Francis A Sahali Research Report
Francis A Sahali Research Report
Francis A Sahali Research Report
SONGEA
RESEARCH REPORT
DECLERATION .......................................................................................................................... iv
LIST OF TABLES AND FIGURES ............................................................................................ v
ACKNOWLEDGEMENT ........................................................................................................... vi
LIST OF ABBREVIATIONS .................................................................................................... vii
OPERATIONAL DEFINITION OF TERMS ......................................................................... viii
ABSTRACT ................................................................................................................................... x
CHAPTER ONE: INTRODUCTION ......................................................................................... 1
1.1 BACKGROUND INFORMATION ....................................................................... 1
1.2 PROBLEM STATEMENT ..................................................................................... 2
1.3 RATIONALE OF THE STUDY ............................................................................ 3
1.4 OBJECTIVES ......................................................................................................... 4
1.4.1 GENERAL OBJECTIVE ............................................................................ 4
1.4.2 SPECIFIC OBJECTIVES ........................................................................... 4
1.5 RESEARCH QUSESTIONS .................................................................................. 4
1.6 STUDY VARIABLES ............................................................................................ 5
1.6.1 DEPENDENT VARIABLE ........................................................................ 5
1.6.2 INDEPENDENT VARIABLES .................................................................. 5
1.7 HYPOTHESES STATEMENT .............................................................................. 5
1.7.1 ALTERNATIVE HYPOTHESIS (H1) ........................................................ 5
1.7.2 NULL HYPOTHESIS (H0) ......................................................................... 5
CHAPTER TWO: LITERATURE REVIEW ............................................................................ 6
CHAPTER THREE: RESEARCH METHODOLOGY ......................................................... 10
3.1 STUDY DESIGN.................................................................................................. 10
3.2 STUDY AREA ..................................................................................................... 10
3.3 STUDY POPULATION ....................................................................................... 10
3.4 SAMPLING PROCEDURE ................................................................................. 11
3.5 SAMPLE SIZE ..................................................................................................... 11
3.6 DATA COLLECTION TECHNIQUE AND TOOLS .......................................... 12
3.7 DATA PROCESSING AND DATA ANALYSIS ............................................... 12
3.8 ETHICAL CONSIDERATIONS .......................................................................... 12
ii
CHAPTER FOUR: FINDINGS ................................................................................................. 13
CHAPTER FIVE: DISCUSSION .............................................................................................. 22
CHAPTER SIX: CONCLUSION .............................................................................................. 25
CHAPTER SEVEN: RECOMMENDATION .......................................................................... 26
CHAPTER EIGHT: REFERENCES ........................................................................................ 27
CHAPTER NINE: APPENDICES ............................................................................................ 30
DATA COLLECTION TOOL .......................................................................................... 30
ENGLISH VERSION QUESTIONNAIRE .......................................................... 30
SWAHILI VERSION QUESTIONNAIRE .......................................................... 33
iii
DECLERATION
I, FRANCIS SAHALI, do hereby declare that this is my own work and that, it has not been
presented and will not be presented to any academic institution for similar or any other diploma
award.
Signature………………………………….
Date……………………………………....
iv
LIST OF TABLES AND FIGURES
Table 1 : Showing socio-demographic characteristics of respondents
Table 2 : Showing knowledge on Voluntary Blood Donation among clinical medicine
students in Songea Municipal
Table 3 : Showing respondents with good knowledge on how often an individual can
donate blood
Table 4 : Showing knowledge on the safe amount of blood volume that not more than
which should be donated during each donation per person
Table 5 : Showing knowledge on eligibility of women to donate blood
Table 6 : Showing respondents with good knowledge on types of blood donation
Table 7 : Showing proportion of blood donors to non-donors & factors that hinder
participation in voluntary blood donation
Table 8 : Showing gender and voluntary donors among respondents
Table 9 : Showing year of study and reason for blood donation among respondents who
ever donated blood
Table 10 : Showing attitude towards voluntary blood donation among clinical medicine
students in Songea Municipal
Table 11 : Showing attitude towards VBD among donors and non-donors
Table 12 : Showing religion and attitude towards VBD
Table 13 : Showing willingness to donate in the future among blood donors and non-donors
Figure 1 : Showing proportion of blood donors and non-donors
v
ACKNOWLEDGEMENT
I would like to express my deepest appreciation to all those who provide me the possibility to
complete this research report. Special thanks to my parents Mr. & Mrs. SAHALI and my sisters
MBONI SAHALI & CHONGE SAHALI for their prayers, advice and support which made me
who I am today and toward accomplishment of this work.
Furthermore I would also like to acknowledge with much appreciation the crucial and outstanding
role of my tutors who taught me Operational Research Dr. REGINA HYERA and Dr.
JEREMIAH KIHUNRWA, they made a foundation of this work through their inspiration which
encouraged and guided me to write this work. My thanks to Dr. OMARY DACKO, Head of
Clinical Medicine Department at Songea COTC for coordinating the whole activity since title
presentation till this stage of report writing. Also special thanks goes to the Principal of Songea
COTC Dr. GEOFREY MDEDE and the whole SONGEA - COTC STAFF for their support
towards accomplishment of this work. Last but not least great thanks to my fellow students who
always are my immediate advisors to give me suggestions and hope to carry on.
vi
LIST OF ABBREVIATIONS
AJUCO - Archbishop James University College
COTC - Clinical Officers Training Centre
FRDs - Family Replacement Donors
HBV - Hepatitis B Virus
HCV - Hepatitis C Virus
HIV/AIDS - Human Immunodeficiency Virus / Acquired Immunodeficiency
Syndrome
NBTS - National Blood Transfusion Service
PDs - Paid Donors
SPSS - Statistical Package for Social Science
SSA - Sub-Saharan Africa
TTIs - Transfusion Transmitted Infections
UN - United Nations
UNFPA - United Nations Population Fund / United Nations Fund for Population
Activities
UNICEF - United Nations International Children Emergency Fund
UNPD - United Nations Procurement Division
VNRBD/VBD - Voluntary Non-remunerated Blood Donor
WHO - World Health Organization
vii
OPERATIONAL DEFINITION OF TERMS
Attitude
The way that you think and feel.
Blood transfusion
Refers to the process of transferring blood or blood products into one's circulation
intravenously.
Good knowledge
Those answered correctly greater than or equal to 50% of questions out of total knowledge
related questions.
Heath
Refers to a state of complete physical, mental and social well-being and not merely the
absence of disease or infirmity.
Knowledge
In this study refers to understanding about voluntary blood donation among clinical
medicine student. It was be evaluated by students’ answer to the questions.
Negative attitude
Those who answered positively to less than 50% of attitude related questions.
Poor knowledge
Those answered correctly less than 50% of questions out of total knowledge related
questions.
viii
Positive attitude
Those who answered positively greater than or equal to 50% of attitude related questions.
Risk behavior
Refers to any consciously or non-consciously controlled behavior with a perceived
uncertainty about its outcome, and/or about its possible benefits, or costs for the physical,
economic or psycho-social well-being of oneself or others.
Vulnerable groups
Refers to groups of people who are particularly vulnerable to HIV and other blood borne
infections in certain situations or contexts.
ix
ABSTRACT
Background: Students are potential source of blood donation. In order to meet blood demand for
saving those in need collaborative initiatives should be placed at emphasizing Voluntary blood
donation since it is reliable and safer compared to other forms of blood donation.
Objective: Main objective of this study was to assess knowledge and attitude on voluntary blood
donation among clinical medicine students in Songea Municipal.
Results: A total of 166 clinical medicine students were enrolled. Their mean age was 21.17 years,
ranging from 17 to 31 years. Of them 35 (21.1%) have ever donated blood. 131 (78.9%) of
respondents never donated before, major reasons of not donating blood were being not eligible to
donate blood (36.6%), fear of weakness after donation (15.3%) and Lack of information about
when and where to donate blood (11.4%). Majority of the participants (95.2%) had positive
attitudes towards blood donation and 70.5% were willing to donate in the future. Higher
knowledge on VBD was associated with being in higher level of study. Being male was
significantly associated with ever donating blood.
Conclusion: Clinical medicine student have knowledge and positive attitude towards voluntary
blood donation also willingness to participate in the future hence offer the cheapest source for high
volume of safe blood collection though female clinical medicine students should be encouraged
further to take part in voluntary blood donation.
Recommendation: NBTS and Ministry of Health should focus on giving relevant information
required for a person to donate and conducting blood donation events in heath training institutions,
prioritize the use of clinical medicine students for voluntary blood donation, Blood donation and
associated topics like blood transfusion should be incorporated in Curriculum of Clinical
Medicine, NBTS - Ruvuma should cooperate with administration of Songea COTC to organize
blood donation campaigns within Ruvuma Region in which clinical medicine students will support
x
to provide education on voluntary blood donation and help those who are willing to donate to do
so, the administration of Songea COTC and other health training institutions in Songea Municipal
should join hands with NBTS to organize events that will add the knowledge on voluntary blood
donation among clinical medicine students, the administration of Songea COTC and other health
training institutions in Songea Municipal should focus on empowering and encouraging female
clinical medicine students to participate in VBD.
xi
CHAPTER ONE: INTRODUCTION
1.1 BACKGROUND INFORMATION
Students, who tend to be healthy, when well informed and motivated, are excellent source of
potential voluntary unpaid blood donors. Recruiting and retaining students as donors not only
improves the long-term safety and sufficiency of blood supply, but can also promote safe
lifestyles among students who most of the time are susceptible to be involved in various risk
behaviors for contracting blood borne diseases.
The World Health Organization (WHO) estimations on blood donation show that every year
there are about 108 million blood donations worldwide. Almost Fifty percent of them are
collected in high-income countries though these countries account for less than 20% of global
population. [1] Lower middle-income countries group collected 22% of the global donations
though it represent 39% of the global population. The whole blood donation rate (median)
was 7.8 donations per 1000 population per year in lower middle-income countries. [2] This is
equivalent to 0.78% of population. It is estimated that at least 1% of the population should
donate blood (10 donations per 1000 population) to meet a nation’s most basic requirements
for blood. [3]
The WHO emphasize that each government have responsibility of providing safe and
adequate blood also it is recommended that services regarding blood donation and transfusion
to be included in each country’s national health care policy and health care infrastructure. [4]
In 2015 WHO, UNICEF, UNFPA, World Bank Group and UNPD estimated 303,000 maternal
deaths worldwide. About 201,000 (66.33%) these maternal deaths to occur in sub-Saharan
Africa [5], with hemorrhage as the champion direct cause contributing about 24.5% of maternal
deaths in the area. [6]
When performed properly blood transfusion saves lives of those who were about to die due
to deficiency of blood. A number of patients requiring blood transfusion do not get safe blood
on time hence led to deaths and many patients suffering from ill-health unnecessarily. To have
adequate and reliable supply of safe blood a stable base of regular, voluntary, unpaid blood
donors should be established. Regular, voluntary, unpaid blood donors are the safest group of
donors since the prevalence of blood borne infections is lowest among them. [7]
1
In Tanzania progress have been made to increase the number of units collect although demand
not yet met. In 2016, Tanzania’s National Blood Transfusion Service (NBTS) reported
1962,735 units were collected while in 2005 collection was only 52,000 units. This show that
from 2005 to 2016 blood collection have tripled although the challenge was an increase in
reliance on family replacement donors from 10%-15% (five years before 2016) to 21%
(2016), this led to another problem where by more than 15% of all blood units donated were
discarded in 2016 due to TTIs. Also Tanzania still face a problem unsustainable programs
since most of them depend donors’ fund. [8]
Different initiative have been made to ensure that blood and its products are available to save
lives of patients requiring blood transfusion. Both global and local authorities have placed
emphasis on the availability of safe blood for transfusion, the United Nations (UN) through
its agency World Health Organization (WHO) work in cooperation with government and non-
government organizations to promote voluntary blood donation through campaigns which
provide education to sensitize society to participate in donating blood voluntarily but the gap
between demand and supply of blood and its products still wide especially in developing
countries. [4]
According to NBTS still there is unmet demand for voluntary blood donation in Tanzania. In
2016 it was estimated that about 10 units of whole blood must be donated in every 1000
people in order to meet blood transfusion requirements but only 3.6 out of 1000 was collected
corresponding to 36% of the target.[8]
In two studies conducted among university students in Tanzania the results show that positive
attitude towards voluntary blood donation is high (> 90%) though only 75.6% were willing to
donate blood and very few about 30% ever donated. [9, 10]
2
By considering efforts made to promote Voluntary Blood Donation worldwide and Tanzania
particularly in schools and colleges where majority of youth are found it was expected that
the problem of insufficient blood and its product for transfusion would not exist since youth
are the main source of blood donation worldwide. [1]
Therefore, why high positive attitude towards voluntary blood donation but the amount of
blood donated annually still low and inadequate despite efforts made?
This research was conducted to clinical medicine students who are expected after completion
of their studies will work with community to solve different health problem including the
issue of insufficient blood donors to save the lives of those who are in need including pregnant
women, children and other people who have lost significant amount of blood and require
blood transfusion.
This study intended to assess knowledge and attitude of clinical medicine students on
voluntary blood donation hence provide more information which will not only help to capture
this group as a potential source of voluntary blood donation but also to make them good
ambassadors of voluntary blood donation to the community they are going to work with. This
study also add cognition to clinical medicine students of their duty as life savers also through
donating blood for others.
Also this study was conducted for partial fulfilment of Diploma in Clinical Medicine.
3
1.4 OBJECTIVES
iii. To assess attitude towards voluntary blood donation among clinical medicine
students in Songea Municipal.
2. What is the proportion of blood donors to non-blood donors among clinical medicine
students in Songea Municipal?
3. What is the attitude of clinical medicine students in Songea Municipal towards voluntary
blood donation?
4. Which factors that are known to hinder participation in voluntary blood donation among
clinical medicine students in Songea Municipal?
4
1.6 STUDY VARIABLES
5
CHAPTER TWO: LITERATURE REVIEW
Timely availability of blood for transfusion has been a big challenge in provision of health care
services worldwide. In 1981 new challenge of blood safety emerged after the onset of the
HIV/AIDS pandemic, this brought blood safety into the public eye worldwide. Comparison studies
on safety of Family Replacement Donors verses Voluntary Non-Remunerated Blood Donors
(VNRBD) has shown that the prevalence of TTIs were much higher in Family Replacement
Donors than in Voluntary Non-Remunerated Blood Donors. [11]
Global Database on Blood Safety report show that the use of family replacement blood donation
and paid blood donation are still prevalent in low income countries by 36% and middle income
countries 27% while in high income countries prevalence of family replacement blood donation
and paid blood donation is only about 0.3%. [4]
A study conducted in India among university students 96% of participants agreed that general
public should be encouraged to participate in voluntary donation, up to 82% of general population
lack awareness about Voluntary Blood Donation. No participant had 100% correct response to
[12]
knowledge part of questionnaire. Previous blood donation has significant impact on the level
of knowledge among students. Blood donor have more positive attitude toward blood donation
compared to non-donor students. About one in two college students fear that either they are not
healthy enough to qualify for donating blood or that they will become ill after blood donation.
Almost one quarter reported to fear needle pain hence they do not come forward for blood
donation. [13]
In 2009 the Blood Transfusion Safety team at WHO headquarters decided to address the challenge
of improving access to safe blood transfusion specifically in developing countries, hence it
organized a Global Consultation on 100% Voluntary Non-Remunerated Blood Donation of Blood
and Blood Components. They aimed at providing the importance of the voluntary non-remunerated
donation of blood and blood components for global blood safety and availability, to assess the
nature and magnitude of challenges towards 100% VNRBD, to provide a platform for countries to
share experiences and develop evidence based strategies to strengthen their programs for VNRBD,
to agree on strategies to be considered by countries to achieve 100% VNRBD, To develop and
issue the 'Melbourne Declaration' on behalf of the participants of the Global Consultation, urging
countries to work towards the achievement of 100% VNRBD. [11]
6
Study conducted in developing countries highlighted wrong information about blood donation,
fear to donate blood, readiness to donate for loved ones, concern about selling blood and transfer
of negative attitudes about blood donation as things that are prevalent in the area. [14] Lack of an
opportunity to donate blood and lack of awareness on blood donation also were identified as the
main factors that hindered blood donation. [15]
In Africa the review revealed a common understanding that blood and blood donation save lives.
The main deterrent to blood donation was fear due to lack of knowledge and discouraging spiritual,
religious and cultural perceptions of blood donation. The main motivators for blood donation were
altruism, donating blood for family and incentives. [16]
The study involved 43 African countries showed that about 3,486,192 units of blood are collected
each year. The average annual blood donation rate was 4.3 units per 1000 population, only 5
countries collected at least 10units per 1000 population. Average Voluntary Non-Remunerated
Blood Donors (VNRBD) is 74.8% but the values range from 0% in Equatorial Guinea to 100% in
10 countries. [17]
Family Replacement Donors (FRDs), donating blood only when there is a need by a patient who
is known to them provide the main source of blood donation accounting about 60–90% of the total
blood supply in the region. The threat posed by FRD is that it may include hidden Paid Donors
(PDs), who receive often money, from relatives of patient for donating but present as FRDs. The
World Health Organization recommend blood for transfusion to be obtained from repeat VNRBD,
as key to safe, adequate and sustainable blood supply. Evidence from different studies has
demonstrated that blood from VNRBD is safer and has lower incidence of TTIs sero-reactivity
than that from FRDs and PDs although the safest type of donor is one who donates repeatedly. [16]
Something interesting in Africa is that, in region the highest increase of volunteer and non-
remunerated blood donors (VNRBD) is actually seen (85%), where 21 countries of them (45.6%)
had reached the level of 80-100% VNRBD although the overall donation rate remains below the
targeted WHO value of 1-2% of each Country’s total population for minimum requirement to fulfil
country population. [18]
Surveys conducted in Sub-Saharan Africa (SSA) suggest that a significant number of countries are
[17]
unable to have enough and secured source for blood donation. The results of study involving
7
healthcare workers at the University of Benin Teaching Hospital revealed that 81.6% of
respondents said blood donation is good, 71.2% said blood donation may have adverse effects,
12.3% said a donor can get infection during the process of donating blood, 60.7% said the donor
[16]
may become weak temporary following donation, and 5.5% said the donor may fall sick.
Another study among medical students in Nigeria revealed majority 85.9% had good knowledge
on Voluntary Non-Remunerated Blood Donation, 87.7% of respondents had a positive attitude
towards blood donation however, 11.4% of them had ever donated [20]
The study done in Ethiopia about 35.4% had adequate knowledge about blood donation and 94.5%
had positive attitude towards blood donation, about 85.5% of study participants had ever donated
blood. Perceptions of fear of needle pain, medically unfit to donate and lack of information about
[21]
blood donation were mentioned as a reason for not donating blood. Another study involved
students in the same region showed 86.7% of respondents have positive attitude towards blood
donation, 73.3% of the respondents agreed that voluntary donor is the major source of blood
donation. Not being approached to donate or fear of result and consequences of donation were
among of reasons of not to donate blood. [22]
Survey conducted by WHO showed no East African Country collected at least 10 units of blood
per 1000 population, three countries depend on VNRBD by 100% and these countries include
Kenya, Uganda, and Rwanda. Among of the five East African Countries Tanzania has collected
the least of all average annual blood donation rate (2.7 units per 1000 population), also the use of
VNRBD are least in Tanzania. [17]
8
A study conducted among 422 University Students in Kilimanjaro showed that 30% have ever
donated blood and 55% of those who had ever donated were repeated blood donors. 93% of
participants had positive attitudes towards blood donation and 88% were willing to donate blood
in the future. [9]
Another study conducted among 176 Medical Students of Archbishop James University College
(AJUCO) in Ruvuma region had the following results 80 (45.5%) ever donated blood while among
of them 66 (82.5%) of those being out of volunteering also 159 (90.3%) of students had positive
attitude toward blood donation, 135 (77%) identified voluntary blood donation to be useful and
133 (75.6%) were willing to donate in the future. [10]
9
CHAPTER THREE: RESEARCH METHODOLOGY
3.1 STUDY DESIGN
This was a quantitative prospective cross - sectional study of knowledge and attitude on
Voluntary Blood Donation among clinical medicine students in Songea Municipal.
The study based its data on numerical values (quantity) of particular response to asked
questions rather than the quality of the response hence became quantitative study. Also the
study involved collecting data as perceived by respondent during the study period hence the
study was prospective. Both knowledge and attitude among donors and non-donors were
studied at the same time or simultaneously hence was a cross sectional study.
Inclusion criteria:
All clinical medicine students studying at Songea Clinical Officers Training Centre who
provided consent were included in the study.
Exclusion criteria:
10
Those clinical medicine students were studying at Songea Clinical Officers Training
Centre who refused to provide consent.
Study participants with a serious illness and unable to communicate during the data
collection period were excluded from the study.
𝑍 2 × 𝑃 × (100 − 𝑃)
𝑁=
𝐸2
Where
N = Minimum sample size required
P = Proportion of target population who had good attitude towards Voluntary Blood Donation
in the previous study conducted in in Ruvuma region among medical students studying at
AJUCO 2018. [10]
= 90.3%
Therefore
1.962 × 90.3% × (100% − 90.3%)
𝑁=
(5%)2
𝑁 = 134.6 ≅ 135
Therefore minimum sample size calculated was 150 students after adding 15 Non respondent.
A final sample of 166 students were available after reviewing the completeness of
questionnaire and data cleaning.
11
3.6 DATA COLLECTION TECHNIQUE AND TOOLS
The data collection technique used in this study was self - administered questionnaire.
Participants were given questionnaires, read them and write their response then submit them.
This method was used since it is relatively cheap, give respondent enough time to answer
question and it permit anonymity hence maintain confidentiality and may lead to honesty
responses.
Data collection tool used to collect data in this study was a questionnaire comprising both
open and closed ended questions with 4 sections. Section A comprised the socio demographic
characteristics of the respondents, section B consist of questions that assessed respondents
knowledge on Voluntary Blood Donation, section C consist of questions that assessed the
proportion of blood donors to non-donors and questions that aimed to assess the knowledge
on factors that hinder participation in voluntary blood donation, section D consist of questions
that assessed respondents' attitude towards blood donation.
There were two versions of questionnaire, English version and Swahili version. Swahili
version questionnaire was used to collect data.
12
CHAPTER FOUR: FINDINGS
SOCIO - DEMOGRAPHIC CHARACTERISTICS
A final sample of 166 students were available for final analysis, after reviewing the completeness
of questionnaire and data cleaning. Among the 166 participants, the average age was 21.17 years,
ranging from 17 to 31 years. Details of the demographic characteristics are shown in (Table 1).
13
KNOWLEDGE ON VOLUNTARY BLOOD DONATION AMONG CLINICAL MEDICINE
STUDENTS IN SONGEA MUNICIPAL.
All participants 166 (100%) were aware of blood donation and 159 (95%) knew that Voluntary
Blood donation is among of types of blood donation. Only 69 (41.6%) participants had knowledge
on how often an individual can donate blood while the remaining 59.4% either provided incorrect
responses or were totally unable to suggest any duration. Prevalence of knowledge on disease
screened in donated blood were as follow HIV 162 (97.6%), HBV 150 (90.4%), HCV 136 (81.9%),
Syphilis 94 (56.6%) and Malaria 82 (49.4%). Only 41 (24.7%) Clinical medicine students had
knowledge on the safe amount of blood volume that not more than which should be donated during
each donation per person while 125 (75.3%) had no that knowledge. More than 124 (74%) were
aware that either men, women or people with body weight more than 50 Kilogram are eligible for
blood donation. The overall knowledge on Voluntary Blood Donation is shown below.
Frequency Percent
Have you ever heard about Blood Yes 166 100.0%
donation?
No 0 0.0%
Voluntary blood donation is a type of Yes 159 95.8%
blood donations? No 1 0.6%
I don't know 6 3.6%
Replacement blood donation is a type Yes 142 85.5%
of blood donations? No 14 8.4%
I don't know 10 6.0%
Self-blood donation is a type of blood Yes 32 19.3%
donations? No 105 63.3%
I don't know 29 17.5%
Paid blood donation is a type of blood Yes 36 21.7%
donations? No 101 60.8%
I don't know 29 17.5%
How often can an individual donate? Monthly 3 1.8%
After every 3-4 months 69 41.6%
After every 6 months 35 21.1%
I don't know 59 35.5%
Is HIV screened in donated blood? Yes 162 97.6%
No 1 0.6%
I don't know 3 1.8%
14
Is HBV screened in donated blood? Yes 150 90.4%
No 2 1.2%
I don't know 14 8.4%
Is HCV screened in donated blood? Yes 136 81.9%
No 7 4.2%
I don't know 23 13.9%
Is Syphilis screened in donated Yes 94 56.6%
blood? No 48 28.9%
I don't know 24 14.5%
Is Malaria screened in donated Yes 82 49.4%
blood? No 64 38.6%
I don't know 20 12.0%
What volume of blood is collected <=450 Mls 41 24.7%
during each donation? 450 - 1000 Mls 45 27.1%
I don't know 80 48.2%
Men are eligible to donate blood? Yes 151 91.0%
No 14 8.4%
I don't know 1 0.6%
Women are eligible to donate blood? Yes 145 87.3%
No 16 9.6%
I don't know 5 3.0%
<18 Years Old are eligible to donate Yes 21 12.7%
blood? No 133 80.1%
I don't know 12 7.2%
>65 Years Old are eligible to donate Yes 4 2.4%
blood? No 150 90.4%
I don't know 12 7.2%
Vulnerable Groups are eligible to Yes 3 1.8%
donate blood? No 153 92.2%
I don't know 10 6.0%
Healthy are eligible to donate blood? Yes 152 91.6%
No 9 5.4%
I don't know 5 3.0%
Diseased are eligible to donate blood? Yes 2 1.2%
No 155 93.4%
I don't know 9 5.4%
Body Weight >=50 Kg are eligible to Yes 124 74.7%
donate blood? No 8 4.8%
I don't know 34 20.5%
15
Table 2: Showing knowledge on Voluntary Blood Donation among clinical medicine students
in Songea Municipal
16
YEAR OF STUDY FIRST SECOND THIRD TOTAL
YEAR YEAR YEAR
Number of clinical medicine students know at least 65 36 43 144
2 out of 4 mentioned types of blood donation
Total number of students participated in the study 77 41 48 166
Prevalence of knowledge 84.4% 87.8% 89.6% 86.7%
Table 6: Showing respondents with good knowledge on types of blood donation
Only 4 (0.02%) Clinical medicine students were aware of all mentioned types of blood donation
and 6 (0.04%) were not aware of any mentioned types of blood donation.
17
THE PROPORTION OF BLOOD DONORS TO NON-DONORS & FACTORS THAT
HINDER PARTICIPATION IN VOLUNTARY BLOOD DONATION
Regarding the proportion of blood donors and non-donors among clinical medicine students, 35
(21.1%) of the respondents they at least donated blood once in their life time. Among those who
donated 30 (85.7%) of those were voluntary donors while 5 (14.3%) were replacement donors.
131 (78.9%) respondents never donated blood due to deferent factors as shown in table 7 below.
Frequency Percent
Have you ever donated? Yes 35 21.1%
No 131 78.9%
What was a reason for donation As voluntary donor 30 85.7%
For family member 5 14.3%
replacement
What is a reason for not donating Not eligible to donate 48 36.6%
blood
Fear of needle pain 6 4.6%
Fear of knowing blood test 1 0.8%
results
Lack of information about 15 11.4%
when and where to donate
blood
Parental restriction 1 0.8%
Fear of weakness after 20 15.3%
donation
No reason 40 30.5%
Table 7: Showing proportion of blood donors to non-donors & factors that hinder
participation in voluntary blood donation
18
PROPORTION OF BLOOD DONORS AND NON - DONORS
Have you ever donated? Yes Have you ever donated? No
21%
79%
PERCENTAGE
VOLUTARY BLOOD
GENDER (donors / number of participants of particular
DONORS
gender) ×100%
Male 24 26.4%
Female 6 8.0%
VOLUTARY Percentage
Year of study BLOOD DONORS (donors / number of participants in particular level)
×100%
First Year 11 14.3%
Second Year 7 17.1%
Third Year 12 25.0%
Table 9: Showing year of study and reason for blood donation among respondents who ever
donated blood
19
ATTITUDE TOWARDS VOLUNTARY BLOOD DONATION AMONG CLINICAL
MEDICINE STUDENTS IN SONGEA MUNICIPAL
The attitude of the clinical medicine students towards blood donation was quite good 159 (90.3%)
also 135 (77%) perceived voluntarily donated blood to be the best blood source.
Frequency Percent
What do you think about Good practice 164 98.8%
voluntary blood donation? Neutral 2 1.2%
What do you think is the best Voluntary donor 152 91.6%
source of blood donors? Replacement donor 9 5.4%
Remunerated donor 3 1.8%
Self-donor 2 1.2%
Do you think it is right for patient Yes 80 48.2%
relatives to pay or be asked to No 76 45.8%
donate blood for their patient? I don't know 10 6.0%
Are you willing to donate blood in Yes 117 70.5%
the future? No 49 29.5%
Table 10: Showing attitude towards voluntary blood donation among clinical medicine
students in Songea Municipal
20
Have you ever Are you willing to donate Total Percentage of Percentage of
donated? blood in the future? respondents willing respondents not
Yes No to donate in the willing to
future donate in the
future
Yes 28 7 35 80% 20%
No 89 42 131 67.9% 32.1%
Table 13: Showing willingness to donate in the future among blood donors and non-donors
21
CHAPTER FIVE: DISCUSSION
This study has presented findings that clinical medicine students in Songea Municipal to have good
knowledge on voluntary blood donation and positive attitude towards voluntary blood donation.
Almost all clinical medicine students in Songea Municipal 166 (100%) ever heard about blood
donation and about 95% of them knew that Voluntary Blood donation is among of types of blood
donation. 69 (41.6%) of respondents had good knowledge on how often an individual can donate
blood, this proportion is relatively low compared to another study conducted among university
medical students in Southern Tanzania in which 54.5% of respondent had good knowledge on how
often an individual can donate blood [10], this difference in knowledge might be due to differences
of levels of education among participants of two studies.
Table 3 show that 31 (64.6%) third year clinical medicine students have good knowledge on how
often an individual can donate blood while 25 (32.5%) first year students and 13 (31.7%) of second
year also have good knowledge on how often an individual can donate blood. Table 4 show that
17 (35.4%) third year clinical medicine students have good knowledge on the safe amount of blood
volume that not more than which should be donated during each donation per person while 15
(19.5%) first year students and 9 (22.0%) of second year also have good knowledge on the safe
amount of blood volume that not more than which should be donated during each donation per
person. Table 6 show that clinical medicine students know at least 2 out of 4 mentioned types of
blood donation were 65 (84.4%), 36 (87.8%) and 43 (89.6%) among first year, second year and
third year clinical medicine students respectively. This finding show that knowledge on voluntary
blood donation increases with year of study (education level).
From this study I learned that 35 (21.1%) of respondents have donated at least once in their life,
identified reasons for blood donation include volunteering 30 (85.7%) of them and for replacement
5 (14.3%) of them. This is absolutely low compared to another study conducted among university
medical students in Southern Tanzania in which 45% of respondents had donated previously, 82%
[10]
volunteering and 16.25% for replacement. Also when these findings were compared with
another study conducted among university students in Kilimanjaro, Tanzania it was found that
donor proportion was higher, more than 29.9%, 90.5% volunteering and 7.9% for replacement. [9]
22
131 (78.9%) respondents in this study never donated blood before, among of reasons of not
donating mentioned include being not eligible to donate blood, fear of needle pain, fear of knowing
blood test results, lack of information about when and where to donate blood, parental restriction,
fear of weakness after donation and 40 (30.5%) do not have any reason for not donating blood this
is absolutely higher than findings obtained in the study conducted among university medical
students in Southern Tanzania in which 54.5% of respondents never donated. [10]
Table 8 show that only 6 (8%) female respondents participated in voluntary blood donation which
is lower compared to 24 (26.4%) male respondents reported to participate in voluntary blood
donation this pattern was similar to that in study conducted among university medical students in
Southern Tanzania in which male respondents had higher involvement in VBD (52.6%) compared
to female respondents (23.1%). [10]
In table 9 Third year clinical medicine students who previously showed high knowledge are seen
leading in participating in voluntary blood donation by 25% compared to 14.3% and 17.1% of first
year students and second year students respectively.
In this study I noticed that three major reasons of not donating blood among clinical medicine
students never donated blood were being not eligible to donate blood (36.6%), fear of weakness
after donation (11.4%) and Lack of information about when and where to donate blood (11.4%)
different from described in southern Tanzania fear of weakness after donation (7.6%) and Lack of
information about when and where to donate blood (0.5%). [10]
In this study something interesting was that a significant proportion of non-donor 40 (30.5%)
responded to have no reason for not donating, this was shocking but gives an opportunity to find
out a means to convince this group engage in voluntary blood donation.
The attitude of the clinical medicine students towards blood donation was high at 95.2% (average
of 98.8% reported VBD to be a good practice and 91.6% suggested VBD as the best source of
blood donors) compared to 90.3% in Southern Tanzania [10] and this was consistent with findings
in Kilimanjaro Tanzania (93.0%), [9] this is due to the fact that clinical medicine students always
witness the needs of blood in their daily practices in saving the life of people in need.
23
80 (48.2%) of respondents suggested that it is right for patients relatives to be asked to pay or
donate blood for their patient compared to 76 (45.8%) who said it is not right for patients relatives
to be asked to pay or donate blood for their patient.
Attitude towards VBD among different religious groups including Roman Catholic, Protestant and
Muslim were almost similar 98.7%, 98.7% and 100% respectively. No respondent reported
religion restriction to participate in VBD.
117 (70.5%) respondents reported to be willing to donate blood in the future, this is lower
[9] [10]
compared to 88% and 75.6% in studies conducted in Kilimanjaro and Southern Tanzania
respectively. 28 (80%) of blood donors reported to be willing to donate in the future and 89
(67.9%) of non-donor reported to be willing to donate in the future.
24
CHAPTER SIX: CONCLUSION
The study revealed that clinical medicine student have positive attitude towards voluntary blood
donation also willingness to participate in the future. Clinical medicine students offer the cheapest
source for high volume of safe blood collection since they are knowledgeable and have positive
attitude toward VBD. This is an opportunity for the government to give these young and potential
blood donors correct information on the process of blood donation and on frequency of blood
donation as well as the knowledge on the value of blood in saving lives also to meet the WHO
goals for 100% non-remunerated blood donations which require each country to develop strategy
which will enable them to depend 100% on VBD. Female clinical medicine students should be
encouraged to take part in voluntary blood donation.
25
CHAPTER SEVEN: RECOMMENDATION
TO GOVERNMENT AND NBTS
I recommend that the National Blood Transfusion Services and Ministry of Health to focus on
giving relevant information required for a person to donate and conducting events that will collect
blood from clinical medicine students since a significant proportion of them are knowledgeable
with positive attitude towards VBD.
[11]
To meet the WHO goal of 100% voluntary non-remunerated blood donation , Tanzania and
other African countries have to prioritize the use of clinical medicine students for voluntary blood
donation.
I recommend Blood donation and associated topics like blood transfusion to be incorporated in
Curriculum of Clinical Medicine this will increase emphasis and sense of responsibility among
clinical medicine students to increase availability of blood and its products to save lives of those
in need.
I recommend the administration of Songea COTC and other health training institutions in Songea
Municipal to join hand with NBTS to organize events that will add the knowledge on blood
donation among clinical medicine students so as to support human resource in blood donation
programs coordinated in Ruvuma Region.
I recommend the administration of Songea COTC and other health training institutions in Songea
Municipal to focus on empowering and encouraging female clinical medicine students to
participate in VBD.
26
CHAPTER EIGHT: REFERENCES
1. World Health Organization [Internet]. Geneva: Voluntary unpaid blood donations must
increase rapidly to meet 2020 goal; 13 June 2016 [cited 2020 December 24]. Available
from: https://www.who.int/news/item/13-06-2016-voluntary-unpaid-blood-donations-
must-increase-rapidly-to-meet-2020-
goal#:~:text=Voluntary%20unpaid%20blood%20donations%20must%20increase%20rap
idly%20to%20meet%202020%20goal,-13%20June%202016&text=Voluntary%2
2. World Health Organization. Global Status Report on Blood Safety and Availability.
Geneva, Switzerland. (2016)
3. World Health Organization. Global database on blood safety summary report (2009).
4. World Health Organization. Global database on blood safety summary report (2011).
5. World Health Organization. Trends in maternal mortality: 1990 to 2015 Estimates by
WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division
(2015).
6. World Health Organization. Global causes of maternal death: a WHO systematic analysis
(2014).
7. World Health Organization [Internet]. Geneva: 10 facts on blood transfusion; 2020 June
10 [cited 2020 December 24]. Available from: https://www.who.int/news-room/facts-in-
pictures/detail/blood-transfusion
8. Mama ye. Tanzania’s blood services: Factsheet 2017
9. Mauka W, Jeremia D, Mahande M, Msuya S. Knowledge, Attitudes, Practices, and Factors
Associated with Voluntary Blood Donation among University Students in Kilimanjaro,
Tanzania. Journal of Blood Transfusion. January 2016. Available from: DOI:
10.1155/2016/8546803
10. Shabani M, Zimbwe K, Mbwele B. The Potential Opportunity to Use Medical Students in
Voluntary Blood Donation: Learning From Ruvuma, Southern Tanzania. HSOA Journal
of Internal Medicine and Primary Health Care. 2020. Available from: DOI:
10.24966/IMPH-2493/100028
11. World Health Organization. Global Consultation : 100% Voluntary Non–Remunerated
Donation of Blood and Blood Components (2009) (Pg. 6)
27
12. Dnyanesh L, Pooja N, Tejal V, Arlan S, Priyanka S, Chaitali S, et al. Knowledge and
attitude towards voluntary blood donation among students from Mumbai University.
International Journal of Scientific Reports 2018 4(6):142. Available from: DOI:
10.18203/issn.2454-2156.IntJSciRep20182202
13. Shailesh K, Suchet S, Neelam M, Ajit A. Dovepress: Study of knowledge and attitude
among college-going students toward voluntary blood donation from north India. Journal
of blood medicine. Available from: DOI: 10.2147/JBM.S91088
14. Lownik E, Riley E, Konstenius T, Riley W, McCullough J. Knowledge, attitudes and
practices surveys of blood donation in developing countries. International journal of
transfusion medicine 2012. Available from: DOI: 10.1111/j.1423-0410.2012.01600.x
15. Wilkinson Anne R. Factors that Motivate and Hinder Blood Donation among First Time
Blood Donors. Scholars Journal of Applied Medical Sciences 2015. Available from:
http://saspublisher.com/wp-content/uploads/2015/01/SJAMS-31D284-286.pdf [Accessed
22nd December 2020]
16. Lucy A, Oliver W, Imelda B, Henrik U. Blood donors’ perceptions, motivators and
deterrents in Sub-Saharan Africa – a scoping review of evidence. British Journal of
Hematology. 2017, 177, 864–877. Available from: DOI: 10.1111/bjh.14588
17. Tapko J, Toure B, Sambo L. Report of the 2010 Survey Status of Blood Safety in the Who
African Region. Congo; 2014 (Pg. 3, 7, 8)
18. Lassina B, Victor J, Ghislain G, Claude T, Magdy E, Shirley O, et al. Blood transfusion in
sub-Saharan Africa: understanding the missing gap and responding to present and future
challenges. International journal of transfusion medicine 2018. Available from: DOI:
10.1111/vox.12705
19. Benedict N, Usimenahon A, Alexander I. Knowledge, Attitude, and Practice of Voluntary
Blood Donation among Healthcare Workers at the University of Benin Teaching Hospital,
Benin City, Nigeria. Hindawi Publishing Corporation: Journal of blood transfusion. 2013.
Available from: https://downloads.hindawi.com/archive/2013/797830.pdf [Accessed 22nd
December 2020]
20. Ogboghodo E, Ofili A, Ogunbor O, Ogenyi C, Okpala C. Knowledge, attitude and practice
of voluntary non-remunerated blood donation among medical students in a tertiary
institution in southern Nigeria. A Peer-review Journal of Biomedical Sciences. 2015.
Available from: https://www.ajol.info/index.php/jmbr/article/view/144677/134328
[Accessed 22nd December 2020]
28
21. Bamlaku E, Aregawi Y, Elias S. Blood donors’ knowledge and attitude towards blood
donation at North Gondar district blood bank, Northwest Ethiopia: a cross‑sectional study.
2019. Available from: DOI: 10.1186/s13104-019-4776-0
22. Terefe E. Attitudes of students towards blood donation in university of Gondar. Arts and
Humanities Open Access Journal. 2018. Available from: https://medcraveonline.com/
AHOAJ/AHOAJ-02-00094.pdf [Accessed 22nd December 2020]
23. The National Blood Transfusion Service of Tanzania. Clinical guideline for appropriate
use of blood and blood products NBTS Tanzania Available from:
https://drive.google.com/file/d/1USpWl7nSX4mdy3KJXR52mEJBSFyWPQiL/view
[Accessed 22nd December 2020]
29
CHAPTER NINE: APPENDICES
DATA COLLECTION TOOL
ENGLISH VERSION QUESTIONNAIRE
SECTION A: SOCIO DEMOGRAPHIC DATA
1. How old are you? _________ years
2. Sex
a. Male
b. Female
3. Year of study
a. First year
b. Second year
c. Third year
4. Religion
a. Roman catholic
b. Protestant
c. Muslim
d. Others _____________________ (specify)
30
e. Malaria YES( ) NO( ) I don’t know( )
9. What volume of blood is collected during each donation?
a. Not more than 450 mls
b. 450–1000 mls
c. Don’t know
10. Who are eligible to donate blood?
(Tick the correct response)
a. Men YES( ) NO( ) I don’t know( )
b. Women YES( ) NO( ) I don’t know( )
c. Young less than 18 years old YES( ) NO( ) I don’t know( )
d. Old more than 65 years old YES( ) NO( ) I don’t know( )
e. Vulnerable group YES( ) NO( ) I don’t know( )
f. Healthy individuals YES( ) NO( ) I don’t know( )
g. Diseased individuals YES( ) NO( ) I don’t know( )
h. Those with 50 Kg. body weight and above YES( ) NO( ) I don’t know( )
SECTION C: THE PROPORTION OF BLOOD DONORS TO NON-DONORS &
FACTORS THAT HINDER PARTICIPATION IN VOLUNTARY
BLOOD DONATION
11. Have you ever donated blood?
a. Yes
b. No
12. If YES what was the reason for donating blood?
a. As voluntary donor
b. For family member replacement
c. As remunerated donor
d. As self-donor
13. If NO what is a reason of not donating blood?
a. Not eligible to donate blood
b. Fear of needle pain
c. Fear of knowing blood test results
d. Religion restriction
e. Donated blood may be sold
f. No remuneration
g. Lack of time to donate
h. Lack of information about when and where to donate blood
i. Parental restriction
j. Fear of weakness after donation
k. No reason
31
SECTION D: ATTITUDE TOWARDS VOLUNTARY BLOOD DONATION
14. What do you think about voluntary blood donation?
a. Good practice
b. Bad practice
c. Neutral
15. What do you think is the best source of blood donors?
a. Voluntary donor
b. Replacement donor
c. Remunerated donor
d. Self-donor
16. Do you think it is right for patient relatives to pay or be asked to donate blood for
their patient?
a. Yes
b. No
c. I don’t know
17. Are you willing to donate blood in the future?
a. Yes
b. No
32
SWAHILI VERSION QUESTIONNAIRE
SEHEMU A: TAARIFA ZA MSHIRIKI
1. Umri wako ni miaka ___________.
2. Jinsia
a. Kike
b. Kiume
3. Mwaka wa masomo
a. Mwaka wa kwanza
b. Mwaka wa pili
c. Mwaka wa tatu
4. Dini
a. Mkatoliki
b. Mprotestanti
c. Muislamu
d. Dini nyingine (Itaje) ___________________________
SEHEMU B: UELEWA KUHUSU UCHANGIAJI DAMU KWA HIARI
5. Je! Umewahi kusikia kuhusu uchangiaji Damu?
a. Ndiyo
b. Hapana
6. Ikiwa NDIYO ni zipi kati ya zifuatazo ni aina za uchangiaji damu?
(weka alama kwenye jibu sahihi kwa kila kipengele)
a. Uchangiaji damu kwa hiari NDIYO( ) HAPANA( ) SIJUI( )
b. Uchangiaji damu kwa ajili ya ndugu/rafiki NDIYO( ) HAPANA( ) SIJUI( )
c. Uchangiaji damu kwa ajili yako mwenyewe NDIYO( ) HAPANA( ) SIJUI( )
d. Uchangiaji damu kwa ajili ya kupata malipo NDIYO( ) HAPANA( ) SIJUI( )
7. Mtu anaweza kuchangia damu kila baada ya muda gani?
a. Kila mwezi
b. Kila baada ya miezi 3 – 4
c. Kila baada ya miezi 6
d. Sijui
8. Je! Ni magonjwa gani yanayochunguzwa katika damu iliyochangiwa?
(weka alama kwenye jibu sahihi kwa kila kipengele)
a. Virusi vya UKIMWI NDIYO( ) HAPANA( ) SIJUI( )
b. Virusi vya Homa ya ini aina B NDIYO( ) HAPANA( ) SIJUI( )
c. Virusi vya Homa ya ini aina C NDIYO( ) HAPANA( ) SIJUI( )
d. Kaswende NDIYO( ) HAPANA( ) SIJUI( )
e. Malaria NDIYO( ) HAPANA( ) SIJUI( )
9. Je! Ni kiasi gani cha damu kinachokusanywa wakati wa kila mchango wa damu?
a. Mililita zisizozidi 450
b. Kati ya mililita 450 – 1000
c. Sijui
33
10. Ni nani wanaostahili kuchangia damu?
(weka alama kwenye jibu sahihi kwa kila kipengele)
a. Wanaume NDIYO( ) HAPANA( ) SIJUI( )
b. Wanawake NDIYO( ) HAPANA( ) SIJUI( )
c. Vijana chini ya miaka 18 NDIYO( ) HAPANA( ) SIJUI( )
d. Wazee zaidi ya miaka 65 NDIYO( ) HAPANA( ) SIJUI( )
e. Kundi lililoko hatarini NDIYO( ) HAPANA( ) SIJUI( )
f. Watu mwenye afya NDIYO( ) HAPANA( ) SIJUI( )
g. Wagonjwa NDIYO( ) HAPANA( ) SIJUI( )
h. Uzito wa mwili Kg. 50 au zaidi NDIYO( ) HAPANA( ) SIJUI( )
SEHEMU C: UWIANO KATI YA WACHANGIAJI WA DAMU NA WASIO
WACHANGIAJI & VINAVYOKWAMISHA USHIRIKI KATIKA
UCHANGIAJI DAMU KWA HIARI
11. Je! Umewahi kutoa damu?
a. Ndiyo
b. Hapana
12. Ikiwa NDIYO nini ilikuwa sababu ya kutoa damu?
a. Kuchangia kwa hiari
b. Kwa ajili ya ndugu/rafiki
c. Kwa ajili ya kupata malipo
d. Kwa ajili yako mwenyewe
13. Ikiwa HAPANA ni nini sababu ya kutochangia damu?
a. Sina sifa za kuchangia damu
b. Naogopa maumivu ya sindano
c. Naogopa matokeo ya vipimo vya damu
d. Imani ya dini yangu hainiruhusu
e. Nahofia damu yangu itauzwa
f. Hakuna malipo
g. Sina muda wa kuchangia
h. Ukosefu wa habari kuhusu wakati na mahali pa kuchangia damu
i. Nakatazwa na wazazi wangu
j. Naogopa kupata udhaifu baada ya kuchangia damu
k. Sina sababu
SEHEMU D: MTAZAMO KUHUSU UCHANGIAJI WA DAMU KWA HIARI
14. Je! Unafikiria nini juu ya uchangiaji wa damu kwa hiari?
a. Ni jambo zuri
b. Ni jambo baya
c. Siko upande wowote
15. Unafikiri ni chanzo kipi bora cha wachangiaji wa damu?
a. Wachangiaji wa hiari
b. Wachangiaji kwa ajili ya ndugu/rafiki
34
c. Wachangiaji wa kulipwa
d. Wachangiaji kwa ajili yao binafsi
16. Je! Unafikiri ni sawa kwa ndugu wa mgonjwa kulipa au kuulizwa kutoa damu kwa
ajili ya mgonjwa wao?
a. Ndiyo
b. Hapana
c. Sijui
17. Je! Uko tayari kuchangia damu siku zijazo?
a. Ndio
b. Hapana
35