Institutional Decoupling in China’s Blood Donation Reform: Bridging the Gap Between Policy Intentions and Implementation Realities

Document Type : Viewpoint

Authors

College of Humanities & Social Sciences, Huazhong Agricultural University, Wuhan, China

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Introduction

 

Healthcare quality depends fundamentally on the alignment between policy intentions and clinical realities. When well-intentioned reforms encounter complex operational realities and structural limitations, a critical divide emerges, aphenomenon widely referred to as the theory-policy-practice gap.1 ...(Read more...)

References

  1. Chinitz DP, Rodwin VG. On Health Policy and Management (HPAM): mind the theory-policy-practice gap. Int J Health Policy Manag. 2014;3(7):361-363. doi:15171/ijhpm.2014.122
  2. Law of the People's Republic of China on Blood Donation. 1997. https://www.nhc.gov.cn/fzs/c100048/201808/ea9fb73f399d4cedb1b3438825646505.shtml. Accessed September 6, 2025.
  3. Gao D, Li H, Wang K. The development of a legal framework for blood donation and blood safety in China over 24 years. BMC Health Serv Res. 2020;20(1):1099. doi:1186/s12913-020-05944-6
  4. National Health Commission: Clinical Blood Use Has Transitioned Smoothly Since the Cessation of Mutual Blood Donation. 2019. https://www.xinhuanet.com/politics/2019-06/11/c_1124607976.htm. Accessed September 7, 2025.
  5. The Lancet Haematology. Much to hope for in blood donation. Lancet Haematol. 2025;12(7):e483. doi:1016/s2352-3026(25)00173-5
  6. Ding WT. Blood Donation Data is Rising but Hospital Blood Use is Still Difficult. Economic Observer; 2024. http://m.eeo.com.cn/2024/0615/666876.shtml. Accessed September 9, 2025.
  7. National Health Commission of the People's Republic of China. Regular Press Conference. 2025. https://www.nhc.gov.cn/xcs/c100122/202506/beb54498ea2244a9b8fd2575da724daa.shtml. Accessed September 9, 2025.
  8. Watt S, Sword W, Krueger P. Implementation of a health care policy: an analysis of barriers and facilitators to practice change. BMC Health Serv Res. 2005;5:53. doi:1186/1472-6963-5-53
  9. Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013;3(1):e001570. doi:1136/bmjopen-2012-001570
  10. Gizaw Z, Astale T, Kassie GM. What improves access to primary healthcare services in rural communities? A systematic review. BMC Prim Care. 2022;23(1):313. doi:1186/s12875-022-01919-0
  11. Ping H, Xing N. Blood shortages and donation in China. Lancet. 2016; 387(10031):1905-1906. doi:1016/S0140-6736(16)30417-2
  12. Guan Y. When Voluntary donations meet the state monopoly: understanding blood shortages in China. China Q. 2018;236:1111-1130. doi:1017/S0305741018001327
  13. Zhou X. The Logic of Governance in China: An Organizational Approach. Cambridge University Press; 2022.
  14. Michel J, Chimbindi N, Mohlakoana N, et al. How and why policy-practice gaps come about: a South African Universal Health Coverage context. J Glob Health Rep. 2019;3:e2019033. doi:29392/joghr.3.e2019069
  15. Rowe R, Calnan M. Trust relations in health care--the new agenda. Eur J Public Health. 2006;16(1):4-6. doi:1093/eurpub/ckl004
  16. Yu SC, Yao YT. The influence of the COVID-19 pandemic on blood donation and supply in China. Transfus Med. 2024;34(2):124-135. doi:1111/tme.13020
  17. Gong Y, Dai Y, Ma Z, Li J. Do incentives work to motivate voluntary blood donation? Psychol Mark. 2023;40(4):656-673. doi:1002/mar.21780
  18. Meyer JW, Rowan B. Institutionalized organizations: formal structure as myth and ceremony. Am J Sociol. 1977;83(2):340-363. doi:1086/226550
  19. Dorle A, Gajbe U, Singh BR, Noman O, Dawande P. A review of amelioration of awareness about blood donation through various effective and practical strategies. Cureus. 2023;15(10):e46892. doi:7759/cureus.46892
  20. Harvey G, Kitson A. Translating evidence into healthcare policy and practice: single versus multi-faceted implementation strategies - is there a simple answer to a complex question? Int J Health Policy Manag. 2015;4(3):123-126. doi:15171/ijhpm.2015.54
  21. Li B, Wu C, Liu Z, Pan SW. Leveraging behavioral sciences to augment voluntary blood donation in china: a randomized control trial and latent class analysis. Int J Behav Med. 2025. doi:1007/s12529-025-10375-w
  22. Chen X, Liu L, Guo X. Analysing repeat blood donation behavior via big data. Ind Manag Data Syst. 2020;121(2):192-208. doi:1108/imds-07-2020-0393
  23. Endalamaw A, Khatri RB, Mengistu TS, et al. A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact. BMC Health Serv Res. 2024;24(1):487. doi:1186/s12913-024-10828-0
  24. Jomy J, Lin KX, Huang RS, et al. Closing the gap on healthcare quality for equity-deserving groups: a scoping review of equity-focused quality improvement interventions in medicine. BMJ Qual Saf. 2025;34(2):120-129. doi:1136/bmjqs-2023-017022

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History

  • Received Date: 13 October 2025
  • Revised Date: 24 December 2025
  • Accepted Date: 28 January 2026
  • First Published Date: 02 February 2026
  • Published Date: 01 December 2026

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