June, Burkina Faso severed diplomatic relations with France entirely, accusing Paris of backing the very terrorists it claims to fight, an allegation offered without evidence and flatly rejected. Niger’s government, for its part, blamed the Niamey attack on mercenaries funded by President Macron, again without proof. The promise was straightforward: sovereignty restored, foreign influence reduced, terrorism defeated. Judged by the junta’s own promise, the bet has failed. The violence has not receded. It has spread.

This should not be read as a uniquely Russian failure. It exposes the limits of any strategy built around a single external guarantor. No partner, whether Russia, France or the United States, can resolve a conflict rooted in governance failure, economic exclusion, local grievance and hollow institutions. Force can kill fighters. It cannot rebuild public trust, settle a quarrel between communities, open a clinic or create a job for an idle young man, and those are the very conditions the insurgents harvest for recruits. Russia carries constraints of its own: bogged down in Ukraine, its resources finite, it was outfought alongside Malian troops at Kidal even after reportedly receiving a warning of the assault. A security architecture resting on a single distracted partner does not reduce risk; it concentrates it, and when that partner underdelivers, there is no second line. The 2026 Global Terrorism Index now names the Sahel the global epicentre of terrorism, the source of more than half the world’s terrorism deaths and one in five of its attacks.

None of this stays in the Sahel. Ghana shares roughly 550 kilometres of frontier with Burkina Faso, much of it porous and threaded with informal crossings used daily by traders and herders. Southward expansion rarely begins with a spectacular attack. It begins quietly: a recruiter, a supply route, a financing cell, fighters embedding in border communities long before a shot is fired. That is precisely how the contagion crossed from Mali into Burkina Faso and Niger, and how it has already reached Benin and Togo, with Côte d’Ivoire and northern Ghana plainly exposed. Alongside the fighters’ travels, something almost as corrosive: a flood of assault rifles, explosives and military hardware that does not stop at extremist hands but arms robbers, traffickers and illegal mining syndicates, hollowing out a country’s security long before any jihadist banner appears.

The wider world has its own reasons to watch. Niger holds some of the planet’s richest uranium. A jihadist proto-state straddling West Africa would command migration routes toward the coast and the Mediterranean, strain fragile coastal economies, disrupt trade corridors and rattle investor confidence. At the same time, every successful strike on a capital broadcasts a template to armed groups from Nigeria to Mozambique. What looks today like a regional security crisis could become an international one. A region generating one in five of the world’s militant attacks is not a distant problem. It is a lit fuse.

Africa has paid before for believing that outside powers can guarantee its security. They cannot. Partners can offer intelligence, training and equipment; they cannot substitute for legitimate governance and functioning institutions. This crisis will be settled not only on the battlefield but in courtrooms, classrooms, local councils and marketplaces, where citizens decide whether the state or an armed movement better delivers justice and opportunity. For Ghana, the task is preventive, not reactive: intelligence cooperation, stronger borders, regional collaboration, community resilience and investment in local governance, all of it far cheaper than containment once the violence has taken root. And for the Sahel’s rulers, there is a harder truth.

Sovereignty that trades several partners for total dependence on one distant and overstretched power is not sovereignty; it is a fresh vulnerability dressed in the language of liberation. The question is no longer whether the crisis will spread beyond Mali, Burkina Faso and Niger. It already has. The only question left is whether West Africa acts before the Sahel becomes the world’s next strategic emergency.

Joseph McCarthy is an analyst and researcher specialising in governance, security, and political transitions in the Sahel. He writes on geopolitics, development, and African diplomacy. Email: joecarthy30@gmail.com

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