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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 3  |  Issue : 2  |  Page : 123-127

Voluntary blood donation in a rural block of Vellore, South India: A knowledge, attitude and practice study


Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India

Date of Web Publication29-Feb-2016

Correspondence Address:
Anu Mary Oommen
Department of Community Health, Christian Medical College, Vellore - 632 002, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2348-3334.177638

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  Abstract 

Context: There is a shortage of voluntary blood donors in developing countries which are, therefore, more dependent on replacement donors. Aim: To study the knowledge, attitude, and practices regarding voluntary blood donation in a rural block in Vellore, South India. Settings and Designs: A cross-sectional survey in randomly selected villages of a rural block in Vellore, South India. Materials and Methods: Knowledge, attitude, and practices were assessed using a pilot-tested, semi-structured, interviewer-administered questionnaire on randomly chosen rural adults aged between 18 and 60 years. Results: Of the 104 individuals interviewed, 90% were aware of voluntary blood donation, the main source of this awareness being television. Nearly, two-thirds of the participants felt they would fall sick by donating blood and that women and manual laborers were not capable of blood donation. Among the interviewed, 70.3% were of the opinion that blood can purchased with money. Only 44% were willing to donate blood on a voluntary basis. Perceived weakness and a misconception on the apparent lack of blood were the major reasons for unwillingness to donate blood. There was a significant association between willingness to donate blood and educational status as well as occupation, with the less educated and manual laborers unwilling to donate blood on a voluntary basis (odds ratio [OR] = 3.758, confidence interval [CI] = 1.54–9.156; OR = 5.333, CI = 1.429–19.90, respectively). Conclusions: The study found that although awareness on voluntary blood donation among individuals in the rural community was widespread, hesitancy to donate blood in real life situation was high. Since voluntary unpaid donors are the best candidates for blood donation, community being the best available source, education, and motivation of the community should play a greater role in increasing voluntary blood donation.

Keywords: Blood donation, replacement donor, voluntary blood donor


How to cite this article:
Kurup A, Jha A, Sahu S, Sindhu K, Bhatt A, Oommen AM. Voluntary blood donation in a rural block of Vellore, South India: A knowledge, attitude and practice study. CHRISMED J Health Res 2016;3:123-7

How to cite this URL:
Kurup A, Jha A, Sahu S, Sindhu K, Bhatt A, Oommen AM. Voluntary blood donation in a rural block of Vellore, South India: A knowledge, attitude and practice study. CHRISMED J Health Res [serial online] 2016 [cited 2019 Oct 21];3:123-7. Available from: http://www.cjhr.org/text.asp?2016/3/2/123/177638


  Introduction Top


There has been an ever-growing demand for blood and its products in India and the need for it has been growing exponentially. In India, the annual requirement for blood is around 12 million units, with only 9 million units available at any point of time.[1] Though India has more than a thousand blood banks established all over the country, voluntary blood donation is just around 52% which is far below the replacement level of the blood required.[2] Although there are studies on voluntary blood donations documented at hospitals and blood banks where replacement donors are encountered at large, there are very few studies done in the community which is a potential catchment area for voluntary blood donors who can be motivated to donate blood by simple interventional measures.[3],[4],[5],[6],[7],[8],[9],[10] A hospital-based study conducted in South India found that voluntary blood donation at the hospital was just 22.8%.[3] A shift in the recruitment of voluntary donors from the hospital to the community fruitfully yielded an increase in voluntary donors from 5% to 30% in a tertiary care set-up of South India.[4] Willingness to donate blood voluntarily seems to be associated with a higher education, especially in the developing countries and hence there is a need to target this population which is a pragmatic as well as a feasible approach in the community to fill up the deficit in blood reserves.[7],[11] The aim of this study was to assess the knowledge, attitude, and practices regarding voluntary blood donation in a rural community of South India, and the factors associated with unwillingness to voluntarily donate blood and to thereby use the study results to improve future voluntary blood donation yield in the area.


  Materials and Methods Top


The study was conducted in a rural block of Vellore in Tamil Nadu, South India, where the population largely belongs to the lower socioeconomic status and is involved in animal husbandry, daily wage labor, and agriculture. The study design adopted was a cross-sectional study design with both qualitative and quantitative components. Two focus group discussions that served as the qualitative component were held separately for males and females to structure and refine the questionnaire. This was followed by the administration of a semi-structured, pilot-tested, interviewer-administered questionnaire for the quantitative assessment of knowledge, attitude, and practice in the community. The questionnaire was translated into Tamil and was back translated into English. This study was approved by the institutional review board and ethical committee.

Based on a pilot study done in the same block in which the prevalence of blood donation willingness was found to be 50%, the sample size was calculated to be 120 assuming a design effect of 1.2. Five villages were chosen using a table of random numbers, from the list of all the villages of the block using the health information system available at the secondary care hospital in the area. Systematic random sampling was performed to choose 25 households from each village. One adult aged between 18 and 60 years (the eligible age group for blood donation as per the Indian blood bank guidelines)[12] who was first encountered by the interviewer was chosen from each of the selected households and informed consent was obtained.

The data collected were entered using EpiData Data Entry (Data Management and basic Statistical Analysis System, Odense Denmark, EpiData Association, 2000–2008) and analyzed using SPSS version 20.0 software (IBM Corp. Released 2011, IBM SPSS Statistics for Windows, Version 20.0, IBM Corp., Armonk, NY, USA). Discrete variables were expressed as proportions. The Chi-square test was used to study the association between two proportions for the independent variables and was thereby expressed as the odds ratio (OR) with 95% confidence interval (CI).


  Results Top


The focus group discussion among men and women revealed the general perception of the community toward voluntary blood donation which was that manual laborers cannot and should not donate blood as the same would result in physical weakness thereby delaying their return to work following donation. They also felt that women lacked adequate blood in general as a consequence of periodic loss of blood in the form of menstruation and hence women were regarded unfit to donate blood [Table 1].
Table 1: Focus group discussion with men and women

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The median age of the 104 participants who were interviewed was 34.5 years. 13 (12%) had a preexisting condition (diabetes, hypertension). Majority (42%) were in the age group of 18–30 years. The other baseline characteristics are shown in [Table 2].
Table 2: Demographic characteristics of participants

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Awareness of voluntary blood donation was elicited among 90 (94%) participants, the main source of this awareness being television (32%), or a previous visit to the hospital (33%) with further results shown in [Table 3] and [Table 4].
Table 3: Knowledge of blood and voluntary blood donation

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Table 4: Attitudes and practices regarding voluntary blood donation

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Among those who were aware of voluntary blood donation, 56% were not willing to donate with the belief of not having enough blood [Table 4]. Among those willing to donate blood (40), 82% were willing to donate to anyone in need, and 70% stated that their main motive for blood donation was service to society. While only 15% had donated blood in the past, 73% said they would permit their family members to donate in the future but not at the present [Table 4]. Among the married participants, 39% said they would not permit their spouse to donate blood.


  Discussion Top


This survey was conducted in Kaniyambadi, a rural block in Vellore district, Tamil Nadu, South India, to elicit the knowledge, attitude, and practices regarding voluntary blood donation in the rural community and willingness to donate blood voluntarily.

Our study showed that 90% of the participants were actually aware of the existence of voluntary blood donation though only 29.8% of them were educated beyond 10th standard. Nearly, one-third of the participants had gained this awareness through television, highlighting the role of mass media as a powerful tool on improving the awareness of voluntary blood donation. Television played a similar role in the study by Dubey et al. with 45.2% having obtained this awareness through the same.[5] This medium of communication should, therefore, be harnessed to the fullest to increase the number of voluntary blood donors across the country even among the uneducated. One-fourth obtained information on voluntary blood donation through friends and neighbors compared to 53% as in the study by Baig et al. and this shows that information to just a section of the community can help to spread the awareness to a significant extent.[13]

Though awareness of voluntary blood donation was high, the willingness to donate blood was not met with too much enthusiasm, with only 44% of those aware being willing to be a voluntary blood donor. There was a significant association between education and voluntary blood donation with the more educated being more willing to donate blood (OR = 3.758, P = 0.003, CI = 1.54–9.156) [Table 5] as in the studies by Shenga et al. and Agrawal et al.[6],[7] Furthermore, as in the Shenga et al. study there was a significant association between occupation and willingness to donate with manual laborers being less willing (OR = 5.33, P = 0.007, CI = 1.429–19.90)[6] [Table 5]. There was no association between gender and the willingness to donate blood as in the study by Wiwanitkit, but this was not so as in the study by Nwogoh et al.[10],[14]
Table 5: Bivariate analysis of the factors affecting willingness to donate blood (n=91)

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Among those willing to donate blood, 82% were willing to donate to anyone in need and 70% put forth that their main motto behind donating blood was service to society, similar to the study by Shah et al.[15] where 80.6% were willing to donate blood for the same reason.[16] Among those not willing to donate blood, 43% said they did not have enough blood in them, and 25% cited the fact that they were not healthy enough to donate blood, in contrast to the finding by Dubey et al. where the main reason for not donating was that they were never asked to do so, but similar to the studies by Shenga et al. and Kulkarni and Kulkarni where physical harm or weakness following blood donation was the main reason.[5],[6],[8] Furthermore, 64% of them believed that they would fall sick after blood donation which could probably be a strong reason behind the same and a similar proportion opined that women and manual laborers should not donate blood. Awareness of one's own blood group was poor. While 31.7% thought that the donated blood was directly transfused to an individual in need, 77% were of the opinion that blood can be bought by money in emergency situations. Awareness that one can donate blood once in 3–6 months was 69.2% as compared to 51.2% as in the study by Uma et al.[9]

Only 15% of our study population had donated blood in the past on a voluntary basis which is in concordance with Shenga et al. study where 12.7% of the population had donated blood voluntarily.[16] This implies that voluntary blood donation is very low, not uniform, and blood donation on a voluntary basis is uncommon still in many parts of our country. Harnessing modern technology could play a pragmatic role in increasing the yield of voluntary blood donation. Appropriate use of the electronic media such as cell phones, internet, and social networking are the current innovative methods that are easily accessed by the general public and can be used to promote awareness of voluntary blood donation as well as to inform them about the time of blood donation camps happening in their vicinity.[17]

The strength of the study lies mainly in the fact that it was conducted in a rural community of South India in contrast to the majority of other studies being in urban-based hospital setups. India being a country with the vast majority from the rural background, the rural community can be an enormous source of voluntary blood donors if myths regarding their physical health following blood donation were removed. A major limitation of the study is that the percentage of people willing to donate blood could be exaggerated since many of them said they were willing, but it was difficult to estimate the true numbers of people in the community who would actually go on to donate blood later.


  Conclusions Top


Though the awareness of the existence of voluntary blood donation is high, the rural community that forms the majority of our population appears to be still hesitant to donate blood on a voluntary basis with the feeling that they would experience physical ill-effects following donation. Electronic media such as the television and mobile phones could probably increase the knowledge on voluntary blood donation thereby increasing its yield, to cope up with the ever growing need for blood and its products, especially in the developing world.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Indian Red Cross Society – National Voluntary Blood Donation Day – Message of the Secretary General. Available from: http://www.indianredcross.org/sg-message-27-sep-2013.html. [Last cited on 2015 Jun 10]  Back to cited text no. 1
    
2.
NACO ǀ National AIDS Control Organisation. Available from: http://www.naco.gov.in/NACO/National_AIDS_Control_Program/Services_for_Prevention/Access_to_Safe_blood/. [Last cited on 2015 Jun 10].  Back to cited text no. 2
    
3.
Unnikrishnan B, Rao P, Kumar N, Ganti S, Prasad R, Amarnath A, et al. Profile of blood donors and reasons for deferral in coastal South India. Australas Med J 2011;4:379-85.  Back to cited text no. 3
    
4.
Siromani U, Rajaiah M, Daniel D, Mammen JJ, Nair SC. Ahead to 100% of voluntary nonremunerated blood donation at a tertiary referral hospital blood bank in South India. Asian J Transfus Sci 2012;6:190.  Back to cited text no. 4
[PUBMED]  Medknow Journal  
5.
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. 5
    
6.
Shenga N, Thankappan K, Kartha C, Pal R. Analyzing sociodemographic factors amongst blood donors. J Emerg Trauma Shock 2010;3:21-5.  Back to cited text no. 6
[PUBMED]  Medknow Journal  
7.
Agrawal A, Tiwari AK, Ahuja A, Kalra R. Knowledge, attitude and practices of people towards voluntary blood donation in Uttarakhand. Asian J Transfus Sci 2013;7:59-62.  Back to cited text no. 7
[PUBMED]  Medknow Journal  
8.
Kulkarni P, Kulkarni A. Mass counseling: Effective tool to improve knowledge, attitude and behavior regarding blood donation. Ann Med Health Sci Res 2014;4:90-4.  Back to cited text no. 8
[PUBMED]  Medknow Journal  
9.
Uma S, Arun R, Arumugam P. The knowledge, attitude and practice towards blood donation among voluntary blood donors in Chennai, India. J Clin Diagn Res 2013;7:1043-6.  Back to cited text no. 9
    
10.
Nwogoh B, Aigberadion U, Nwannadi AI. Knowledge, attitude, and practice of voluntary blood donation among healthcare workers at the University of Benin Teaching Hospital, Benin City, Nigeria. J Blood Transfus 2013;2013:797830.  Back to cited text no. 10
    
11.
Mariano Gislon da Silva R, Kupek E, Peres KG. Prevalence of blood donation and associated factors in Florianópolis, Southern Brazil: A population-based study. Cad Saude Publica 2013;29:2008-16.  Back to cited text no. 11
    
12.
Donors Guidelines. Available from: http://www.indianbloodbank.com/donors-guidelines.html. [Last cited on 2015 Jun 10].  Back to cited text no. 12
    
13.
Baig M, Habib H, Haji AH, Alsharief FT, Noor AM, Makki RG. Knowledge, misconceptions and motivations towards blood donation among university students in KSA. Pak J Med Sci 2013;29:1295-9.  Back to cited text no. 13
    
14.
Wiwanitkit V. Knowledge about blood donation among a sample of Thai university students. Vox Sang 2002;83:97-9.  Back to cited text no. 14
    
15.
Shah R, Tiwari AK, Shah P, Tulsiani S, Harimoorthy V, Choudhury N. Knowledge about HIV-AIDS among first-time and regular voluntary non-remunerated blood donors. Indian J Pathol Microbiol 2007;50:896-900.  Back to cited text no. 15
[PUBMED]    
16.
Shenga N, Pal R, Sengupta S. Behavior disparities towards blood donation in Sikkim, India. Asian J Transfus Sci 2008;2:56-60.  Back to cited text no. 16
[PUBMED]  Medknow Journal  
17.
Siromani U, Rita Isaac TT, Daniel D, Kg S, Mammen JJ, Nair SC. Recruitment and retention of voluntary blood donors through electronic communication. Acta Inform Med 2013;21:142.  Back to cited text no. 17
    



 
 
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  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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