|Year : 2022 | Volume
| Issue : 1 | Page : 28-35
Myths and misconceptions preventing college going students from voluntary blood donation: A prospective study in a tertiary care medical college from North India
Shailesh Kumar Mishra
Department of Transfusion Medicine, PGIMER, Chandigarh; Department of Blood Transfusion, SHKM Government Medical College Nalhar Nuh, Haryana, India
|Date of Submission||31-Jan-2022|
|Date of Decision||23-Feb-2022|
|Date of Acceptance||19-Mar-2022|
|Date of Web Publication||29-Apr-2022|
Dr. Shailesh Kumar Mishra
Department of Transfusion Medicine, PGIMER, Chandigarh; Department of Blood Transfusion, SHKM Government Medical College Nalhar Nuh, Haryana
Source of Support: None, Conflict of Interest: None
Background and Objectives: Blood services are facing a shortage of blood all over the world. Demand for blood is rising day by day and current blood donation is insufficient to meet the demand. This study was planned to assess the myths of college-going students regarding blood donation, address their misconceptions, and raise awareness among college students on the importance of blood donation. Methods: The study population comprised 1000 students above the age of 18 years who qualify for blood donation after assessment of suitability to donate blood as per the blood donor questionnaire and consent form of the department. Results: Myths and misconceptions were more prevalent among nonblood donor students. The most common reason for not donating blood, as stated by nonblood donor students, was fear of needle pain in 137 (27.4%), followed by being not fit to donate in 134 (26.8%) and the fear of becoming weak in 95 (19%). Conclusion: The most common reason comes out to be related to health of the individual donor; almost one in two college-going students (45.8%) fear that either they are not fit enough to donate blood (26.8%) or that they will become weak (19%) after blood donation.
Keywords: College student, knowledge, misconception, myths, voluntary blood donation
|How to cite this article:|
Mishra SK. Myths and misconceptions preventing college going students from voluntary blood donation: A prospective study in a tertiary care medical college from North India. Glob J Transfus Med 2022;7:28-35
|How to cite this URL:|
Mishra SK. Myths and misconceptions preventing college going students from voluntary blood donation: A prospective study in a tertiary care medical college from North India. Glob J Transfus Med [serial online] 2022 [cited 2022 Dec 10];7:28-35. Available from: https://www.gjtmonline.com/text.asp?2022/7/1/28/344343
| Introduction|| |
Blood services are facing a shortage of blood all over the world. Demand for blood is rising day by day and current blood donation is insufficient to meet the demand. Knowledge, attitude, and behavior surveys were performed between 1995 and 2011 in 17 countries classified as emerging and developing by the International Monetary Fund. The subject of these studies was blood donation. These surveys have been used in many countries to understand factors that influence blood donation and form the basis for communication and donor mobilization strategies. These surveys were performed in 17, countries namely Bangladesh, Brazil, Burkina Faso, Chile, China, Haiti, Iran, Moldova, Nigeria, Pakistan, Saudi Arabia, South Africa, Tanzania, Thailand, Trinidad and Tobago, Togo, and Uganda. Despite considerable differences in culture and demographics of these countries, many common themes emerged from different surveys, inclusive of misinformation about blood donation, fear of blood donation, willingness to donate for family and friends, concern about selling blood, and failure to transfer positive attitude into actual blood donation.
Carrying out survey in the Indian population may provide insight into developing appropriate strategies in rooting out these misconceptions. Governments of both India and Pakistan identified knowledge and attitude survey on blood donation as a part of their strategic plan for both blood safety and HIV prevention., Voluntary Blood Donation Program – an operational guideline, National AIDS Control Organization (NACO), Ministry of Health and Family Welfare (MOHFW), Government of India (GOI) states that blood collection target for National AIDS Control Programme (NACP-III) is 100 lakh units, while the existing annual blood collection in India is 72.7 lakh., Therefore, as per this operational guideline of NACO, MOHFW, GOI, there is a shortfall in annual blood collection of 27.3 lakh units from the set target. Therefore, it is the need of the hour not only to recruit new blood donors but also to retain existing blood donors. In European countries, each year demand for blood rises by 2%–3% and recruiting new donors is becoming increasingly difficult. In the developed world, most blood donors are unpaid volunteers who give blood for community supply. In Thailand, 100% of donors are voluntary and nonremunerated because the system will not accept blood donations of any other kind. In Nigeria, 67% of donors were family donors because the policy of many hospitals requires donation in order for a family member to receive antenatal care. In a poor country, like Nigeria, often, the established supplies are limited and donors usually give blood when family or friends need a transfusion. A decline in altruism has been suggested as a major factor threatening blood supply. Altruism can be defined as “prosocial behaviour that has no obvious benefit for the respondent but is beneficial to the recipient.” Individual studies also attributed donor behavior primarily to altruism.
World Health Organization has categorized zones based on whole blood donation per thousand populations, as depicted in [Figure 1]. The maximum blood collection occurs in developed countries such as Canada, the USA, Australia, and most of the European countries. Blood collection in most of the African countries is lowest. Russia falls in the borderline zone. Blood collection in India is lower than in Russian collection but marginally better than the African countries., Therefore, India needs to improve its blood collection.
|Figure 1: Whole blood donation per thousand population across the world,|
Click here to view
During the recent year, the percentage of voluntary blood donation was 79.4% against the target of 80%. Thus currently, there is a shortfall in blood collection across India.
Aim and objective
The aim of the study was to assess the myths of college-going students regarding the blood donation, address their misconceptions, and raise awareness among college students on the importance of blood donation so that voluntary blood donation may increase in the near future.
| Materials and Methods|| |
Study design and Ethical clearance
The study was done at the Department of Transfusion Medicine, PGIMER, Chandigarh, after obtaining approval from the Institutional Ethics Committee (IEC approval reference no.-NK/364/MD/10046-47). The study was a prospective case–control study. The study was exploratory in nature, exploring the myths and misconceptions among college-going students with regard to voluntary blood donation.
The study population comprised five hundred students above the age of 18 years who qualify for blood donation after assessment of suitability to donate blood as per the blood donor questionnaire and consent form of the department. Five hundred students of a similar age group who were not participating in blood donation were also recruited.
Study area included educational institutions where regular voluntary blood donation camps being conducted by the Department of Transfusion Medicine, PGIMER, Chandigarh.
The questionnaire was offered to the students of college willing for blood donation. They were recruited for blood donation after screening by a medical officer from the department as per the blood donor questionnaire and consent form. The questionnaire was also got filled from students who were not blood donors present at the venue of blood donation. The questionnaire was distributed in a separately demarcated area at the blood donation venue and was collected personally from the participants. Care was taken that participants answered questions individually and not after discussion amongst themselves. The participants were helped to interpret any question that they did not understand [Figure 2].
The statistical analysis was carried out using Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA, version 25.0 for Windows). Scores were presented as mean ± standard deviation, median, and interquartile range. Qualitative or categorical variables (e.g., age gender) were described as frequencies and proportions. Normality of quantitative data was checked by measures of Kolmogorov–Smirnov tests of normality. Independent t-test was applied for comparison of age of two groups (donors and nondonors). Mann–Whitney U-test was used for statistical analysis of scores. Kruskall–Wallis test was applied for comparison of scores for more than two groups. Proportions were compared using Chi-square or Fisher's exact test whichever was applicable. All statistical tests were two sided and were performed at a level of α = 0.05.
| Results|| |
Data were analyzed based on the objectives using descriptive and inferential statistics. The data collected was transferred to a master sheet for each section of the tool.
Age distribution among participants
The minimum age of both donors and nondonors was 18 years and maximum age of participating donors was 24 years and that of nondonors was 26 years with P = 0.278.
[Table 1] depicts that the mean age for blood donors was 19.80 ± 1.31 (years) and for nondonors was 19.69 ± 1.69 (years) with an overall mean of 19.75 ± 1.51.
[Figure 3] depicts the age distribution of study participants (donor and nondonor participants).
Gender distribution among participants
Data presented in [Table 2] and [Figure 4] show that 75.80% of donors were male and 24.20% were female in blood donor students, whereas among nonblood donor participants, 55.0% were male and 45.0% were female. More male than female donated blood, and the difference was statistically significant in both donor and nondonor group.
Reasons for not donating blood
Among nonblood donor students, 287 students cited a single reason, 119 students cited two reasons, 50 students told three reasons, 20 students told four reasons, 14 students told five reasons, and 10 students told six reasons for not donating blood, which is shown in [Table 3] and [Figure 5].
|Table 3: Number of reasons for not donating blood by non blood donor students|
Click here to view
Data presented in [Table 4] depict that fear of needle pain was the most common reason which inhibits nonblood donor students to donate blood, 137 (27.4%) students did not donate for fear of needle pain, 134 (26.8%) students thought that they were not fit to donate blood, 95 (19.0%) student stated reason as fear of becoming weak, and 23 (4.6%) students stated fear of contracting disease. Another 21 (4.2%) students felt that blood bank sell their collected blood, 10 (2.0%) students had no time for blood donation, 9 (1.8%) students had fear of discovering unknown disease, 8 (1.6%) students told that they would not be able to donate blood when someone close to them might require blood in future, and 5 (1.0%) had no knowledge of blood donation place.
|Table 4: Overall reason stated by nonblood donor students for not donating blood|
Click here to view
Pie chart in [Figure 6]. depicts the various reasons for not donating blood.
|Figure 6: Pie chart showing percentage of reasons stated by nondonor as a reason for not donating blood|
Click here to view
| Discussion|| |
This study was conducted in order to obtain information from the college-going students which may be useful in implementing donor recruitment and introducing strategies for maintaining an adequate and safe blood supply. [Table 5] depicts the comparative sample size, population surveyed, sample selection, and survey delivery methods among various studies.
A study from Bangladesh consisted of 200 university students, a study from Brazil consisted of 1600 blood donors and another from Burkina Faso comprised of 544 blood donors.
Among the various studies depicted in [Table 6], the risk of contracting disease was observed as misconception in 94.6% of participants in Chile. This misconception was more common in China. A study from Haiti concluded a similar finding done on 1622 adults by trained fieldworker administered survey and study from Nigeria, Tanzania, Trinidad and Tobago, Togo, Iran,, and Moldova, as compared to the present study. Studies conducted in Chile, Uganda, Iran, and Togo depicted that participants think that donated blood is sold by the hospitals; however, this misconception was less prevalent among the participants in the present study. More number of Bangladeshi respondents believed that blood donation affects physical health as compared to the participants in the present study; however, participants in Chile and South Africa had less such misconception than participants in the present study. Participants in the study done in Bangladesh, Chile, Iran, South Africa, and Tanzania had more misconception that donating blood poses a health risk and causes adverse effects as compared to the participants in the present study. This misconception was least common among the participants in the present study.
In the study from Pakistan, 51.6% of participants stated that no one ever asked them to donate blood as a major reason for not donating blood.
Data presented in [Table 7] depict the specific fear cited as a reason not to donate blood. Fear of physical harm or infection was the most common deterrent among nondonors in nine of the 18 surveys. Just over 90% of those surveyed in China reported a fear of pain upon needle insertion. Fear of being infected by HIV was the most common fear in both Nigeria and Tanzania. In Saudi Arabia, 4.8% of respondents stated fear of infection or fear of contracting a disease. The women in Iran most commonly cited fear of infection and hepatitis. In South African studies, no participant stated any specific reason for not donating blood. In the present study, the most common fear among the respondent for not donating blood was fear of needle followed by fear of becoming unfit on blood donation. More than 50% of Bangladeshi and Chinese respondents had fear of physical harm, whereas in Moldova and Thailand and respondents had less fear compared to the respondents in the present study. Participants in the Nigerian, Tanzanian, Togo, Uganda, and Moldova study had more fear of infection than participants in the present study, whereas participants in the Saudi Arabia had almost the same fear as the participants in the present study. Only participants in the Chinese study had more fear about needle pain, whereas Moldova and Saudi Arabian participants had less fear as compared to the participants in the present study. Fear of being unfit to donate blood was a common perception in the present study.
[Table 8] depicts a comparison of various reasons for not donating blood. More number of participants in the study conducted in Moldova, China, and Chile reported being anemic as a cause for nondonation as compared to the participants in the present study, whereas the participants in Bangladesh, Iran, Trinidad and Tobago, and Uganda stated this reason less than the participants in the present study.
Participants in Uganda, Trinidad and Tobago, Iran, and Bangladesh stated that collection facility was not accessible, and comparatively lesser number of the participant in the present study stated such reason. Participants in the study in China and Iran stated that they did not have enough time to donate blood; however, this reason was told by less number of participants in the present study. A similar percentage of South African participants stated this reason as compared to the participants in the present study. More number of participants in Chile and Bangladesh were concerned about the sterility of equipment as compared to the participants in the present study.
No one ever asked for blood donation was the reason for not donating blood in the study by Dubey et al. from Lucknow, Pakistan, Saudi Arabia, and Moldova; however, in the present study, this reason was stated by less number of participants.
| Conclusion|| |
The most significant finding in the present study is the reasons brought out for not donating blood. The most common reason comes out to be related to health of the individual donor, almost one in two college-going students (45.8%) fear that either they are not fit enough to donate blood (26.8%) or that they will become weak (19%) after blood donation. This observation is in contrast to the other study from India, where majority of participants responded that no one ever asked them to donate blood (40.8%), so they never volunteered. Therefore, it can be concluded from the findings of the present study that blood donor motivation, recruitment, and retention strategies should be more specific and focus on the myths and misconceptions prevalent in the donor demographic area. Such studies are recommended across different parts of the country with the aim of sampling all representative eligible blood donor population in order to generate evidence to formulate region-specific blood donor recruitment and retention strategies for a stable and sustainable blood supply.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Horton R. Blood supply and demand. Lancet 2005;365:2151.
Lownik E, Riley E, Konstenius T, Riley W, McCullough J. Knowledge, attitudes and practices surveys of blood donation in developing countries. Vox Sang 2012;103:64-74.
Whyte G. Quantitating donor behaviour to model the effect of changes in donor management on sufficiency in the blood service. Vox Sang 1999;76:209-15.
Wiwanitkit V. Knowledge about blood donation among a sample of Thai university students. Vox Sang 2002;83:97-9.
Olaiya MA, Alakija W, Ajala A, Olatunji RO. Knowledge, attitudes, beliefs and motivations towards blood donations among blood donors in Lagos, Nigeria. Transfus Med 2004;14:13-7.
Ferriman A. Decline in altruism threatens blood supplies. BMJ 1998;317:1405.
Zillmer EA, Glidden RA, Honaker LM, Meyer JD. Mood states in the volunteer blood donor. Transfusion 1989;29:27-30.
London P, Hemphill BM. The motivations of blood donors. Transfusion 1965;5:559-68.
Annual Reports. National AIDS Control Organisation Ministry of Health, Government of India. Available from: http://www.naco.nic.in
. [Last accessed on 2012 Jul 22].
Hosain GM, Anisuzzaman M, Begum A. Knowledge and attitude towards voluntary blood donation among Dhaka University students in Bangladesh. East Afr Med J 1997;74:549-53.
Goncalez TT, Sabino EC, Chen S, Salles NA, Chamone DA, McFarland W, et al.
Knowledge, attitudes and motivations among blood donors in São Paulo, Brazil. AIDS Behav 2008;12:S39-47.
Nébié KY, Olinger CM, Kafando E, Dahourou H, Diallo S, Kientega Y, et al.
Lack of knowledge among blood donors in Burkina Faso (West Africa); potential obstacle to transfusion security. Transfus Clin Biol 2007;14:446-52.
Vásquez M, Ibarra P, Maldonado M. Blood donation: Knowledge and attitudes of a university population in Chile. Rev Panam Salud Publica 2007;22:323-8.
Zaller N, Nelson KE, Ness P, Wen G, Bai X, Shan H. Knowledge, attitude and practice survey regarding blood donation in a Northwestern Chinese city. Transfus Med 2005;15:277-86.
Javadzadeh Shahshahani H, Yavari MT, Attar M, Ahmadiyeh MH. Knowledge, attitude and practice study about blood donation in the urban population of Yazd, Iran, 2004. Transfus Med 2006;16:403-9.
Javadzadeh Shahshahani H. Why don't women volunteer to give blood? A study of knowledge, attitude and practice of women about blood donation, Yazd, Iran, 2005. Transfus Med 2007;17:451-4.
Gilani I, Kayani ZA, Atique M. Knowledge, attitude and practices (kap) regarding blood donation prevalent in medical and paramedical personnel. J Coll Physicians Surg Pak 2007;17:473-6.
Alam M, Masalmeh Bel D. Knowledge, attitudes and practices regarding blood donation among the Saudi population. Saudi Med J 2004;25:318-21.
Mwaba K, Keikelame MJ. Blood donation behaviour and beliefs among a sample of high school students in Mmabatho. Curationis 1995;18:2-3.
Jacobs B, Berege ZA. Attitudes and beliefs about blood donation among adults in Mwanza Region, Tanzania. East Afr Med J 1995;72:345-8.
Agbovi KK, Kolou M, Fétéké L, Haudrechy D, North ML, Ségbéna AY. Knowledge, attitudes and practices about blood donation. A sociological study among the population of Lomé in Togo. Transfus Clin Biol 2006;13:260-5.
Sampath S, Ramsaran V, Parasram S, Mohammed S, Latchman S, Khunja R, et al.
Attitudes towards blood donation in Trinidad and Tobago. Transfus Med 2007;17:83-7.
Uganda Red Cross Society: Research of Blood Donor and Non-Blood Donor Behaviors: Report and Analysis. Submitted by Communication for Development Foundation, Uganda; 2003.
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.
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8]