Factors affecting Voluntary Blood Donation among Admas

University Students in Addis Ababa, Ethiopia.

PI : Abraham Tenaw
Advisor: Mesafint Abeje (BSc, MPH)

February, 2020
Addis Ababa, Ethiopia 1
Outline
1. Introduction
2. Justification
3. Significance of the study
4. Conceptual framework
5. Objectives
6. Methods
7. Ethical consideration
8. Results and Discussion
9. Strength and Limitation of the study
10. Conclusion
11. Recommendations
12. Acknowledgement
13. References
2
1. Introduction
 Blood is a specialized body fluid in humans (Carver C, Scheier M, 2012).

 Blood donation is an act of a healthy person giving blood which will be

used by another person (Cha Y, Nwabueze S, Nnebue C, 2014).

 The donated blood plays a big role during (surgery, accident, delivery
cases, bleeding cases, etc ) (WHO, 2008).

 Who can donate a blood ( age18-65 yrs, Weight 45 kg and above and not on
medication) (Ethiopian National Blood Bank, Guide lines, 2014).
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 Introduction cont.……………

 Globally estimated around 112.5 million collected annually of which

approximately (50% collected in developed countries only 19% of the world’s
population lives) (WHO, 2010).

 In sub Saharan Africa 510 maternal deaths per 100 000 live births (Hassall O, Bates I
and Baya B, 2017).

 44 % of maternal deaths due to blood loss during childbirth 20% of maternal and
15 % of child death as a result of anemia (WHO, 2015). 4
Introduction cont.………
•The Ethiopian National Blood Bank Service has 25 regional blood banks that
supply more than 50% of the country’s hospitals with blood (Saberton P, 2014)

•Currently, 22 regional blood banks (RBB) including Addis Ababa collects blood
100% only from voluntary blood donors.

•The Ethiopian national blood bank planned to collected 241,107 units of blood.

•In 2010 Ethiopian fiscal year (EFY) out of 186,497 units of blood collected
98.1% was from voluntary blood donors (Ethiopian National Bank, 2018).
5
Introduction cont.………

• 25% to 40% of Ethiopian mothers die due to lack of enough blood from
donors each year (Sintayehu c, 2018).

• Fear of needles, pain, the sight of blood, future weakness, and possible ill
effects, an objection from elders, ignorance, and illiteracy, etc are all
reasons for many people who are hesitant in donating blood (Saberton P, 2014).

6
2. Justification
 Blood donation is a self-directed volunteer service, however no sufficient
data throughout Ethiopia including the study area.

• Since the data recorded in national blood bank data base on 2010 E.C for
Admas university, the total numbers of volunteer blood donors were very
small from others universities and colleges (Ethiopian National Bank, 2018).

• The findings of this study were provide information for stakeholders to

develop strategies and take appropriate measures to narrow the gaps.
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3. Significance of the study

 The outcome of a study may help in program formulation for researchers

and ENBBS
• To create awareness on the general factors affecting
• Incorporate students in regular donation activity
• Educate the public about the importance of blood donation
• And the risks associated with the donation

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 4. Conceptual framework

Figure 1: Conceptual frame work of the study developed based on different literatures, 2019, Addis Ababa
9
 5. Objectives

 To determine factors affecting voluntary blood donation among Admas

University Students in Addis Ababa, Ethiopia, 2019.

10
6. Methods

Study area and period

•The study was conducted in Addis Ababa.

•From July 23, to September 15, 2019

•Currently in Addis Ababa Admas University has 6 campuses

Study design
Institution based unmatched case control study.

11
 Methods cont.………..

Source population
 The source population were all students in Admas University, Addis
Ababa.

Study population
 The study populations were students both voluntary blood donors (case) and
non-blood donors (controls) in Admas University, Addis Ababa.

12
 Sample size determination
Sample size determination
 double population proportion formula using Epi-Info statistical software’s

Variables Blood donation practice AOR Sample size Plus 10%

no-response rate=(n)

Age 18-20 years 17.6 6.14 233

≥24 years 37

Attitude Favorable 22.9 1.77 402

Unfavorable 10.9

Religion Muslim 11.1 0.391 314

Orthodox 25.5

 Since 402 is the largest sample size, it is taken as the final sample size for this study
13
Methods cont.……….
Sampling procedure
•Simple random sampling were used
Six campus site in Admas University with total of 870 cases and 23,730 controls
students were identified in the survey

Olompia(5000) Megenagna (4800) Mekanisa(4000) Meskel (4000) East (3800) Kality(3000)

Case=27 Case=26 Case=22 Case=22 Case=21 Case=16

Controls=54 Controls=52 Controls=44 Controls=44 Controls=41 Controls=33

Simple random sampling technique will be used

134 cases and 268 controls

Final sampling size, n= 402
14
Figure 2: Sampling procedure
Methods cont.……
Inclusion and Exclusion criteria

Inclusion criteria
 All students in Admas University were included in the study

Exclusion criteria
 The students who are seriously sick in the time of data collection.

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 Methods cont.……..
-Study variables
• Dependent variables
– Voluntary blood donation
• Independent variables
Socio demographic
characteristics :
• Sex
• Age
• Religion
•Education status
•year and department
 Knowledge on blood donation
 Attitude toward blood donation
Institutional factors:
• Working hour
• Educational promotion, and
• Reminding schedule
 Source of information
• Inter Personal
• mass media, and
• social media
 Trust in blood transfusion
service 16
Methods cont.………
Operational definition

 Case: Students who donated blood at least once in their life time.

 Controls: Students who never donated blood.

17
 Methods cont.……….
• Knowledge:
 Adequate knowledgeable - Participants who were answer >8 of 10 knowledge
based questions.
 Inadequate knowledge - Participants who were answer ≤8 of 10 knowledge
based questions.
• Attitude:
 Favorable attitude - Those participants who were answer >4 of 6 on attitude
based questions.

 Unfavorable attitude - Participants who were answer ≤4 of 6 on attitude based

questions.
18
Methods cont.……….
Data collection procedures and quality assurance

• Self-administered structured questionnaire

• Pre-tested for self-administered questionnaire

• Experienced data collectors and supervisors

• Trained for data collector

• Data was checked for consistency and completeness before entry to computer

software for analysis.

19
Methods cont.………
Data management and analysis
• Data were coded, entered into Epi-Info version 7.0 and were cleaned
• SPSS version 22 were used for analysis
• Descriptive statistics

• At 25% level of significance univariable binary logistic regression analysis

• Multi-collinearly were checked

• Multivariable binary logistic regression analysis at 5% level of significance

• Hosmer-Lemeshow goodness of fit test 0.706

– 95% CI
– p-value <0.05 20
7. Ethical consideration

• Ethical clearance were obtained from GAMBY Medical and Business

College and Addis Ababa Health Bureau Ethical Review Board
• Written consent were obtained

• Confidentiality were maintained

• The collected data were kept safe throughout the whole process of the
research

21
8. Results and Discussion
• A total of 129 cases and 263 controls were participated in this study with
the response rate of 97.5%.

22
 Socio demographic characteristics
Socio demographic variable Case (n=129) (%) Control (n=263) (%) Total (392)
Gender Female 96 (24.5%) 202 (51.5%) 298 (76.0%)
Male 33 (8.4%) 61 (15.6%) 94 (24.0%)
Age group 18-25 106 (27.0%) 174 (44.4%) 280 (71.4%)
>25 23 (5.9%) 89 (22.7%) 112(28.6%)
Religion Muslim 48 (12.2%) 81 (20.7%) 129 (32.9%)
Orthodox 56 (14.3%) 132 (33.7%) 188 (48.0%)
Protestant 6 (1.5%) 35 (8.9%) 41 (10.5%)
Others 19 (4.8%) 15 (3.8 %) 34 (8.7 %)
level of education 1st years 73 (18.6%) 131 (33.4%) 204 (52.0%)
2nd year 31 (7.9%) 101 (27.8%) 132 (33.7%)
3rd years 25 (6.4%) 31 (7.9%) 56 (14.3%)
Departments Computer science 35 (8.9%) 58 (14.8%) 93(23.7%)
Economics 12 (3.1%) 43 (11.0%) 55 (14.0%)
Managements 18 (4.6%) 39 (9.9%) 57 (14.5%)
Accounting 52 (13.3%) 108 (27.6%) 160 (40.8%)
Others 12 (3.1%) 15 (3.8%) 27 (6.9%)
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Institutional factors
Institutional factors Case (n=129) (%) Control (n=263) (%) Total (392)
knew the National Blood Bank
working hour Yes 104 (26.6%) 195 (49.7%) 299(76.3%)
No 25 (6.4%) 68 (17.3%) 93 (23.7%)
have learnt about voluntary blood
donation by the National Blood
Bank Yes 96 (24.5%) 184 (46.9%) 280 (71.4%)
No 33 (8.4%) 79 (20.2% ) 112 (28.6%)
had information about the blood
donation scheduled date Yes 83 (21.1%) 179 (45.7%) 262 (66.8%)
No 46 (11.7%) 84 (21.4%) 130 (33.2%)

Source of information
Source of information Case (n=129) (%) Control (n=263) (%) Total (392)
friend and family Yes 120 (30.6%) 159 (40.6%) 279 (71.2%)
No 9 (2.3%) 104 (26.5%) 113 (28.8%)
mass media Yes 72 (18.4%) 171 (43.6%) 243 (62.0%)
No 57 (14.5%) 92 (23.5%) 149 (38.0%)
social media Yes 93 (23.7%) 225 (57.4%) 318(81.1%)
No 36 (9.2%) 38 (9.7%) 74 (18.9%)
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Trust in blood transfusion service
Trust in blood transfusion Case (n=129) (%) Control (n=263) (%) Total (392)
Service
believed NBBS used donated
blood properly Yes 108 (27.6%) 228 (58.1%) 336 (85.7%)
No 21 (5.4%) 35 (8.9%) 56 (14.3%)
How much you trust them they
will providing the collected blood
to health care in free
I do not believe them they will
proving to in free 45 (11.5%) 67 (17.1%) 112 (28.6%)
100% I trust the NBBS providing
in free 47 (12.0%) 122 (31.1%) 169 (43.1%)
They may provide to government
health Institution for free and to
the private for sale 5 (1.3%) 51 (13.0%) 56 (14.3%)
All will be for sell 32 (8.2%) 23 (5.8%) 55 (14.0%)
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 Knowledge and attitude
Variables Case (n=129) (%) Control (n=263) (%) Total (392)
Knowledge Knowledgeable 108 (27.56%) 217 (55.4%) 325 (82.9%)
Not Knowledgeable 21 (5.4%) 46 (11.7%) 67 (17.1%)
Attitude Favorable 85(21.7%) 166(42.3%) 251(64.0%)
Unfavorable 44 (11.2%) 97(24.7%) 141(36.0%)

Voluntary Blood Donation

Voluntary Blood Donations Case (n=129) (%) Control (n=263) (%)
when donated Blood Once 56 (14.3%)
Twice 28 (7.1%)
Three times 17 (4.3%)
Four times 13 (3.3%)
Five times and above 15 (3.8%)
the reason not to donate blood
Fear of needle 111(28.3%)
No enough time 75 (19.1%)
Transportation problem 22 (5.6%)
No one invite me to donate blood 55 (14.0%)
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Factors associated with voluntary blood donation
• Accordingly, the odds of voluntary blood donation among first year students
were 4 times the odds of second year students (AOR=3.73, 95% CI: 1.21,
11.45).

• Regarding department, the odds of voluntary blood donation among

economics students were 3 times the odds of computer sciences students
(AOR=2.90, 95% CI: 1.82, 24.23).

• the odds of voluntary blood donation among Students who had favorable
attitude were 2 times the odds of those who had unfavorable attitude towards
voluntary blood donation (AOR=2.01, 95% CI: 1.02, 3.97).

27
Factors associated with voluntary blood donation ….
• the odds of voluntary blood donation among students who heard about
voluntary blood donation by social media were 2 times the odds of those
who did not heard by social media (AOR=1.70, 95% CI: 1.06, 2.79).

• Students who believed that the donated blood provide to government health
institution for free and to the private for sale were 97% less likely to donate
blood voluntarily than those students who did not believe it is not provided
for free (AOR=0.03, 95% CI: 0.01,0.29).

28
 Factors associated with voluntary blood donation …
Table 8: Univariable and multivariable binary logistic regression analysis (n= 392)
Socio Case Control COR (95%CI) AOR(95%CI) P
demographic (n=129) (n=263)
variable (%) (%)
level of education
1st years 73 (18.6%) 131 (33.4%) 1.82(1.11, 2.98) 3.73(1.21,11.45) 0.022*
nd
2 year 31 (7.9%) 101 (27.8%) 1.00 1.00
Department
Computer 35 (8.9%) 58 (14.8%) 1.00 1.00
Economics 12 (3.1%) 43 (11.0%) 0.46(0.22, 0.99) 2.90(1.82, 24.23) 0.015*
Attitude Favorable 85(21.7%) 166(42.3%) 1.13(0.73,1.76) 2.01(1.02, 3.97) 0.043*
Unfavorable 44 (11.2%) 97(24.7%) 1.00 1.00
Mass media Yes 72 (18.4%) 171 (43.6%) 0.68(0.44, 1.05) 9.80(1.79, 53.80) 0.009*
No 57 (14.5%) 92 (23.5%) 1.00 1.00
Social media Yes 93 (23.7%) 225 (57.4%) 0.44(0.26, 0.73) 1.70 (1.06, 2.79) 0.002*
No 36 (9.2%) 38 (9.7%) 1.00 1.00
Trust in blood
transfusion
services
Didn’t trust 45 (11.5%) 67 (17.1%) 1.00 1.00
providing for free
To government
health Institution 5 (1.3%) 51 (13.0%) 0.15(0.05, 0.39) 0.03 (0.01,0.29) 0.003*
for free and to the
private one for sale
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 Results and Discussion
• In line with the objective of the study, an effort was made to find out the factors
affecting voluntary blood donation.

• Accordingly, the odds of voluntary blood donation among first year students were
4 times the odds of second year students.

• First year students are more egger to establish or strengthen blood donation clubs.

• Since they are fresh and they are too sensitive to join any activities, focusing on
blood donation campaigns through the mobilization and motivation of students to
remove the misconceptions than the second year students.

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 Results and Discussion……..
• A similar study done among Madawalabu University students showed year of
study was significantly associated with voluntary blood donation which first year
students more donated than other batches (Darega N, 2015).

• Department was also among the statistically significant factors. the odds of
voluntary blood donation among economics students were 3 times the odds of
computer sciences students.

• This might be due to the higher frequent age Economics students are in relative to
computer sciences students.

• The odds of voluntary blood donation among Students who had favorable attitude
were 2 times the odds of those who had unfavorable attitude towards voluntary
blood donation.
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Results and Discussion……..
• This may be due to the fact that those who had unfavorable attitude perceived that
they are unfit, fear to give blood related to culture.

• A similar study done in Madawalabu and Arsi University showed that attitude was
significantly associated with voluntary blood donation (Darega N,2015, Gebresilase H, 2017).

• The odds of voluntary blood donation among Students who heard about voluntary
blood donation by mass media were 9 times the odds of those who did not heard by
mass media.

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 Results and Discussion……..
• This might be due to those who heard about voluntary blood donation through
mass media could gain better information about blood donation.

• Well-constructed ideas, information’s and human-interest stories that provided to

responsive journalists used strengthen information dissemination through mass
media.

• The odds of voluntary blood donation among students who heard about voluntary
blood donation by social media were 2 times the odds of those who did not heard
by social media.
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 Results and Discussion……..
• This might be due to those who have higher access and better information from
social media about blood donation may have better understanding.

• Students who believed that the donated blood provide to government health
institution for free and to the private for sale were 97% less likely to donate blood
voluntarily than those students who did not believe it is not provided for free.

• The possible explanation for this finding might be when there is lack of information
about blood transfusion service, the donors may have not trust on blood transfusion
because of this reason they may not donate blood.
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 9. Strength and Limitation of the study
Strength of the study
•Previously studies conducted on voluntary blood donation were cross sectional
studies. However, this study is a case control study.

Limitation of the study

The use of participant reported information for identifying cases and controls
during survey may leads to selection bias as cases and controls.

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9. Conclusion

• Level of education, department, mass media, social media, attitude towards

voluntary blood donation and trust in blood transfusion services were
significantly associated with voluntary blood donation among Admas
University students.

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11. RECOMMENDATIONS
Based on the findings of the study the following recommendations are made:

To National Blood Bank Service:

•Intervention activities to bring attitude changes and to increase knowledge
level on voluntary blood donation targeted on fear of needle, departments,
source of information and first batch students are recommended.

•Clubs in the university should organize different events to build students

attitude positively and to increase the numbers of blood donors.

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12. Acknowledgment

• I would like to, My heartfelt deepest appreciation special thanks to my

advisor Mesafint Abeje

• I would like to express my deepest appreciation to my brother.

• My heartfelt appreciation is for GAMBY Medical and business College

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