This example is longer than 3 pages because the instructions for each section have been included.EXAMPLE
Policy Analysis Brief
Increasing U.S. Blood Supply by Increasing Donations
1. Problem statement This section defines the problem being addressed in the analysis, using one sentence, usually in the form of a question. The problem statement should be phrased broadly enough to lead to the possibility of several options. No recommendation is contained or implied in the problem statement.
How can the U.S. double the amount of whole blood collected from donors?
2. Background This section explains why a problem has been chosen for analysis, and provides the basic facts and information necessary to understand the problem being addressed.
The US blood inventory has been stressed by higher blood consumption from advances in surgeries and cancer treatment. At the same time, the voluntary donation rate, which was already low, has declined further due to tightened blood donation criteria, seasonal shortages, and aging of the blood donor population. The coronavirus has also discouraged many lifelong donors from donating.
Approximately 36,000 units of red blood cells are needed every day in the U.S., including 7,000 units of platelets and 10,000 units of plasma. Nearly 21 million blood components are transfused each year in the U.S. For example, sickle cell disease affects 90,000 to 100,000 people in the U.S., and about 1,000 babies are born with the disease each year. Sickle cell patients can require blood transfusions throughout their lives. 4.5 million Americans will a need blood transfusions each year.
Blood agencies cannot meet the current demand. As a result of covid-19, blood centers across the country are reporting inventories falling to their lowest levels since the early stages of the pandemic. Blood drives have been repeatedly canceled, as many businesses, high schools and community organizations remain partially closed, and social distancing measures have limited blood centers’ ability to collect blood at pre-pandemic levels. Nearly 2,700 Red Cross blood drives have been canceled across the country, resulting in 86,000 fewer blood donations.
The “critical situation” involving the blood shortage now facing the U.S. has received national attention (see Christopher Flavelle, “Red Cross Warns of a ‘Staggering’ Drop in Blood Supplies,” NY Times, June 2, 2020.) For example, the American Red Cross blood inventory is down to a 2-day supply and is no longer able to respond to some hospital requests for blood deliveries. Hospitals and physicians must now decide which patients may receive blood among the many requests. The situation has reached a crisis.
The major problem is that historically only about 3% of the U.S. population donate blood. The other 97% of the population have been relying for decades on that small minority of donors to contribute the entire nation’s blood supply. If there were a way to expand the donor pool, the blood shortage could be easily solved.
3. Landscape This section provides the overall context of the issue by identifying key stakeholders and the issues that should be considered when analyzing the problem. Which stakeholders will be included depends on the issue being analyzed and the phrasing of the problem statement. Examples of the aspects of a problem that a policy analyst may discuss in this section include political factors, social factors, economic factors, legal factors and practical factors.
The US Food & Drug Administration requires that blood from paid donors must be labeled as such. Hardly any blood from paid donors is used in the US healthcare system, because the FDA has warned that donors with bloodborne illnesses may lie about their medical history and their risk behaviors in order to receive payment for their blood. The World Health Organization also discourages countries from paying blood donors because of the increased risk of contamination. Additionally, blood agencies such as the American Red Cross consider it unethical to pay donors for their blood.
Characteristics of blood donors:
People with bachelors and masters degrees are more likely to donate blood than people with less education
People with higher incomes are more likely to donate blood than people with lower incomes
Married people donate at higher rates than single people
Non-smokers donate more than smokers
Physically active people donate more than those who seldom exercise
Native-born Americans donate more often than foreign-born Americans
Males donate more frequently than females
The Philanthropy Roundtable has reported that conservatives and Republicans are more likely to donate blood than liberals and Democrats. Similar findings have been reported by Professor Arthur Brooks at Syracuse University. As reported by Nicholas Kristof in the New York Times, “If liberals and moderates gave blood as often as conservatives…the American blood supply would increase by 45 percent.”
The worsening blood supply has received extensive coverage by the U.S. media. Examples of recent headlines:
EDITORIAL: Coronavirus leads to urgent need for blood, The Daily Gazette
Effects of the COVID-19 pandemic on supply and use of blood for transfusion, The Lancet
Roll up your sleeves, Nashville: Blood donations urgently needed amid coronavirus, Fox17 Nashville
COVID-19 drains blood supply to historic low in Harrisburg region, Pennlive
Blood supply suffers as coronavirus pandemic continues, Alabama News Center
Hospitals in ‘dire need’ of blood as elective surgeries restart, ABC News
Uptick in elective surgeries causes blood shortages in eastern Iowa, Local 5 News
According to the American Association of Blood Banks, 38% of Americans are medically eligible to donate blood. However, according to the American Red Cross, only about 2.1% of Americans actually donate their blood each year. Millions of Americans who are physically fit would be suitable blood donors, but the vast majority of these eligible donors apparently have other priorities and prefer not to donate.
4. Options Analysis This section should provide three to five options for the reader to consider. Each option should address the challenge summarized in the problem statement and should be within the power of the client organization to do. This section should also identify the criteria that will be used to evaluate the options, and should identify pros and cons for each option. A side-by-side table may clarify the options discussed in this section.
Blood banks try to develop strategies and incentives to retain donors, such as a shorter waiting time, more personal attention, entertainment, enhancing blood donor satisfaction, minimizing adverse reactions of donation and offering a convenient and accessible place to donate. Policy options to increase the number of donors include the following:
Pay blood donors
Studies have shown that financial incentives usually backfire by discouraging pro-social behaviors like blood donation and will reduce the number of blood donors in long term. Note also that the FDA has warned that donors with bloodborne illnesses may lie about their medical history and their risk behaviors in order to receive payment for their blood. The World Health Organization also discourages countries from paying blood donors because of the increased risk of contamination. Other studies have shown that using direct financial incentives may attract at-risk donors, and even worse, may undermine the motivation to voluntarily donate blood.
Give donors souvenirs and trinkets
Blood procurement organizations could give donors minimal value items or incentives for donating blood, such as t-shirts, event tickets, museum vouchers or even lottery drawings for televisions or computer laptops. However, this is already being done at many blood drives, yet many of the most reliable blood donors decline such offers, because these souvenirs are not the reason they donate.
Give donors time off from work
Some states require private employers to provide time off from work for blood, bone marrow or organ donations. Additionally, many companies offer this benefit to their employees who donate. However, this is already being done by most employers, even in states that do not require companies to give time off from work.
Blood assurance programs
These programs reward blood donors by assuring that up to three of their own family members will be guaranteed access to whole blood if they need it, at no out-of-pocket charge, for up to one year following the date of blood donation. However, this strategy is already being used by many blood procurement organizations.
Involuntary blood extraction from medically qualified citizens
This option would require people who are medically qualified, but who have never voluntarily donated blood, to donate blood against their will. Names of people who will be forcibly compelled to donate blood will be selected by the government, following review of confidential medical records. Individuals who refuse to report as directed for their mandatory blood drawing will be subject to fines and imprisonment.
Criteria for Policy Comparison
Effectiveness – likelihood the option will actually double the current amount of blood obtained for the U.S. inventory, as measured by whether the option will achieve 86,000 pints of blood per day. Alternatively, effectiveness can be measured by the number of patients who receive transfusions each day, in excess of the number currently receiving the existing 43,000 units obtained under current blood acquisition policies. This important segment of the population would represent “additional blood recipients helped.”
Cost of implementation, as measured by the estimated dollar amount required
Sociopolitical feasibility – extent to which the proposed option aligns with existing cultural values and beliefs that are prevalent in American society, as measured by the percent of waiting blood recipients who deem this mandatory program to be appropriate to meet their medical needs.
Equity – extent to which the option is expected to change the distribution of burdens and benefits in society to achieve a more balanced allocation of blood.
5. Recommendation This section should choose one of the options as the recommended course of action for the client organization. Note that doing nothing by maintaining the status quo may be an option. For the recommended option, this section should summarize why this option is better than the others, despite the disadvantages that may be associated with the option. Identify any action that may be taken to mitigate the disadvantages associated with the recommended option.
Effectiveness
Cost
Sociopolitical
Equity
Pay donors
3
1
3
3
Give souvenirs
1
2
5
4
Time off from work
1
3
5
4
Blood assurance
1
3
5
3
Involuntary blood extraction
5
5
4
5
1 = weak support for this option 5 = strong support for this option
Involuntary blood extraction from otherwise healthy individuals who have never donated before, is the recommended option. The typical adult human has 8-12 pints of blood in their body, and if the individual is otherwise healthy, that quantity is more blood than their body really needs. According to Memorial Sloan Kettering, it will only take their bodies four to eight weeks to completely replace the red blood cells that were withdrawn from them. The people who are forced to give blood will probably not notice any adverse physical changes related to the pint they donated because after all, they already have more than they need. The number of blood donors who are forced to give blood will be limited to the number needed to achieve 86,000 pints of blood per day. Once that total has been reached, the remaining individuals who have been rounded up may be released to return to their private lives.
Since approximately 97% of Americans do not donate blood, they obviously see nothing wrong with the majority of the population depending on a small minority to produce enough blood for everyone. So if an additional few percentages of the U.S. population are inconvenienced and possibly opposed to the new policy that takes their blood involuntarily, it is unlikely that the majority of the population would care.
The advantage of this option is that it will maximize “additional blood recipients helped” and will benefit millions of Americans who truly need blood, by simply taking blood from others whose bodies contain more blood than they need. In this sense, when the government re-distributes blood from those who have extra blood to transfuse into those who are in critical need of blood, the government will be upholding the principles of fairness and morality. By focusing on the common good, this approach will achieve a solution that is more equitable by achieving the greatest good for greatest number of people. This option will improve the distribution of burdens and benefits in American society, by acknowledging that we must all share what we have with one another to achieve the greatest equity in society. It would be hard to think of a reason why millions of Americans who need blood should suffer, simply because some selfish people who are perfectly healthy, dislike helping others so much that they prefer to keep their own blood.
This submission would probably receive a grade of B-minus. Although the supporting background data are helpful in understanding the problem, and although the proposed solution is likely to be effective and likely to dramatically improve social equity and fairness of blood collection, the proposed solution is overly simplistic, crudely authoritarian, disrespectful of the rights of a small minority and questionable on the important criterion of sociopolitical feasibility. Using the urgency of the need for blood that is experienced by those waiting for blood is a crude, one-dimensional measure of sociopolitical feasibility. The proposal is not balanced because it overlooks the opposition and the negative consequences of forcible, involuntary blood drawing. The proposed solution also neglects to provide an estimate of the cost of implementation.
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