Psychosocial outcomes of medical specialty camps for children with physical disabilities.

The World Health Organization (WHO) and the International Federation of Red Cross and Red Crescent Societies have called for the global elimination of family/replacement and paid blood donation systems by 2025, advocating instead for voluntary and non-remunerated blood donation (VNRD) as the most sustainable and ethical model (). A key factor in achieving VNRD is the consistency of donor eligibility policies across healthcare institutions (HIs). While individuals decide whether to donate, their experiences – shaped by recruitment, questionnaires, selection criteria, and deferral outcomes – influence perceptions of eligibility and willingness to donate (; ; ). As this study shows, a donor accepted at one hospital may be permanently deferred at another, creating confusion and undermining the perceived legitimacy of the VNRD system. A transparent, standardized framework can build trust and support sustained donor engagement by addressing the complex interplay between individual motivation and institutional regulation (). While past research has focused on donor compliance, retention, and recruitment (; ), it has also emphasized how contextual and institutional factors shape donor behavior. Tailored communication strategies and questionnaire design are known to improve engagement (; ). Beyond individual factors, institutions play a foundational role: situates donation within moral economies, highlighting how infrastructures and institutional logics mediate altruism. extend this view, showing how bureaucratic norms and transnational policy frameworks shape participation across Europe. These studies position donation not merely as a biomedical or behavioral act, but as a structurally contingent process shaped by how institutions define and operationalize eligibility. In this context, Lebanon’s decentralized blood system offers a critical case. Although it records the highest whole blood donation rate in the Eastern Mediterranean (29 per 1000 people), its VNRD rate is among the lowest – just 4.1% (). With no central national blood bank, the country relies largely on fragmented, hospital-based services and family or replacement donations (). To align with WHO goals, Lebanon aims to raise hospital-based VNRD to 30% and Lebanese Red Cross (LRC) center-based VNRD to 60% by 2025 ().