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Table of Contents
ORIGINAL ARTICLE
Year : 2018  |  Volume : 6  |  Issue : 1  |  Page : 18-21

An evaluation of barriers to blood donation from a tertiary care teaching institution


1 Department of Internal Medicine, Shaheed Hasan Khan Mewati Government Medical College, Nuh, Haryana, India
2 Department of Ophthalmology, Shaheed Hasan Khan Mewati Government Medical College, Nuh, Haryana, India
3 Department of Community Medicine, Shaheed Hasan Khan Mewati Government Medical College, Nuh, Haryana, India

Date of Web Publication05-Nov-2018

Correspondence Address:
Dr. Abhishek Singh
Department of Community Medicine, Shaheed Hasan Khan Mewati Government Medical College, Nuh, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JIHS.JIHS_7_18

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  Abstract 


Introduction: The demand for blood transfusion is increasing over time, and we need to cope up with this demand. The aim of this study was to evaluate the perceived barriers to blood donation and to assess any association between the demographic variables with the barriers predicting blood donation. Methodology: This cross-sectional study was carried out for 3 months, i.e., from July to September 2015. All patients who never donated blood were included in this study. Purposive sampling technique was adopted. Study participants were interviewed using a pretested questionnaire. Results: A total of 150 patients were enrolled into the study. The variables that were significant in the univariate model included male gender, age group 25–44 and older, and education more than 10th standard. Perceived barriers to blood donation were fear of needles (29.33%), too inconvenient (28.67%), and fear of collapse after donating blood (24.67%). About 17.33% were of the view that they might contract the disease in the process of blood donation. 17.33% cited a reason for not donating blood as lack of time. Nearly 8% of participants had a fear of seeing blood. Five percent were of the view that blood donation reduces the lifespan. Of the barriers, which negatively predicted blood, donation was fear of pain, fear of seeing blood, fear of anemia, and no access to the blood bank. Conclusion: Based on inputs of this study, community outreach activities such as blood donation campaigns may be initiated to alleviate people's fear of blood donation. Health authorities can utilize this data to tailor the interventions to raise voluntary blood donation rates.

Keywords: Barriers, blood donation, voluntary


How to cite this article:
Singh AA, Kaur M, Singh A. An evaluation of barriers to blood donation from a tertiary care teaching institution. J Integr Health Sci 2018;6:18-21

How to cite this URL:
Singh AA, Kaur M, Singh A. An evaluation of barriers to blood donation from a tertiary care teaching institution. J Integr Health Sci [serial online] 2018 [cited 2018 Nov 13];6:18-21. Available from: http://www.jihs.in/text.asp?2018/6/1/18/245028




  Introduction Top


Blood donors are lifesavers in the true sense. Round the clock availability of safe blood and blood products is a critical factor for any health-care center. Nearly half of blood donations across the globe occur in the high-income countries while <45% of donated blood is collected in developing and transitional countries, where approximately 80% of the world's population stay.[1],[2] Average blood donation rates are 33.1 donations per 1000 people in high-income countries, 11.7 donations in middle-income countries, and 4.6 donations in low-income countries.[3]

As per the World Health Organization (WHO), for any country to meet the minimum demand for blood, the collection should be at least 1% of the total population.[4] The demand for blood transfusion is increasing over time because of the increase in the number of serious unintentional injuries, advanced surgical procedures, and the treatment of hematological disorders and cancers. On the other hand, because of a higher risk of transmitting infections from paid donors, the WHO recommends to collect blood only from voluntary and unpaid donors, which makes it more challenging to meet the demand.[5],[6]

Targeted and tailored interventions cannot be designed unless local barriers are identified. As per the available information from the regional blood bank, the average number for blood donations is insufficient to meet the local requirements. However, no study has been done in this area to identify the barriers to blood donation. To fill this gap, this study was undertaken to evaluate the perceived barriers of blood donation and to assess any association between the demographic variables, the barriers to predicting blood donation from a tertiary care teaching institution.


  Methodology Top


The present cross-sectional study was carried out in the Department of Internal Medicine of a tertiary care teaching institution from northern India for 3 months, i.e., from July to September 2015. Patients seeking care at the outpatient department of the Department of Internal Medicine during the study period formed the study population.

Purposive sampling technique was adopted. A total of 150 patients were enrolled in this study. The study adhered to the tenets of the declaration of Helsinki for research in humans. Informed consent was obtained from all the study participants. Study participants were interviewed using a pretested questionnaire. Sociodemographic information related to age, sex, education, etc., was collected. Socioeconomic status was assessed based on the modified BG Prasad classification scale. All the questionnaires along with other relevant data were manually checked and were then coded for computer entry. After compilation of the collected data, the analysis was performed using Statistical Package for Social Sciences, version 20 (IBM, Chicago, USA). The results were expressed using appropriate statistical methods.

To find the predictors of blood donation from some demographic variables, and barriers, univariate and multivariate regression analyses were done. Those who ever donated blood was coded “1” and those who did not donate blood was coded “0.” The association of blood donation was assessed for the demographic variables and perceived barriers. Univariate odds ratio (OR) estimation was followed by the derivation of different multivariate models through logistic regression with forward entry and forward step-wise methods and the best multivariate derived model was selected. A two-tailed P < 0.05 was considered statistically significant.


  Results Top


A total of 150 patients were enrolled for this study. The mean age of study participants was 30.5 ± 8.2 years, ranging from 17 to 76 years. About 20% (n = 31) of the participants were <25 years of age, 63% (n = 95) were from 25 to 44 years, and 16% (n = 24) were >45 years. Females (57.3%, n = 86) outnumbered male (42.7%, n = 64) participants. The majority (64.67%, n = 97) of the people were educated to 10th standard or below. Nearly 65% of participants belonged to low socioeconomic status [Table 1].
Table 1: Baseline characteristics of study participants

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Following reasons were elicited by study participants in response to a question on why you never donated blood. Top three barriers to blood donation were fear of needles (29.33%), too inconvenient (28.67%) and fear of collapse after donating blood (24.67%). 17.33% were of the view that they might contract the disease in the process of blood donation. 17.33% cited a reason for not donating blood as lack of time. Eight percent of participants had a fear of seeing blood. Five percent were of the view that blood donation reduces lifespan [Table 2].
Table 2: Perceived barriers to blood donation

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To ascertain predictors of blood donation, the variables those were significant in the univariate model included male gender, age group 25–44 and older (P < 0.001), and education more than 10th standard (P < 0.001). Of the barriers, which negatively predicted blood donation were fear of pain (P = 0.04), fear of seeing blood (P = 0.02), fear of anemia (P < 0.001), and no access to the blood bank (P = 0.034). In multiple logistics regression model, the variables that remained significant after controlling for the confounders included male gender (P < 0.001), age group 25–44 (P = 0.018), age group 45 and older (P < 0.001), and fear of anemia (P = 0.003) [Table 3].
Table 3: Factors associated with blood donation

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  Discussion Top


In this study, we observed that females did not participate in blood donation. It could be because females are usually not involved in outdoor activities. Thus, opportunities for blood donation are less as compared to males. In Saudi Arabia, the rate of blood donation in males was five times as common as in females (66% vs. 13.3%, respectively, P < 0.001).[7] Similarly, males outnumbered the females in blood donation (67% vs. 33%, respectively) in the Iranian population.[8]

Not surprisingly, our study shows that the majority of the people who did not donate blood were educated to 10th standard or below. This finding was consistent with the studies conducted in Gondar, which indicated that secondary and higher educational status were significantly associated with adequate knowledge toward voluntary blood donation.[9] Another study in Saudi Arabia also reported that the knowledge about blood donation level increased progressively with the increase in the educational level (P < 0.001).[10]

In this study, we observed that nearly 65% of participants who never donated blood belong to low socioeconomic status. It could be because low socioeconomic status is usually associated with poor education; hence, low levels of knowledge for blood donation. Low socioeconomic status (OR = 4.47, 95% confidence interval 2.11–15.06) was found to be significantly associated with poor knowledge regarding blood donation in a study by Singh et al.[11] This is in contrast to another study by from Benin City of Nigeria in which Nwogoh et al. showed that health-care workers had a good knowledge and positive attitude toward blood donation, but no significant association was observed between the level of education and blood donation in that study.[12]

In our study, the top three barriers to blood donation were fear of needles (29.33%), too inconvenient (28.67%), and fear of collapse after donating blood (24.67%). About 35% feared about getting new infections and no time for blood donation (17.3% each). Eight percent of participants had a fear of seeing blood. Another study from Himachal Pradesh reported fear of needle, fear of anemia after blood donation and objection from family members as the reasons for not donating blood among the respondents.[13] Other observed reasons for nondonation include nobody approached them for donation (25.2%), unfit to donate (16.5%), need to donate for a friend or relatives in future (19.7%), fear of needle (6.3%), and fear of knowing their screening status (3.1%).[14]

This study is unique and special in the sense that it identified the local barriers, which prevented people from donating blood. These barriers included fear of pain, fear of seeing blood, fear of anemia, and difficulty in accessing blood donation centers. It is worthy to note that most of the barriers identified are amenable for intervention in the country. Another study from the United States showed that the major reasons for not donating blood were ineligibility due to medical reasons, fear of needles and pain and inconvenience. Blood donation agencies should take serious attempts to lessen the myths fears, and wrong conceptions about dangers of blood donation.[15] Another study by Al-Haqqan et al. is also in concordance with our observations. He also studied barriers regarding blood donation in Kuwaiti population and observed that male gender, middle and older age, knowledge score, fear of getting new infection, and fear of anemia remained significant predictors of blood donation.[16]

This study has several strengths. We gave a fair attempt to identify the local barriers to blood donation. The finding of this study has policy implications. Health authorities can utilize data to tailor the interventions to raise the voluntary blood donation rates. This study had some limitations. Our data collection instrument was not an objective measure since it relied on the self-reported response of the people, which may be susceptible to information bias. Temporal association of knowledge and attitude on blood donation practice cannot be definitely established due to the nature of the cross-sectional study design.


  Conclusion Top


Based on inputs of this study, community outreach activities such as educational programs and blood donation campaigns may be initiated to alleviate people's perception about the barriers. Health authorities can utilize data to tailor the interventions to raise the voluntary blood donation rates.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Singh P, Gupta RK, Shora TN, Langer B, Kumari R, Gupta R. Gender based knowledge, attitude and practice study about blood donation among medical students in a sub-Himalayan state. Int J Res Med Sci 2017;5:1882-7.  Back to cited text no. 1
    
2.
Chopra D, Jauhari N. Knowledge attitude and practices towards voluntary blood donation among medical students in Barabanki. Ind J Community Health 2015;27:386-90.  Back to cited text no. 2
    
3.
Bharucha ZS. Donor management in South East Asian region. Dev Biol (Basel) 2005;120:145-53.  Back to cited text no. 3
    
4.
World Health Organization Towards 100% Voluntary Blood Donation: A Global Framework for Action; 2010. Available from: http://www.who.int/bloodsafety/publications/9789241599696/en/. [Last accessed on 2017 Sep 02].  Back to cited text no. 4
    
5.
World Health Organization Safety WB, Availability-Fact Sheet N 279; 2014. Available from: http://www.searo.who.int/thailand/factsheets/fs0029/en/. [Last accessed on 2017 Sep 02].  Back to cited text no. 5
    
6.
Dubey A, Sonker A, Chaurasia R, Chaudhary R. Knowledge, attitude and beliefs of people in North India regarding blood donation. Blood Transfus 2014;12 Suppl 1:s21-7.  Back to cited text no. 6
    
7.
Abolfotouh MA, Al-Assiri MH, Al-Omani M, Al Johar A, Al Hakbani A, Alaskar AS, et al. Public awareness of blood donation in central Saudi Arabia. Int J Gen Med 2014;7:401-10.  Back to cited text no. 7
    
8.
Mousavi F, Tavabi AA, Golestan B, Ammar-Saeedi E, Kashani H, Tabatabaei R, et al. Knowledge, attitude and practice towards blood donation in Iranian population. Transfus Med 2011;21:308-17.  Back to cited text no. 8
    
9.
Melku M, Terefe B, Asrie F, Enawgaw B, Melak T, Tsegay YG, et al. Knowledge, attitude, and practice of adult population towards blood donation in Gondar Town, Northwest Ethiopia: A Community based cross-sectional study. J Blood Transfus 2016;2016:7949862.  Back to cited text no. 9
    
10.
Alfouzan N. Knowledge, attitudes, and motivations towards blood donation among king Abdulaziz medical city population. Int J Family Med 2014;2014:539670.  Back to cited text no. 10
    
11.
Singh AA, Kaur M, Singh A, Khan H, Goel S, Mengi A, et al. Rapid appraisal of factors impacting the blood donation process from rural Haryana. Indian J Sci Res 2015;6:87-90.  Back to cited text no. 11
    
12.
Nwogoh B, Aigberadion U, Nwannadi A. Knowledge, attitude and practice of voluntary blood donation among healthcare worker at the university of Benin teaching hospital, Benin city, Nigeria. Blood Transfus 2013;797830:6.  Back to cited text no. 12
    
13.
Meinia SK, Kumar Y, Meinia A, Singh G, Dutt N. A study to assess the knowledge, attitude, and practices about voluntary blood donation amongst the undergraduate medical students in Solan, North India. Int J Med Sci Public Health 2016;5:2550-4.  Back to cited text no. 13
    
14.
Mulatu K, Hailu T, Yegezu A, Tena B. Assesment of knowledge, attitude and practice on blood donation in Aman sub city residents, South West, Ethiopia, 2015. Health Sci J 2017;11:1.  Back to cited text no. 14
    
15.
Shaz BH, Demmons DG, Crittenden CP, Carnevale Cdents. Transfus Apher Sci 2009;41:191-7.  Back to cited text no. 15
    
16.
Al-Haqqan T, Husain A, Al-Kandari N, Al-Rashidi L, Al-Daihani N, Mitra AK. A Cross-Sectional Study of Knowledge, Attitude, Practice, and Barriers Regarding Blood Donation among General Population in Kuwait. Int J Community Fam Med 2016;1:120. Available from: https://www.graphyonline.com/archives/archivedownload.php?pid=IJCFM-120. [Last accessed on 2018 Aug 25].  Back to cited text no. 16
    



 
 
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  [Table 1], [Table 2], [Table 3]



 

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