Voluntary and non-remunerated blood donation by 2025? A comparative study of blood donor eligibility in 19 healthcare institutions in Lebanon.

Eligibility criteria in blood donation are essential to protect both donor and recipient health. This study examines variability in donor selection criteria and donor health questionnaires across 19 healthcare institutions in Lebanon amid its transition toward a voluntary and non-remunerated blood donation (VNRD) system. Notable discrepancies were identified across medical, behavioral, demographic, and geographic deferral categories. A comparative analysis against Lebanese Committee for Blood Transfusion guidelines and EU-based standards reveals a lack of centralization and inconsistent adherence to evidence-based practices. Many institutions apply precautionary deferrals not grounded in current science, leading to overly restrictive outcomes. Ethnoracial biases are also evident, with policies that disproportionately exclude migrant groups. These inconsistencies risk confusing donors, reducing trust, and undermining donor retention. The findings highlight the urgent need for standardized, equitable, and medically sound eligibility criteria. This research offers critical insights for policymakers in Lebanon and other countries navigating similar reforms toward sustainable VNRD systems.