Blood donation practice and its associated factors among health professionals of University of Gondar Hospital, Northwest Ethiopia: a cross sectional study

Blood is an essential element of human life and there are no substitutes for it [1]. World Health Organization (WHO) proposes countries to focus on young people to achieve 100% non-remunerated voluntary blood donation by 2020 Dhingra [2]. Donated blood can be life saving for individuals who have lost large volumes of blood from serious accidents, obstetric and gynecological hemorrhages, or surgery and stem cell transplant patients as well as for individuals who have symptomatic anemia from medical or hematologic conditions or cancers. Therefore, blood is an important concern to the society. The use of these lifesaving products may be complicated by infectious and immunological diseases some of which could be life threatening [3].

The blood donation is the only source of blood but the recruitment of voluntary, non-remunerated donors is the most important challenge throughout the world [4]. Blood is the essence of life, and is one of the most precious donations. Blood services are facing shortage of blood all over the world. Demand for blood is rising alarmingly and current blood donation is insufficient to meet the demand [5]. The only source of blood is by blood donation [6]. Globally, 80 million units of blood are donated each year, but only two million units are donated in sub-Saharan Africa where the need is very high [7]. In sub-Saharan Africa (SSA), out of the estimated need of 18 million units of safe blood per year, merely about 15% were collected [8].

Adequate and safe blood supply has remained a challenge in developing countries like Ethiopia [9]. In Ethiopia, there has been gross inadequacy and in equitability in access to blood. The national requirement for blood in Ethiopia is between 80,000 and 120,000 units per year but only 43% is collected [10].

Blood banks have a duty to provide adequate and safe blood to the community. Generally, donors are classified as: voluntary, family replacement remunerated or paid donors, and autonomous donors. The risk of transfusion transmissible diseases is highest with the use of blood procured from remunerated donors. A person who is in need of money is more likely to hide his/her true state of health [3].

Many studies have been conducted to determine people’s knowledge, attitude and practice of blood donation. However, to be motivated or discouraged about blood donation is still challenging.

Moreover, it should be understood that blood supplies are sufficient, in balance with demand and are gathered from low-risk population. For this reason, health workers are expected to practice blood donation so as to create a good image to the public [3, 11]. Hence, the study was aimed at assessing factors and blood donation practices among health professionals.

An institution based cross-sectional study was conducted from January to June 2015 among health professionals at University of Gondar Hospital in Northwest Ethiopia. University of Gondar Hospital is found in Gondar town which is 748 km apart from Addis Ababa, the capital city of Ethiopia. The hospital is the oldest medical school in Ethiopia. It was established as the Public Health College in 1954. It is a referral hospital for four district hospitals in the area and is serving more than 5 million people. It has also a blood bank which is established before 10 years. The hospital has 550 beds and 822 health professionals. Out of 822 health professionals, 186, 493, 71, 51, 9, 12 are physicians, nurses, laboratory science technologists, pharmacists, anesthetists and radiographers respectively. The hospital renders services for about averagely 500 clients per day. Annually, about 219,968 clients get services in the hospital.

All health professionals working in University of Gondar Hospital and those available during the study period were the source population and study population respectively.

The finding from this study has showed that 33.2% (95% CI 28.5, 37.5) of the respondents have ever donated blood prior to the study period. This finding is somewhat similar with the findings of a cross-sectional study conducted among Yazd community in Iran where 38% of the respondents had ever donated blood [12]. However, the result of this study is relatively high as compared to the findings of the studies done in Trinidad and Tobago [13], Dhaka in Bangladesh [14], India [15], and Nigeria [7], where the practice of blood donation among the study participants was 18.8, 16, 10.8, and 15.3% respectively.

Nevertheless, the finding of this study was relatively low as compared to the findings of a study in Saudi Army force hospital where 58.2% of the study participants have ever donated blood [16]. This could be due to the defiance in socio-cultural background, difference in study areas, for instance, in the Saudi Army Hospital; the possibility of donating blood is expected to be high as blood could frequently be needed by the army casualties. Activities of organization working in blood bank could be one reason for the difference in the proportion of the study participants who had ever donated blood. In Ethiopia, Ethiopian Red Cross Society and other health associations like Ethiopian Public Health Association, Ethiopian Society of Obstetricians and Gynecologists and Ethiopian Midwives Association are currently promoting blood donation in collaboration with Ethiopian Federal Ministry of Health and other international organizations which might have increased the awareness and might have changed the attitude of the respondents towards donating blood.

A number of factors were reported as predictors of blood donation behaviors of health professionals. In the present study, the age of the study participants was significantly associated with practice of blood donation. Participants who were more than 25 years old were two times more likely to donate blood when compared to those who are 25 years old or less. This is in agreement with a study done in Maryland in USA [17] where older age group were about two times more likely to donate blood when compared to the younger ones. This might be due to the fact that older people have faced different problems in their relatives or families. This could have changed the attitude of their friends (usually in the same age group) to donate blood.

Knowledge of the study participants about blood donation is another factor which was significantly associated with the practice of blood donation. Those who were knowledgeable (scored above mean score of the knowledge questions) were about two times more likely to donate blood when compared with those scored mean score or less. This can be explained by the fact that those who are knowledgeable about blood donation know that donating blood does not harm the donor and hence could have donated the blood to save lives.

Having favorable/positive attitude towards donating their own blood was also one of the factors which were significantly associated with practice of blood donation. Those study participants who have maintained favorable attitude towards donating their blood (scored above mean score of the attitude questions) were three times more likely to donate blood when compared with those who have negative/unfavorable attitude towards donating their blood. This is in line with a study conducted in Maryland in USA [17] where attitudinal problems were mentioned as a hindering factor for blood donation.

This can be explained by the fact that if someone has negative attitude towards something, he/she will not practice it. Feeling that they are medically unfit, fear of pain during drawing blood sample, pressure from their relatives/families or friends not to donate blood, and fear of safety during the donation time were among the main reasons the respondents mentioned for having unfavorable attitude towards blood donation. This could also be attributed to inadequacy of knowledge about blood in general.

Having a family member or relative who had ever received blood was another factor which was significantly associated with the practice of blood donation among the study participants. Those study participants whose family members or relatives had ever received were about five times more likely to practice blood donation.

This could be because those study participants whose family member(s) or relative(s) were in need of blood to continue their life have donated blood might have practiced it for the first time even while their attitude towards donating their blood is negative for the sake of saving the life of their beloved ones. Having once practiced blood donation and feeling that it is not such much posing discomfort without the pain they feel during needle piercing their vein during the drawing but saving the lives of their relatives could have changed the attitude of those participants so that they would have repeated the donation after that even for non-relative ones.

However, the present study has some inherent limitations. The cross-sectional nature of the study which used a snapshot of prevalence of blood donation practice may hinder the cause and effect relationship. This kind of study is better supported by qualitative studies especially to assess attitude of the respondents towards blood donation and this study lacks the qualitative part.

Blood donation practice of health professionals in this study was found to be low as compared to other studies conducted in developing countries. Health professionals knowledge, attitude, age and having family members or relatives received blood before were independently associated with blood donation practice. Thus, creation of awareness about blood donation should be encouraged among health professionals.