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COLLEGE OF MEDICINE AND HEALTH SCIENCES

DEPARTMENT OF SURGICAL NURSING

KNOWLEDE, ATTITUDE AND PRACTICE ON VOLUNTARY


BLOOD DONATION AND ASSOCIATED FACTORS AMONG NON
HEALTH UNDERGRADUATE STUDENTS OF WACHEMO
UNIVERSITY, HOSANNA, ETHIOPIA, 2023

BY
DERARA TAYE…………….1200346
ASMAMAW DAGNAW……1201623
BETHELIHEM BELAY.…...1200787
HAYAT ADAM……….…….1201260

AUGUST, 2023
HOSSANA, ETHIOPIA
KNOWLEDE, ATTITUDE AND PRACTICE ON VOLUNTARY
BLOOD DONATION AND ASSOCIATED FACTORS AMONG NON
HEALTH UNDERGRADUATE STUDENTS OF WACHEMO
UNIVERSITY, HOSANNA, ETHIOPIA, 2023

BY
DERARA TAYE…………….1200346
ASMAMAW DAGNAW……1201623
BETHELIHEM BELAY.…...1200787
HAYAT ADAM……….…….1201260

ADVISORS:

1. JABIR ABDELLA (BSc, MSc) (MAJOR ADVISOR)

2. RUHAMA ERMIAS (BSc, MSc) (CO-ADVISOR)

A RESEARCH RESULT TO BE SUBMITTED TO WACHEMO


UNIVERSITY, COLLEGE OF MEDICINE & HEALTH SCIENCES
IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR
BACHELOR’S DEGREE IN SURGICAL NURSING

AUGUST, 2023
HOSSANA, ETHIOPA

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ACKNOWLEDGEMENT
Firstly, we would like to thank our creator for giving us the strength and power to do and
finish this work. Secondly we would also like to extend our deepest thanks to Wachemo
University, College of Medicine and Health Science, Department of Surgical Nursing for
giving us the chance to prepare this proposal. In addition, our special gratitude goes to
Mr.Jabir Abdella and Mr. Ruhama Ermias for their valuable advice, comments, and
suggestions throughout the preparation of this proposal. Finally, we would like to thank
our families and close friends for their encouragement.

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ABBREVIATIONS AND ACRONYMS
ASTU Adama Science and Technology
AOR Adjusted Odd Ratio
CI Confidence Interval
COR Crude Odd ratio
ERCS Ethiopia Red Cross Society
ETB Ethiopian Birr
FMOH Federal Ministry of Health
GC Gregorian Calendar
HIV Human Immune Virus
KM Kilo Meter
MOU Memorandum of Understanding
NARM Natural Resource Management
NBTS National Blood Transfusion Services
NEMMCSH Nigist Eleni Mohammed Memorial, Comprehensive
Specialized Hospital
PADM Public Administration and Developmental Management
RDA Rural Development and Agriculture
SNNPR Southern Nation Nationalities Peoples Region
SPSS Statistical Package for Social Sciences
SRS Simple Random Sampling
SSA Sub Saharan Africa
VBD Voluntary Blood Donation
VNRBDs Voluntary Non Remunerated Blood Donations
WCU Wachemo University
WHO World Health Organization

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Table of Contents
ACKNOWLEDGEMENT..................................................................................................iii
ABBREVIATIONS AND ACRONYMS...........................................................................iv
LIST OF TABLES.............................................................................................................vii
LIST OF FIGURES..........................................................................................................viii
ABSTRACT........................................................................................................................ix
1. INTRODUCTION............................................................................................................1
1.1. Background...............................................................................................................1
1.2 Statement of Problem.................................................................................................3
1.3 Significance of the Study...........................................................................................5
2. LITERATURE REVIEW.................................................................................................6
2.1 Knowledge towards Voluntary Blood Donation........................................................6
2.2 Attitude towards Voluntary Blood Donation.............................................................7
2.3 Practice towards Voluntary Blood Donation.............................................................8
2.4 Factors........................................................................................................................9
2.4.1 Factors associated with level of knowledge........................................................9
2.4.2 Factors associated with level of attitude...........................................................10
2.4.3 Factors associated with practice of blood donation..........................................11
2.5. Conceptual framework............................................................................................12
3. OBJECTIVE..................................................................................................................13
3.1 General Objective.....................................................................................................13
3.2 Specific Objective....................................................................................................13
4. METHODS AND MATERIALS...................................................................................14
4.1 Study Area and Period.............................................................................................14
4.2 Study Design............................................................................................................14
4.3 Population................................................................................................................14
4.3.1 Source of population.........................................................................................14
4.3.2 Study Population...............................................................................................14
4.4 Inclusion and Exclusion Criteria..............................................................................14
4.4.1 Inclusion criteria................................................................................................14
4.4.2 Exclusion criteria...............................................................................................15
4.5 Sample Size Determination......................................................................................15
4.6 Sampling Procedures and Technique.......................................................................16

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4.7 Study Variables........................................................................................................16
4.8 Operational Definitions............................................................................................17
4.9 Data Collection Tool and Procedures.......................................................................17
4.10 Data Quality Control Measures..............................................................................18
4.11 Data Processing and Analysis................................................................................18
4.12 Ethical Considerations............................................................................................18
4.13 Dissemination of Results........................................................................................19
5. RESULTS......................................................................................................................20
5.1. Socio-Demography/Socio-Economic Back ground................................................20
5.2. Level of knowledge.................................................................................................22
5.3. Level of Attitude.....................................................................................................24
5.4. Practice....................................................................................................................26
5.5. Associated factors...................................................................................................28
5.5.1. Factors associated with knowledge towards voluntary blood donation...........28
5.5.2. Factors associated with attitude towards voluntary blood donation................29
5.5.3. Factors associated with practice of voluntary blood donation.........................29
6. DISCUSSION................................................................................................................30
7. CONCLUSION..............................................................................................................32
8. STRENGTH AND LIMITATION OF THE STUDY...................................................33
8.1 Strength of the study................................................................................................33
8.2 Limitation of the study.............................................................................................33
9. RECOMMENDATIONS...............................................................................................34
REFERENCES...................................................................................................................35
ANNEXES.........................................................................................................................39
Annex I: Subject Information Sheet...............................................................................39
Annex II: Consent form.................................................................................................39
ANNEX III: Questionnaires...........................................................................................39
Annex IV: Sampling Procedure and Technique.............................................................45

LIST OF TABLES

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Table 1: Sociodemographic characteristics on blood donation among non-health Science
............................................................................................................................................20
Students of WCU, 2023.....................................................................................................20
Table 2: Knowledge on blood donation among non-health Science Students of WCU,
2023....................................................................................................................................22
Table 3: Attitude towards blood donation among non-health Science Students of WCU,
2023....................................................................................................................................25
Table 4: Practice of blood donation among non-health Science Students of WCU, 2023 26
Table 5: Factors associated with knowledge among non-health Science Students of WCU,
2023....................................................................................................................................28
Table 6: Factors associated with attitude of blood donation among non-health students of
WCU, 2023........................................................................................................................29
Table 7: Factors associated with practice of blood donation among non-health Science
Students of WCU, 2023.....................................................................................................30
Table 8: Sample size distribution of Natural and Computational Sciences students of
WCU, Hossana, Ethiopia, 2023.........................................................................................46
Table 9: Sample size distribution of Agricultural Sciences students of WCU, Hossana,
Ethiopia, 2023....................................................................................................................47
Table 10: Sample size distribution of Business and Economics students of WCU,
Hossana, Ethiopia, 2023.....................................................................................................47

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LIST OF FIGURES
Figure 1: Conceptual framework showing Knowledge, Attitude and Practice on Voluntary
Blood Donation and Associated Factors among Non-Health Undergraduate Students of
Wachemo University, Hosanna, Ethiopia, 2023................................................................12
Figure 2: Level of knowledge among 311 respondents on Voluntary Blood Donation and
Associated Factors among Non-Health Undergraduate Students of Wachemo University,
Hosanna, Ethiopia, 2023....................................................................................................24
Figure 3: Level of attitude among 311 respondents on Voluntary Blood Donation and
Associated Factors among Non-Health Undergraduate Students of Wachemo University,
Hosanna, Ethiopia, 2023....................................................................................................25
Figure 4: Level of practice among 311 respondents on Voluntary Blood Donation and
Associated Factors among Non-Health Undergraduate Students of Wachemo University,
Hosanna, Ethiopia, 2023....................................................................................................27
Figure 2: Schematic representation of sampling method among different collage among
Non-Health Undergraduate Students of Wachemo University, Hosanna, Ethiopia, 2023 48

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ABSTRACT

Background- Blood transfusion is an important part of health care. It saves millions of


lives annually in each routine and emergency condition. Almost 800 women die from
causes related to complications of pregnancy and childbirth every day. Severe
hemorrhage throughout pregnancy, delivery, or after childbirth is the single biggest cause
of maternal death and can kill a healthy woman within 2 hours if she is unattended. At a
minimum, the World Health Organization estimates that a country needs 1% to 3% of its
population to donate blood to meet its need. Yet, many African countries including
Ethiopia are far below the minimum blood collection rate.

Objective- The aim of the study were to assess Knowledge, Attitude and Practice on
Voluntary Blood Donation and Associated Factors among Non-Health Undergraduate
Students of Wachemo University, Hosanna, Ethiopia, 2023

Methods-An institutional based cross-sectional study was conducted from September 16


to September 30, 2023 among 324 Non Health Undergraduate Students of Wachemo
University. A stratified random sampling procedure was employed according to the
departments. A pretested self-administered structured questionnaire will be used to collect
data. Data were entered into Epi -data software version 3.1 and exported to SPSS version
25 for analysis. Both bivariable and multivariable logistic regressions were used to
identify associated factors
Results: The proportion of students having good knowledge blood donation was 62.9%
and significantly associated with family education (mothers) [AOR=2.007, 95%CI:
0.966-4.171], religion [COR=1.216, 95%CI: 0.976-1.516], sex [AOR=0.662, 95%CI:
0.394-1.112], residence [AOR=0.983, 95%CI: 0.583-1.655].
The Favourable attitude of the respondents towards blood donation were 64.3% and
significantly associated with taking part in blood donation campaigns [AOR=1.962,
95%CI: 1.185-3.240], good knowledge [AOR=2.866, 95%CI: 1.722-4.770].
The practiced of voluntary blood donation were 38.6% and significantly associated with
taking part in blood donation campaign [AOR=0.168, 95%CI: 0.094-0.299], Favourable
attitude [AOR=0.198, 95%CI: 0.2.263-7.789],
Conclusion: The majority (62.4%) of the study participants had good knowledge and
more than half (64.3%) of them had a favorable attitude towards voluntary blood donation
but the practice was low. Therefore, awareness on blood donation should be created
among university students to strengthen the existing knowledge.
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Keywords: Knowledge, Attitude, Practice, Remunerated/paid donors and voluntary
blood donation

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1. INTRODUCTION

1.1. Background

Blood transfusion is an important part of health care. It saves millions of lives annually in
each routine and emergency condition; permits progressively advanced medical and
surgical interventions, and dramatically improve the life expectancy and quality of life of
patients with a variety of acute and chronic conditions (1).
Almost 800 women die from causes related to complications of pregnancy and childbirth
every day. Severe hemorrhage throughout pregnancy, delivery, or after childbirth is the
single biggest cause of maternal death and can kill a healthy woman within 2 hours if she
is unattended (2).Blood donors can be classified into 3 types namely voluntary unpaid,
family/replacement and paid. An adequate and reliable supply of safe blood can be
assured by a stable base of regular, voluntary, unpaid blood donor (3). The aim of a
transfusion is to deliver the blood components that will improve the physiological status
of the patient (4)
Blood and blood products are a novel and precious national resource as a result of they're
available solely from people who present blood or its elements. Most countries
desperately need a considerable increase in the number of individuals who are willing and
eligible to give blood in order to safeguard a stable supply of safe blood and blood
products that is abundant to meet national needs (12).
The proportion of Voluntary Non-Remunerated Blood Donations (VNRBDs) in the
African Region was 67 %(5).A cross-sectional survey on blood safety indicators was
conducted in the World Health Organizations (WHO) African region showed that the
donation rate was ranging from 3.9/1,000 -5.1/1,000 inhabitants. The proportion of
VNRBDs was lowest in Central Africa (34.4 %) and West Africa (48.4%) (6)
Data concerning the gender profile of blood donors show that globally twenty eighth of
blood donations are given by girl’s .In sixteen of the 119 reporting countries, less than
10% of donations are given by female donors. The age profile of blood donors shows
that, proportionally, more young people donate blood in low and middle income countries
than in high income countries. Demographic information of blood donors is important for
formulating and monitoring recruitment strategies(5)

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A survey conducted among 17 developing countries on knowledge, attitude and practice
towards blood donation showed that the overall general knowledge of the uses, typing and
testing of donated blood was high across all surveys .The survey showed that a positive
attitude, ranging from 97.5% in Iran to 69.7% in Tanzania(7).
Blood transfusion services were provided by the Ethiopian Red Cross society since 1969
through a Memorandum of Understanding (MoU) with the Federal Ministry of Health
(FMoH). FMoH made a policy decision to revert the responsibility for the National Blood
Transfusion Services (NBTS) from the Ethiopia Red Cross Society( ERCS) to a
Government led and managed service under the FMoH and the Regional health bureaus a
process that started in 2010 and was completed in 2013 (8).
A study among health science students of Samara University showed that out of total
participants 54% of them had adequate Knowledge regarding voluntary blood donation,
about 65.8% had Favorable attitude and less than one quarter (24.5%) had ever donated
blood (9).

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1.2 Statement of Problem

The adequate supply of safe blood was a major public health challenge in developing
countries where blood shortages were common and had severe consequences. Blood
donation shortages were due to an inefficient blood supply system based on donations by
relatives and friends of individuals needing transfusions, or to replace blood used in
emergencies. This may solve the problem for a short period in small communities, but
this is inefficient for chronic needs for blood (5). At a minimum, WHO estimates that a
country needs 1% to 3% of its population to donate blood in order to meet its needs.
However, the average donation rate were 15 times lower in developing countries than in
developed countries(1). The World Health Organization reported in 2018 that over 118.5
million units of blood were donated annually, with industrialized nations accounting for
nearly 40% of these donations. Fifty-four countries received more than 50% of their
blood supply from family/replacement or paid donors, even though 79 countries receive
over 90% of their blood supply from volunteer unpaid blood donors. In general, the WHO
noted that 60 nations collected fewer than 10 donations for every 1,000 citizens (6). One
of the four components of the WHO internal strategy was to promote global safety and
minimize the risk associated with blood transfusion. The first step toward blood safety
was to encourage blood donations from voluntary non-remunerated regular donors (10).
Demand for blood transfusion was alarmingly rising because of the utilization of newly
expanded invasive procedures, an increase in accidents, and chronic non-communicable
diseases which need a transfusion. But currently, the demand was high than the
supply(11). Blood transfusion helps in improving health and saving the life of a patient.
But many patients requiring transfusion do not have timely access to blood (12). A
voluntary donation of blood is considered as the backbone of blood safety and safe
transfusion practices. There is a critical need to improve the recruitment and retention of
voluntary blood donor populations to ensure a sustainable blood transfusion practice
(13). The blood donation rate in developing countries is 4.6 per 1000 people as compared
to 33.1 donations per 1000 people in developed countries (14). WHO African Region
reported an average annual blood donation rate of 4.3 units per 1000 population with a
range from 0.2/1000 in Nigeria to 33.8/1000 in Mauritius. Only five countries (Algeria,
Botswana, Congo, Mauritius, and South Africa) were able to collect at least 10 units/1000
populations(15). This was why, in many developing countries, there is a wide gap
between blood needs and supplies (5).

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The main reasons for not donating blood among donors in Sub Saharan African (SSA)
countries were due to factors such as a lack of well-established structures for the
provision of blood donation services; poor infrastructure, low blood donor recruitment,
and retention; widespread populations; many of whom live in rural areas with poor access
to blood centers, poor communication networks, and misperceptions about blood and
blood donation due to lack of knowledge and cultural influences (13).Obstetric
hemorrhages were a leading cause of maternal death SSA, and the shortage of blood for
transfusion is a contributory factor(16).
A community-based cross-sectional study recent study findings indicate that Ethiopia still
had a low rate of voluntary blood donations (17). In Ethiopia, 87,000 units of bloods were
donated for transfusion, but the country requires 200,000 units of blood every year.
Ethiopia was one of the developing countries that had a chronic shortage of blood. It had
high maternal mortality 412/per 100,000, and of this, 30% were due to hemorrhage that
resulted from non-availability of blood for transfusion totally or delays that can be
prevented if the mother gets access to blood transfusion services (18). Lack of voluntary
donors, limited access to blood donation centers within the community, and low
participation of blood donors are some of the challenges for blood donation in the country
(19).In Ethiopia, the National Blood Bank Service continues to be confronted with
challenges in its efforts to ensure the availability of blood for healthcare facilities (20).
Blood donation was predominantly dominated by students that accounted for around 60%
as indicated from a study done in Bahir Dar (19). As I know there were no available
literature done on Non-health students around Hossana town and arounds to our best this
research may asses’ Knowledge, Attitude and Practice on Voluntary Blood Donation and
Associated Factors among non-health undergraduate students of Wachemo University. In
Nigist Eleni Muhammed Memorial Comprehensive Specialized Hospital (NEMMCSH)
there were a shortage of blood during we choose this title of research, because of absence
of blood at that time most surgery program were postponed to another time. Therefore, a
better understanding on the level of community knowledge, attitude, and the practice of
donors may help to strengthen the blood donation program for areas that have a similar
setting with the study area.to effectively address this issue, conducting an assessment of
the knowledge, attitude and practices towards blood donation, and identifying the
associated factors that influence these behaviors is crucial. So, this research proposal aims
to asses Knowledge, Attitude and Practice on Voluntary Blood Donation and Associated
Factors among Non-Health Undergraduate Students of Wachemo University
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1.3 Significance of the Study

The study was helpful in addressing (identifying) the gap of knowledge, attitude, and
practice and associated factors among Non-Health Undergraduate Students of Wachemo
University, Hosanna, Ethiopia, 2023. Identifying the gaps of the students and acting upon
the problem was very helpful in educating the community at large about voluntary blood
donation. Furthermore, it will help as base line information for further studies. These
studies were intended to come up with the following major findings that were used to fill
the existing information gap on:-How many peoples in the study area know about the
importance of voluntary blood donation? What are their knowledge, attitude and practice
toward voluntarily blood donation? How many of them was ever donated blood, never
donated before and are regular donors. The study also helps us for partial fulfillment of
the requirements for Bachelor’s Degree in Surgical Nursing.

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2. LITERATURE REVIEW
Blood transfusion is an important concern for the society as it is life saving for patient
with trauma with bleeding, bleeding disorder; Surgery inherited or acquired
hematological disease or malignancies, anemia and other infection (21).
Replacement and paid donors have a higher incidence and prevalence of transfusion
related infection.50% of blood donors in developing countries are replacement and paid
donors (22).
The constant concern in the efforts to meet the demands for blood is the fact that only a
small percentage of the eligible population actually chooses to donate blood on a regular
basis (23).

2.1 Knowledge towards Voluntary Blood Donation

According to Hiremath Krishna Hospital & Medical Research Centre in India the overall
knowledge on blood donation among respondents was observed as good 10% and poor
34%(24).
A cross-sectional study of comparison between medical and non-medical students of two
Colleges conducted in Basrah, Iraq, showed 66.7% of the participants had a good
knowledge (73.0% among medical students vs. 43.0% of the students of College of
administration and Economic) (25).
A cross- sectional study conducted in Rajasthan on medical college students showed that
about (80%) of the subjects knew minimum weight to donate blood, (82%) knew the
interval between donations and (33.33%) knew the volume of blood at one setting(26) .A
cross sectional study conducted among University Students in Tanzania showed that
about 126(37%) knew the amount of blood that could be donated at one setting of blood
donation (27) .A study conducted among health sciences students of Addis Ababa
University showed that 321(83.7%) of respondents have good knowledge. Among the
respondents, 85.7%, 90.4%, 40.9% and 91.4% knew the age, weight limit minimum time
interval between two blood donations and the maximum amount of blood to be donated
respectively (28).
In other study done among Undergraduate Students in Awada Campus, Hawasa
University, Southern Ethiopia shows Around 207 (59.8%) of the before respondents
expressed a good knowledge of the common blood groups, and 132 (38.14%) knew their
own blood groups Exploration questionnaires heard about blood donation, 212 (87.3%)
of respondents have heard about it, while 44 (12.82%) have not heard. The source of

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information obtained by respondents on blood donation: 240 (69.34%) from media, 58
(15.04%) from blood donors, 45 (13%) from family or friends and 9 (2.62%) from other
sources not specified .of those surveyed, 230 (66.5%) had good knowledge about
infection transmission during blood transfusion, but 116 (33.5%) of the respondents had
little knowledge. Out of the respondents 165 (47.7%), stated that the minimum donation
frequency was every three months, 70 (20.2%) every six months, 11 (3.2%) annually and
the remaining 61 (17.6%) were not aware of this(29).

2.2 Attitude towards Voluntary Blood Donation

A cross-sectional study conducted among university students of India, Iraq and Malaysia
showed that 57.8%, 68.7% and 88.8% of the participants had favorable attitude towards
blood donation respectively (19, 25 and 26). A study done among university students in
Kilimanjaro, Tanzania showed that 94.7% of the study participants had favorable attitude
(27).
A cross sectional study conducted on 384(206 male and 178 female) students of Addis
Ababa University, college of health sciences and medicine showed that around one third,
123(32%) of participants had unfavorable attitude towards blood donation .Among the
respondents all of them showed willing to donate in the future. However 23.4%, 34.6%,
and 50% of respondents believe that blood donation makes weak, causes anemia and
reduce immunity respectively (28).
A comparative study conducted in ASTU and Arsi University Non-Health Science and
Health Science students revealed that about 84(46.7%) and 64(35.6%) of Health and Non-
Health Science students had favorable attitudes towards blood donation respectively(30).
According to study done among Undergraduate Students in Awada Campus, Hawasa
University, Southern Ethiopia shows that Among respondents in general, 288 (83.4%) of
the survey said that blood donation is good, while 7 (2.02%) thought it is bad and 51
(14.7%) have no idea. Similarly, 229 (66.2%) of the study participants responded that
voluntary blood donation is the best source of blood. Two hundred and eight (60.12%) of
the participants said something would Happen to a donor, 38 (18.3%), 110 (52.9%) and
60 (28.9%) stated that a donor could get an infection, temporarily weaken and get sick,
respectively. Of the total respondents 225 (76.3%) said that relatives of patients should be
asked to donate blood and two hundred and nine (60.4%) were showed willingness to
donate blood in the future(29).

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A community based cross sectional study done among 422 respondents in Hossana town
shows 213 (50.5%) of them had a poor attitude toward blood donation. A total of 264
(62.62%) participants thought it was a good idea to donate blood, while 16 (3.76%)
participants thought it was a poor idea. The remaining 78 (18.48%) of them were neutral.
A total of 410 people (97.16%) thought that voluntary blood donation was the best way to
obtain blood. From the total, 74 (17.54%) of the participants believed that risk will
happen after donation, and 240 (56.87%) of participants were not certain about risk
occurrence after donation. Nearly 359 (85.07%) had an interest to donate in the future.
However, just 198 (46.9%) of them intended to provide blood freely; instead, 216
(51.2%) of them wanted to give blood as a substitute if necessary. Nearly half of the
respondents, 209 (49.5%), had a positive attitude toward voluntary blood donation (17)

2.3 Practice towards Voluntary Blood Donation

A descriptive cross-sectional study of comparison between medical and non-medical


students of two colleges in Basrah University was conducted in Basrah, Iraq. Of the total
participants only 51 (13%) of total respondents had a history of blood donation, of those
64.7% donated only once. The most mentioned reasons for not donating were; not being
asked to donate (24.6%), inconsideration of donation (11.1%), and fear of drawing blood
(8.8%) (25).
According to Community based study conducted in Nigeria shows indicates that, Less
than one-quarter 212 (22.6%) of the respondents had ever donated blood. The
circumstances leading to blood donation were relation in need of blood 126(59.5%),
blood required by friends 76 (35.8%) while only 10 (1.1%) were voluntary blood
donation. Among the ever donated respondents, majority 92 (43.4%) donated once while
few 19 (9.0%) donated up to 4 times in their life. Most of the ever donated respondents
175 (82.5%) had not donated blood in the past one year. Among donors only 3%
donated voluntarily among this 57% were males. Many of the donors were donated for
relatives (57%) and 75% of them were compelled to donate because of emergency
situation.45% of the non-donor respondents did not donate because of lack of opportunity
due to work load and in adequate knowledge. 29% of them will donate initiated by gift
items(31).
A cross sectional study conducted among health sciences students of Addis Ababa
University showed that only less than one quarter, 90 (23.4%) have ever donated blood.
Out of the total participants (90) who ever donated blood, less than half, 38(42.2%) of

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them were a regular donors. Concerning what motivates them for blood donation, 74%
were motivated by moral duty and 23.3% were motivated for maintaining once health.
Among those who didn’t ever donated blood, the main reason for not donating were: lack
of information, being not asked and fear which were 68.4%, 66.7% and 56% respectively
(28).
According to study done among Undergraduate Students in Awada Campus, Hawasa
University, Southern Ethiopia shows of the total respondents 51 (14.7%) have donated
blood at some time, of which 29 (56.9%) donated once, 13 (25.5%) donated twice and 8
(15.7%) donated three times. Of those who donated blood, 22 (43.1%) feel comfortable,
18 (35.3%) feel fear, 5 (9.8%) feel anger and 6 (11.7%) feel indifferent after donating
blood. His/her donation reason was 29 (56.9%) for a sense of social responsibility and 13
(25.5%) for helping friends or family. Two hundred and ninety-five (85.3%) had never
donated blood in their lives. The reason for the non-donation included 61 (20.8%) have
not approached to donate, 50 (16.9%) unfit to donate, 60 (20.3%) need to donate for
relatives or friends in the future, 72 (24.4%) fear to the needle, 32 (10.8%) fear of
knowing the state of their screen, 4 (2.7%) religion (Jehovah's ingenuity) forbids it, 6
(2.03%) donated blood can be sold and 10 (3.4%) without remuneration (payment)(29).
A community based cross sectional study done among 422 respondents in Hossana town
shows Only 123 (29.15%) (Cl: 24.9–33.7%) of the study participants had ever donated
blood, and of those, 114 (92.7%) had done it voluntarily and 9 (7.3%) had done so in
place of family members.
Only 19 (4.50%) of the participants who had previously donated blood had done so twice
in their lifetime. On the other hand, 299 (70.85%) of the study’s participants had never
previously given blood. The most frequent reasons for not donating blood were that no
one asked, fear of pain and anemia, and a phobia of the sight of blood (17)

2.4 Factors

2.4.1 Factors associated with level of knowledge

A cross sectional study conducted in medical college in Karachi, Pakistan showed that
male gender was associated with knowledge on blood donation when compared to female
gender (32).
Institutional based cross-sectional quantitative among Graduating Class Students of
Assosa University, Benishangul Gumuz study revealed that the level of good knowledge
towards blood donation among graduating class students age, sex, religion, residence, and

9|Page
newspaper redder didn’t show any significant in bivariate analysis(p-value >0.2) and
didn’t include in the multi-variant analysis. Also, collage of study, use of social media,
television user, and radio/FM users show significant association in bi-vibrant but not in
multi-variant analysis. Multiple logistic regression analysis factors significantly
predictive level of knowledge of blood donation among internet users. Bing non-user of
the internet was 1.764 times more likely [AOR= 1.764, 95% CI: 1.029, 3.026] having
inadequate knowledge than when compared to the internet user (33)
A comparative study conducted in ASTU and Arsi University Non-Health Science and
Health Science students respectively showed that gender of the students was found as the
significant predictor. Accordingly, female Health Science students were 3.2 times more
knowledgeable than male .Health Science students, Religion and residence of the students
were significant predictors (30).
A community based cross sectional study done among 422 respondents in Hossana town
shows male has 4.95% poor, 66.9% average and 28.18% good knowledge and female has
7.5% poor, 63.5% average and 29.2% good knowledge (17)

2.4.2 Factors associated with level of attitude

A cross-sectional study among students in Semnan University of Medical Sciences, Iran


showed that no significant association between gender and attitude towards blood
donation(34).
A comparative study conducted in ASTU and Arsi University Non-Health Science and
Health Science students showed Gender and year of study of the students were the
significant factors (30)
A study done in ambo showed that the respondents who had good knowledge were 2.16
times [AOR, (95% CI), 2.16(1.4, 3.35) more likely had positive attitude as compared to
less knowledge towards voluntary blood donation (12).
Institutional based cross-sectional quantitative among Graduating Class Students of
Assosa University, Benishangul Gumuz study revealed In bivariate logistic regression
age, internet user, and level of knowledge were shows significantly associated with the
attitude of the participants towards VBD, while in multivariate logistic regression internet
user doesn’t significantly associate with VBD. When you see the level of knowledge,
inadequate knowledge, was 2.098 times having an unfavorable attitude towards VBD
(AOR= 2.098, 95% CI: 1.281, 3.437) when compared to having adequate knowledge and.
Also, Bing increases the age of respondents from 26-35 was 2.393 times having an

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unfavorable attitude (AOR=2.393, 95% CI: 1.051, 5.449) towards VBD when compared
with age in between 18-25 (33).

2.4.3 Factors associated with practice of blood donation

A study conducted at three different colleges of Kathmandu, Nepal showed that boys
were much more donating than girls, being 31.5% and 8.7% respectively (very
significant, p value 0.01). Donors also had a higher score on knowledge assessment than
non-donors (highly significant, p value 0.01). Those students who participated in
organizing blood donation camps were more likely to donate(35).
A cross sectional study among University Students in Kilimanjaro, Tanzania showed that
knowledge was not significantly associated with donation practices (15,10).A study
conducted among health science students of Addis Ababa University showed that a
statistically significant association with only sex and age >25. Being male and being age
>25 increased odds of practice (27).
Institutional based cross-sectional quantitative among Graduating Class Students of
Assosa University, Benishangul Gumuz study revealed the likelihood of blood donation
in bi-variant analysis Sex, age, religion, the residence where you come, and collage (field
of study) didn’t show significance association towards VBD practice (p-value>0.2) and
didn’t include from a multivariate regression analysis. A multivariate analysis on blood
donation practice revealed that a statistically significant association with television user,
attitude and knowledge level of respondent. Being a user of television 2.015 times more
likely non-donors of blood [AOR= 2.015, 95% CI: 1.100, 3.690] than compared to non-
user but internet and radio / FM user didn’t show statistically significant association with
VBD(33).
According Ahmed (2017), a study on knowledge, attitude, practice and associated factors
of voluntary blood donation among undergraduate students in Hargeisa University
indicates a significant association between blood donation, and age and male gender(36).
A community based cross sectional study done among 422 respondents in Hossana town
to find variables that are independently associated with the practice of blood donation,
variables with a p-value of 0.25 in a bivariate analysis were chosen and incorporated into
the multivariable logistic regression model. Being male and having a positive attitude
were found to be independently associated with the practice of blood donation in the
multivariable logistic regression analysis. Male participants in the study were more than
twice as likely as female participants to donate blood (17)

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2.5. Conceptual framework

This conceptual framework was developed after reviewing different relevant literature.
As indicated by different studies, there is an assumption that these factors have an
association with Knowledge, Attitude, and Practice towards voluntary blood
donation(17),(27),(29),(30),(32),(33),(36)

Socio demographic
factors
 Source of
 Age information
Knowledge,
 Sex Attitude, Practice  Educational
 Department towards voluntary
level of family
blood donation
 Year of study
 Religion
 Residence

Figure 1: Conceptual framework showing Knowledge, Attitude and Practice on Voluntary


Blood Donation and Associated Factors among Non-Health Undergraduate Students of
Wachemo University, Hosanna, Ethiopia, 2023

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3. OBJECTIVE

3.1 General Objective

To assess Knowledge, Attitude and Practice on Voluntary Blood Donation and


Associated Factors among Non-Health Undergraduate Students of Wachemo University,
Hosanna, Ethiopia, 2023

3.2 Specific Objective

 To asses knowledge level on voluntary blood donation Among Non-Health


Undergraduate Students of Wachemo University, Hosanna, Ethiopia, 2023
 To describe attitude on blood donation Among Non-Health Undergraduate Students
of Wachemo University, Hosanna, Ethiopia, 2023
 To assess the practice of blood donation Among Non-Health Undergraduate Students
of Wachemo University, Hosanna, Ethiopia, 2023
 To identify factors associated with knowledge Among Non-Health Undergraduate
Students of Wachemo University, Hosanna, Ethiopia, 2023
 To identify factors associated with attitude Among Non-Health Undergraduate
Students of Wachemo University, Hosanna, Ethiopia, 2023
 To determine factors associated with practice of blood donation Among Non-Health
Undergraduate Students of Wachemo University, Hosanna, Ethiopia, 2023.

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4. METHODS AND MATERIALS

4.1 Study Area and Period

The study was conducted at Wachemo University main Campus. Wachemo University
(WCU) is one of the public higher educational institutions, which was founded in 2009
G.C. It is located 230 km southwest of Addis Ababa, at Hosanna town in the area of over
200 hectares. The University commenced its function in 2012 admitting 538 students in
12 departments under 4 faculties. Currently, the University has admitted over 18,000
students in regular and continuing education programs in 48 departments under 6
Colleges, namely 1) Engineering and Technology, 2) Natural and Computational
Sciences, 3) Medicine and Health Sciences, 4) Agricultural Sciences, 5) Business and
Economics, and 6) Social Sciences and Humanities. In addition to these, the university
has 31 (thirty one) graduate studies, commencing masters programs in all of the six
colleges. From this our study will be conducted in three randomly selected regular
undergraduate non-health science college students of Wachemo University namely
College of business and economics, College of Natural and computational Sciences, and
college of agricultures.
The study was conducted from September 16 to September 30, 2023 Among Non-Health
Undergraduate Students of Wachemo University, Hosanna, Ethiopia, 2023.

4.2 Study Design

Institutional based cross sectional study design was conducted.

4.3 Population

4.3.1 Source of population

All Non-Health Undergraduate regular Students of Wachemo University.

4.3.2 Study Population

All those randomly selected 3rd year Non-Health Undergraduate regular Students of
Wachemo University.

4.4 Inclusion and Exclusion Criteria

4.4.1 Inclusion criteria

 All regular undergraduate students who were 3rd year were included.

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4.4.2 Exclusion criteria

 Students who were seriously ill during data collection.


 Students who were not around for different academic purposes during data
collection period will be excluded.

4.5 Sample Size Determination

The sample size was determined by using the single population proportion formula. The
needed sample size was estimated by using the following assumptions: - 5% marginal
error and 95% confidence interval (∂ (alpha) =0.05). By using the percentage proportion
of variables from Knowledge, Attitude and Practice on Voluntary Blood Donation and
Associated Factors among Ambo University Regular Students, Ambo Town, Ethiopia
done by Abnet Nigatu and Dereje Bayissa Demissie in 2022(12), shows the following
finding.

By taking Knowledge 40.4%, positive attitude 47.4%, practice 23.6%.

(z α /2)2 p (1− p)
N=
d2

Where
N=Sample size

Z=standard normal distribution (Z=1.96) with 95% confidence interval

P= Prevalence 0.404, 0.474 & 0.236 for knowledge, attitude & practice respectively.

d= a tolerable margin of error (d=5%=0.05).

Knowledge, p=0.404

(1.96)2 x (1−0.404) X 0.404


¿ =369.84~370
0.0025

Attitude, p=0.474

(1.96)2 x (1−0.474) X 0.474


¿ =382.96~383
(0.05)2

Practice, p=0.236

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(1.96)2 x (1−0.236) X 0.236
¿ =276.94~277
(0.05)2

By taking the ‘p’ value of attitude (i.e. p=0.474 since it has the maximum sample size
relative to others)

n=383, since total population is less than 10,000 (1281), by using correction factor and
considering 10% non-response rate.

n
nf = n , where, n=initial sample size (383), N=total population (1281), nf=final
1+¿ N ¿
sample size.

383/1+383/1281 +10% of non-response rate, nf= 294.8+29.5(10% of non-response rate.),

nf= 324 this is the final sample size.

4.6 Sampling Procedures and Technique

In the first step out of all collages, three colleges were randomly selected using lottery
method, which are Natural, and Computational Sciences, Agricultural Science and Business
and Economics. A total of 1281 non-health regular undergraduate students of 3 rd year were
attending their study in three colleges under 23 departments .A stratified sampling
procedure was employed according to the departments. After identifying the number of
students in each department with their respective year of study, the sample for each stratum
was distributed using the proportional allocation to size formula. Then, a list of students’
identification number taken from office of registrar was entered into table. Finally,
participants were selected by simple random sampling technique from each sub stratified
populations proportionally

4.7 Study Variables

Dependent variables
 Knowledge of voluntary blood donation
 Attitude of voluntary blood donation
 Practice of voluntary blood donation
Independent variables
 Age
 Sex

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 Marital status
 Religion
 Residence
 Educational level of family
 Department of study
 Years of study

4.8 Operational Definitions

Level of Knowledge: This is the understanding level of the respondents on the benefits,
risks, eligibility criteria of blood donation.
It was assessed by using twelve knowledge-related questions, whereas the mean value
was considered to classify the students as having good knowledge or poor knowledge
Those students who scored more than the mean value((≥ 7) were considered as having a
good knowledge and vice versa (37).
Attitude towards blood donation: Attitude is the intention of participants towards blood
donation practice.
It was assessed by using six questions and those students who scored more than the mean
value(≥4) were considered as having a favorable attitude and vice versa(37).
Remunerated/paid donors: Those individuals who give blood in favor of money or
other payment(37).
Practice of Blood Donation: Those students who donated blood (voluntarily,
replacement, and paid) at least once in a lifetime were categorized as “ever donated”
whereas who never donated blood at all in a lifetime were categorized as “never
donated”(37).

4.9 Data Collection Tool and Procedures

Pretested structured questionnaires were used to collect data through self-administered


questionnaire which was prepared in English. The tool was adapted from other studies
(37) and it contains four parts. Part I was used to assess socio-demographic
characteristics, part II was used to assess knowledge about voluntary blood donation and
part III was used to assess attitude about voluntary blood donation. Part IV used to assess
practice about voluntary blood donation. Knowledge about voluntary blood donations
was assessed by requesting the respondents to answer 12 knowledge assessment
questions. Each correct response was scored one [1] and incorrect response was scored

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zero [0].attitude towards blood donation was assessed by requesting respondents 6
attitude questions. The responses were scored as “1” for favorable attitude” and “0” for
unfavorable attitude for each attitude question. The study participants who scored 4 and
above for the attitude assessment questions were considered as having favorable attitude.
Moreover, practice was assessed by asking about history of previous donation and the
frequency of donation.

4.10 Data Quality Control Measures

To assure the overall quality of the study, the principal investigators were undertake
training for data collectors ahead of the actual data collection date, regarding the study
instrument, procedures, objectives of the study, and confidentiality. The questionnaires
were pre-tested with 5% of the sample size at the College of Engineering and technology,
department of civil engineering to verify validity and the necessary corrections were
made based on the results of the pre-test. The principal investigators and the supervisors
were check for incompleteness, code, and cleanliness to assure the quality of findings.
Incomplete, inconsistent, and unclearly filled questionnaires were given back to the data
collector and get completed.

4.11 Data Processing and Analysis

The collected data was coded, entered, and cleaned using Epi-data software version 3.1
and exported to SPSS (Statistical Package for Social Sciences) version 25 for further
analysis. Bivariate and multivariate analysis was carried out to investigate the association
between dependent and independent variables. Those variables having p values less than
0.25 on bivariate logistic regressions were entered into the multivariate logistic regression
to control all possible confounders and identify associations. The result of the final model
was expressed in terms of adjusted odds ratio (AOR) with 95%CI. P-value <0.05 will be
considered as statistically significant.

4.12 Ethical Considerations

Ethical clearances were obtained from the Wachemo University, Medicine and Health
Science College, Department of Surgical Nursing . In addition to that, verbal consent was
obtained from all respondents who were assure that participation was on a voluntary
basis. Confidentiality of the data was maintained whereby identification number (code)
numbers were used on the top of questionnaires instead of respondents ‘names for the

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purpose of gathering information. Finally, all questionnaires were kept securely after data
entry completion.

4.13 Dissemination of Results

Final copy of this study findings were presented and submitted to Wachemo University
College of Medicine and health science, Department of surgical nursing, NEMMCSH
blood bank, and NEMMCSH admin office.

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5. RESULTS

5.1. Socio-Demography/Socio-Economic Back ground

A total from 324 students of sample size 311 of it were responded properly and 13
students were non-respondents. Involved in the study of which 118 (37.9%) were female
and 193 (62.1%) were male. From all students who were responded 285 of them were in
the age group of 18-24 years and 26 of them were greater than 25 years age. Regarding
religion, 113 (36.3%) were Orthodox, 114 (36.7%) were Protestants, 57 (18.3%) were
Muslims, 15 (4.8%) were Catholics and the rest 12 (3.9%) were others. All of our
respondents were 3rd year students. By their marital status 297(95.5%) were single,
9(2.5%) were married, 3(1%) separated and 2(0.6%) were divorced. Regarding their
residence 142(45.7) rural, 169(54.3%) urban. When we saw their families educational
level 183(58.8%), 128(41.2%) were has educated mother and not educated mothers and
210(67.5%), 101(2.5%) were educated fathers and not educated fathers respectively.
Table 1: Sociodemographic characteristics on blood donation among non-health Science
Students of WCU, 2023
Characteristics Category Frequency Percent
(%)
Age 18-24 285 91.6
≥25 26 8.4
Total 311 100
Male 193 62.1
Sex Female 118 37.9
Total
Religion Orthodox 113 36.3
Muslim 57 18.3
Protestant 114 36.7
Catholic 15 4.8
Others 12 3.9
Total
Marital status Single 297 95.5
Married 9 2.5
Separated 3 1
Divorced 2 0.6
Residence Rural 142 45.7
Urban 169 54.3

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Year of study 3rd 311 100
Yes 210 67.5
Father ever attend
school No 101 32.5
Father’s level of Primary 77 24.8
education
Secondary 66 21.2
Technical/vocational 14 4.5

Higher(college/university) 53 17.5
Mother ever Yes 183 58.8
attend school No 128 41.2
Mother’s level of Primary 100 32.2
education Secondary 51 16.4
Technical 10 3.2
Higher(collage/university 22 7.1

Department Accounting and finance 45 14.5


Agro economics 6 6.1
Animal science 7 2.3
Biology 11 3.5
Biotechnology 9 2.9
Chemistry 12 3.9
Economics 28 9
Environmental science 8 2.6
Geology 6 1.9
Food science 9 2.9
Horticulture 7 2.3
Industrial chemistry 8 2.6
Management 25 8
Marketing 28 9
Mathematics 6 1.9
NARM 6 1.9
PADM 23 7.4
Physics 9 2.9
Plant science 10 3.2
RDA 7 2.3
Sport science 12 3.9
Statistics 9 2.9
Tourism 7 2.3

21 | P a g e
5.2. Level of knowledge

Out of the total participants, 200(62.7%) had good knowledge whereas the remaining
111(37.3%) had poor knowledge about blood donation. A bout 225(72.3%) respondents
had good knowledge of the common blood group type, and only 195(62.7%) knew their
own blood groups. Majority of the respondents 230(74%) had good knowledge on the risk
of transmission of infection by transfusion. The risk of transmission of HIV was
confirmed by 201(64.6%), HBV 17(5.5%) and HCV 2(0.6%).Concerning to the
knowledge of illegible groups to donate blood, majority of the respondents stated
232(74.6%) Diseased,10(3.2%) old>60 years, 22(7.1%) vulnerable groups and 16(5.1%)
young<18 years. Majority; 52(16.7%), 43(13.8%), 81(26%) and 108(34.7%) of the study
participants did not know the volume of blood to be donated once, duration of a donation
process, minimum weight and minimum interval between two donations respectively.

Table 2: Knowledge on blood donation among non-health Science Students of WCU,


2023
Characteristics Category Frequency Percent
(%)
Heard/seen Information Yes 311 100
about blood Donation
No 0 0
From where did you Health professionals/facility 76 24.4
hear or see those Print media (Newspaper, 29 9.3
leaflet, brusher, billboard)
messages?
Electronic media (TV, Radio) 63 20.3
School/University 114 36.7
Friends/ Family, relatives 29 9.3
Religious worship place 1 0.3
Do you know common Yes 225 72.3
blood groups No 86 27.7

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Do you know your blood Yes 195 62.7
group No 116 37.3
Your blood group A+ 42 13.5
B+ 27 8.7
AB + 39 12.5
O+ 66 21.2
A- 5 1.6
B- 6 1.9
AB- 7 2.3
O- 3 1
Can a person be infected Yes 230 74
by receiving blood
No 81 26
transfusion
What disease are HIV 201 64.6
transmissible by blood HBV 17 5.5
transfuse? HCV 2 0.6
Syphilis 1 0.3
Malaria 6 1.9
CMV 3 1
How often individual Weekly 7 2.3
donate Monthly 20 6.4
Three monthly 108 34.7
Six monthly 26 8.4
Annually 51 16.4
Don’t know 99 31.8
Who should not donate Men 8 2.6
blood Women 6 1.9
Young<18yrs 16 5.1
Old >60yrs 10 3.2
Vulnerable groups 22 7.1
Healthy 17 5.5
Diseased 232 74.6
Volume of blood is <500mls 52 16.7
collected during each
500-1000mls 73 23.5

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donation Don’t know 186 59.8
Duration of a donation 20 min 43 13.8
process 20-60min 73 23.5
don’t know 195 62.7
Minimum weight limit <45 Kg 40 12.9
45Kg 81 26
>45Kg 74 23.8
Don’t know 116 37.3

Figure 2: Level of knowledge among 311 respondents on Voluntary Blood Donation and
Associated Factors among Non-Health Undergraduate Students of Wachemo University,
Hosanna, Ethiopia, 2023
5.3. Level of Attitude

From the total respondents, 200(64.3%) had a favorable attitude towards voluntary blood
donation. Majority 256(82.3%) of the study participants thought that blood donation is
good while about 119(38.3%) of the participants were not willing to donate if called upon
or reminded to do so. Regarding the source of blood donation about 200(64.3%) thought
that voluntary donors are the best sources. However, about 187(60.1 %) of them agreed
that the patient's relative should be asked to donate.
Table 3: Attitude towards blood donation among non-health Science Students of WCU,
2023

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What do you think about Good 256 82.3
blood donation Bad 15 4.8
No idea 40 12.9
What do you think is the Voluntary donor 200 64.3
best source of blood Replacement donor 17 5.5
donation? Remunerated donor 3 1
Self-donor 39 12.5
Do not know 52 16.7
Do you think something Yes 182 58.5
harmful happen to a blood
No 53 17.1
donor during or after
I don’t know 76 24.4
blood donation
What can happen to a contract infection 66 21.2
blood donor during or
temporary weakness 160 51.4
after donation?
Fall sick 85 27.3
Do you think that patient's Yes 187 60.1
relative should be asked to
No 52 16.7
Donate?
I do not know 72 23.2
Will you donate if called Yes 192 61.7
upon or reminded to do so No 119 38.3

25 | P a g e
Figure 3: Level of attitude among 311 respondents on Voluntary Blood Donation and
Associated Factors among Non-Health Undergraduate Students of Wachemo University,
Hosanna, Ethiopia, 2023

5.4. Practice

This study revealed that less than a half 120(38.6%) of the participants had ever donated
at least once. Among the donors about 71(22.8%), 36(11.6%), and 13(4.2%) were
donated once, twice and more than two times in their lifetime respectively. The main
reason for blood donation reported was 23(7.4%) moral satisfaction, 36(11.6%) A sick
person needed, 24(7.7) Motivated by friend /family donor, 20(6.4%) media appeal. The
reasons for not donating were 51(16.4%) fear of blood donation, 32(10.3%) no
information, 17(5.5%) never thought of it and 8(2.6 %) feeling of medically unfit. Related
to half 149 (47.9%) of the participants had not taken part in any blood donation
campaigns.
Table 4: Practice of blood donation among non-health Science Students of WCU, 2023
Characteristics Category Freq Percent
(%)
Have you ever donated Yes 120 38.6
blood before? No 191 61.4
How many times do you Once 71 22.8
donate? Twice 36 11.6
More than 2 times 13 4.2
What prompted you? A sick person needed 36 1.6
Moral satisfaction, altruism 23 7.4
Earning profit in cash / kind 1 0.3
For free health check-up 11 3.5
Motivated by friend /family 24 7.7
donor
Media appeal 20 6.4
others(specify) 5 1.6
What was the reason for I have no information 32 10.3
not donating? Fear of blood donation 51 16.4
Medically unfit 8 2.6
Under age 7 2.3

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Cultural or religious rejection 6 1.9
Lack of time 12 3.9
It takes long time 10 3.2
Inaccessibility of the service 12 3.9
Never thought of it 17 5.5
Parental or peer opposition 7 2.3
Never had the opportunity 11 3.5
My blood will be sold 5 1.6
Others specify 13 4.2
Have you taken part in Yes 162 52.1
Blood donation No 149 47.9
campaigns?
Do you encourage Yes 229 73.6
relatives to donate? No 47 15.1
No Response 35 11.3

Figure 4: Level of practice among 311 respondents on Voluntary Blood Donation and
Associated Factors among Non-Health Undergraduate Students of Wachemo University,
Hosanna, Ethiopia, 2023

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5.5. Associated factors

5.5.1. Factors associated with knowledge towards voluntary blood donation

Bivariate analysis showed a statistically significant association of level of knowledge


towards blood donation with gender, family’s educational status (mother and father).
After controlling for the effects of potentially confounding variables using multivariate
logistic regression, there is no variable to be statistically significant predictors of level of
knowledge.
Table 5: Factors associated with knowledge among non-health Science Students of WCU,
2023
Overall
knowledge
Characteristics Category Good Poor COR(95%CI AOR(95%CI) p-Value
)
Gender Male 116 77 1
Female 84 34 0.610(0.373 0.662(0.394 0.049
to 0.957) to 1.112)
Mother Yes 134 49 0.389(0.242 2.007(0.966 0.0632
education to 0.627) to 4.171)
No 66 62 1
Fathers Yes 148 62 0.445(0.272 0.790(0.375 0.536
educations to 0.726) to 1.664)
No 52 49 1
Religion 1.216(0.976 0.082
to 1.516)
Residence Rural 86 56 1.350(0.847 0.983(0.583 0.207
to 2.150) to 1.655)
Urban 114 55 1

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NB: P-value less than 0.05 were show significantly associations.

5.5.2. Factors associated with attitude towards voluntary blood donation

Bivariate analysis showed a statistically significant association of level of attitude


towards blood donation with knowledge and taking part in blood donations campaigns.
Using multivariate logistic regression, knowledge and taking part in blood donations was
found to be statistically significant predictors of level of attitude. Having poor knowledge
about blood donation decreased odds of the level of attitude (See table 6)
Table 6: Factors associated with attitude of blood donation among non-health students of
WCU, 2023
Overall knowledge
Characteristics Categor Favourable Unfavourabl COR(95%CI) AOR(95%CI) p-
y e Value
Knowledge Good 145 55 1

Poor 55 56 2.684(1.653 2.866(1.722 0.000


to 4.358) to 4.770)
Taking part in Yes 109 48 1
campaigns
No 83 62 1.696(1.057 1.962(1.185 0.009
to 2.782) to 3.248)
Religion 0.869(0.691 0.231
to 1.093)

NB: P-value less than 0.05 were show significantly associations.

5.5.3. Factors associated with practice of voluntary blood donation

Bivariate analysis showed a statistically significant association of practice of blood


donation with religion, family’s (mothers) educational status, and taking part in blood
donation campaign, sex, attitude and knowledge. Using multivariate logistic regression,
Taking part in blood donation campaign and attitude were found to be statistically
significant predictors of practice. Having taken part in blood donation campaign increased
the odds of practice while respondents with Unfavourable attitude about blood donation
decrease the odds of practice towards voluntary blood donation.

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Table 7: Factors associated with practice of blood donation among non-health Science
Students of WCU, 2023
Overall
practice
Characteris Category Ever Never COR(95%CI) AOR(95%CI) p-
tics Value
Religion 1.180(0.941 to 1.479) 0.152
Mothers Yes 76 107 0.737(0.462 to 1.178) 1.028(0.570 to 1.856) 0.203
educational
status
No 44 84 1
Taking part Yes 90 67 0.170(0.101 to 0.280) 0.168(0.094 to 0.299) 0.000
in blood
donations
campaigns No 27 118 1

Knowledge Good 83 117 1


Poor 37 74 1.419(0.874 to 2.303) 1.243(0.688 to 2.246) 0.157

Attitude Favourable 99 101 1


Unfavourable 21 90 4.201(2.424 to 7.281) 4.198(2.263 to 7.789) 0.000

Sex Male 80 113 0.724(0.450 to 1.167) 0.65(0.369 to 1.164) 0.185

Female 40 78 1

NB: P-value less than 0.05 were show significantly associations.

30 | P a g e
6. DISCUSSION
In this study, 62.7% of respondents had good knowledge towards blood donation. This
finding is lower than a study conducted in Iraq (medical students) , Malaysia & AAU
health science students and Arsi university Health science students where 73%, 97. 1%,
83.7% & 79.4% of the respondents had good knowledge towards blood donation
respectively (25, 38, 28, and 30). This difference could be from the fact that most of the
studies in other places were conducted among medical and health science students. In
contrary the level of knowledge of this study was higher than the study conducted in
ASTU University Non- Health science students where 13.9% of the respondents had good
knowledge (30)
Only 16.7% the study participants knew the volume of blood to be donated once while
23.8% knew minimum weight allowed. This was lower than the study done in Addis
Ababa University Health Science students which was 91.4% and 90.4% respectively (28).
This was also lower than the study done in Udaipur city of Rajasthan where 33.33% and
84.66% of the respondents had knowledge on the minimum weight, and volume of blood
collected once respectively (26). The explanation for this may be because the other
studies were conducted in health science students.
In our study about 82.3% respondents had good attitude towards blood donation. This
study was lower than the study conducted in Tanzania which was about 94.7% and 88.8%
study conducted in Malaysia (27) and higher than previous studies conducted in India ,
Iraq , and Addis Ababa University which were 57.8% ,68.7% and 68%
respectively(25,38,40,28). A study done in Addis Ababa University all of them were
willing to donate in the future if called upon or reminded to do so. In this study, however,
about 38.3% of the participants were not willing (28) .The explanation could be lack of
knowledge about blood donation and socio demographic differences.
In the current study less than quarter, 22.8% of the respondents had ever donated blood at
least once. This was lower than studies done in Nepal (23.4%) and Addis Ababa

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University health science students (23.4%) (39, 28) .This was higher than the studies
conducted in Iraq (13%) (25) and Udaipur city of Rajasthan (14%) (26). and lower than
the studies conducted in India (47.5%), Malaysia (29.7%), Namibia (28%) and Nigeria
(35.4%) (41,38,42,31). Such differences in blood donation practice could be attributed to
socio-cultural factors, differences in knowledge, lack of awareness creation and
campaigns by NBBS and misconception/ fear about blood donation. Concerning what
motivates them for blood donation, 7.4% were motivated by moral duty. This was lower
than study conducted in health science students of Addis Ababa University which was
about 74% (28). Regarding to the reasons for not donating were; Fear of blood donation
(16.4 %), Never thought of it (5.5%), feeling of medically unfit (2.6%) and My blood will
be sold (1.6%) . This was in agreement with studies done in Nepal ,Iraq, India,
Rajasthan ,Namibia ,Nigeria and Addis Ababa University where Fear of blood donations,
never thought of it, medically unfit, lack of information and not approached were the
most commonly mentioned reasons for not donating blood (39,25,41,26,42,31,28).
On bivariate analysis Religion, gender, residence and educational status of family were
associated with increased level of knowledge, which was comparable to study conducted
in ASTU and Arsi University where religion was significantly associated with increased
level of knowledge towards voluntary blood donation (30), but factors like age, year of
study which were predictors level of knowledge in other studies were not found to be
associated in this study (28, 30, 34). On multivariate there is no variable which were
significantly associated with level of knowledge. This may be explained due to lower
sample size in this study.
On bivariate Religion, knowledge and taking part in blood donations campaigns were
found to be statistically significant predictors of level of attitude. This was in agreement
with study done in Ambo University where knowledge was significantly associated with
increased level of attitude towards voluntary blood donation (12). On multivariate only
taking part in blood donation campaigns and knowledge were associated with increased
level of attitude towards blood donations. This study also revealed gender was not
associated with increased level of attitude which is similar with study conducted in Iran
(34) and in disagreement with a study conducted in Addis Ababa University health
science students were being male increases the odds of level of attitude (28).
On bivariate having taken part in blood donation campaign, religion, Favourable attitude
about blood donation, being female, mother’s educational status, having good knowledge
about blood donations increased the odds of practice of respondents towards voluntary
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blood donation. This was in agreement with study conducted in Nepal where attitude and
taking part in blood donation campaigns were significant associated factors to level of
practice (35). Also this was in disagreement with studies done in Tanzania and Samara
University where knowledge was not associated with practice of blood donation (27,
9).on multivariate only taking part in blood donations campaigns and knowledge were
significantly associated with practice towards blood donations. In this study age,
department and residence were not associated to practice while they were associated in
other studies (9, 28). This may be due to lower sample size in this study and
sociodemographic differences

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7. CONCLUSION
Greater than half numbers of students in this study have good knowledge and while less
than half students have ever good practice of blood donation while the level of attitude is
good. On bivariate religion, sex, residence, and family educational status (mothers and
fathers) were associated with the level of knowledge. Taking part in blood donations
campaigns and knowledge of the participants were associated with the level of attitude.
Having taken part in blood donation campaigns, good attitude about blood donation
increased the odds of the practice of respondents towards voluntary blood donation. The
majority of blood donors were motivated for a sick person needed blood and moral
satisfaction. Fear of blood donation, never thought of it, having no information’s, never
had opportunity, inaccessibility to a service ,lack of time, takes long times and feeling of
medically unfit were mentioned as reasons for not donating blood.

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8. STRENGTH AND LIMITATION OF
THE STUDY
8.1 Strength of the study
Study participants were selected using stratified sampling and Doing the analysis by
applications. This makes the study more representatives by giving each stratum a
proportional allocation and made a study to be good. Taking long time to do the study
also made the study to be done properly.
8.2 Limitation of the study
The cross-sectional nature of study limits the study to show causal association.
Since the study is institution -based, it may not give us the clear picture of
community status of blood donation.
Financial constraints

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9. RECOMMENDATIONS
Ethiopian Red Cross society should work in collaboration with Wachemo University
to improve the low level of blood donors among non-health science students.
National Blood Bank Service & Nigist Eleni blood bank jointly should work with the
university in strengthening awareness creation &organizing blood donation campaigns.
The University should encourage clubs to increase the number of students taking part
in blood donation campaigns as part of organizing or campaign member.
The University should organize different events to increase students’ level of
knowledge and the number of blood donors.
Further studies need to be conducted on this matter to identify more gaps especially
in a community-based setting with mixed methods

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12. Nigatu A, Demissie DB. Community Medicine & Health Education Knowledge ,
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15. Ossai EN, Eze NC, Chukwu O, Ugochinyere A. Archives of Community Medicine
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maternal death in Ethiopia between 1990 and 2016 : systematic review with meta-
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20. Abdella YE, Berhane Y. Obstetric hemorrhage and safe blood for transfusion in
Ethiopia: the challenges of bridging the gap: Obstetric Hemorrhage & Maternal
Mortality. 2017;(October 2018).

21. 2009 Annual Report. 2009;

22. Wiwanitkit V. Research Note A Study On Attitude Towards Blood Donation


Among People In A Rural District , Thailand. 1994;609–11.

23. Flow D, Units R, Forward W, Safety B, Status R, Separation BC, et al. No Title.

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24. Bank B, Hospital K, Maharashtra K, Bank B, Hospital K, Maharashtra K. To
Assess the Knowledge of Blood Donation among Voluntary Blood Donor at
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Blood. 2016;(January 2012).

25. Al-asadi JN, Al-yassen Aq. O R I G I N A L A Rticl E Knowledge , attitude and


practice of blood donation among university students in Basrah , Iraq : A
comparison between medical and non-medical students. 2018;9(6):62–7.

26. Solanki SL. Study on Blood Donation Among Medical Students of Udaipur City ,
Rajasthan. 2018;10(16):8–11.

27. Elias E, Mauka W, Philemon RN, Damian DJ, Mahande MJ, Msuya SE. with
Voluntary Blood Donation among University Students in Kilimanjaro , Tanzania.
2016;2016.

28. Misganaw C, Investigator P. The Level And Associated Factors Of Knowledge ,


Attitude And Practice Of Blood Donation Among Health Science Contribution /
Originality. 2014;1(10):105–18.

29. Shamebo T. Assessment of Knowledge , Attitude and Practice of Voluntary Blood


Donation among Undergraduate Students in Awada Campus , Hawassa. 2020;1–6.

30. Gebresilase HW, Fite RO. Knowledge , attitude and practice of students towards
blood donation in Arsi university and Adama science and technology university : a
comparative cross sectional study. 2017;1–10.

31. Salaudeen AG, Musa OI, Awoyemi AO, Bolarinwa AO, Adegboye AO, Samuel
SO. Community survey on blood donation practices in a northern state of Nigeria.
2011;21–5.

32. Ahmed Z, Zafar M, Khan AA, Anjum MU, Siddique MA. Journal of Infectious
Diseases and Knowledge , Attitude and Practices about Blood Donation among
Undergraduate Medical Students in Karachi. 2014;2(2):2–5.

33. Gumuz B. Knowledge , Attitude , Practices , and Factors Associated with


Voluntary Blood Donation among Graduating Class Students of. 2020;1–10.

34. Majdabadi HA, Kahouei M, Taslimi S, Langari M, Care N. Electronic Physician

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( ISSN : 2008-5842 ). 2018;(May):6821–8.

35. Study on Knowledge , Attitude and Practice of Blood Donation among Students of
Different Colleges of Kathmandu , Nepal. 2013;4(3):424–8.

36. Ahmed AO. Journal of Community Medicine & Knowledge , Attitude , Practice
and Associated Factors of Voluntary Blood Donation among Undergraduate
Students in Hargeisa University. 2017;7(4).

37. Talie E, Wondiye H, Kassie N, Abdissa HG. Voluntary Blood Donation Among
Bahir Dar University Students : Application of Integrated Behavioral Model , Bahir
Dar , Northwest Ethiopia ,. 2020;(November).

38. Elnajeh M, Ghazi HF, Abdalqader MA, Baobaid MF. Knowledge, attitude and
practice towards blood donation and its associated factors among university students in
Shah Alam, Malaysia. Int of J Community Med Public Health. 2017 Jun 23; 4(7):2230.
39. Pokhrel B, Pandey N, Parajuli-Pokhrel K. Knowledge, Attitude and Practice
regarding voluntary blood donation among the bachelor level students of Chitwan, Nepal.
Janaki Med Coll J Med Sci. 2015; 3(2):21–8.
40. Govindasamy V, Sivasankaran D, Purushothaman V. Knowledge, attitude and
practice regarding blood donation among medical students of Tamil Nadu- a cross
sectional study. Int J Community Med Public Health. 2019 Sep 26;6(10):4583.
41. Giri PA, Phalke DB. Knowledge and Attitude about Blood Donation Amongst
Undergraduate Students of Pravara Institute of Medical Sciences Deemed University of
Central India. Ann Trop Med Public Health. 2012 Nov 1;5(6):569.
42. Ojulong J, Muhoza J, Monteiro L. Barriers that prevent health science students from
donating blood in an African setting. Int J Community Med Public Health. 2016 Jan 1;
3544–7.

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ANNEXES

Annex I: Subject Information Sheet

Annex II: Consent form

ANNEX III: Questionnaires

Introduction:
Dear ………….,
This questionnaire is intended to collect information from students of WCU on
assessment of Knowledge, Attitude and Practice on Voluntary Blood Donation and
Associated Factors. The information you provide is very important to understand why
people donate or don’t donate blood. Thus, you are kindly requested to provide us with
genuine information. The information you provide will be confidential. You have every
right not to be involved in this study or to discontinue completing this questionnaire.
Are you volunter to participate?
Yes No
Code……. Date / /
No. Question Response (Option
s)
Remark
Part I: socio-demographic characteristics
1. How old are you? [__ __] years
2. What is your sex? 1.Male 􀀀
2. Female 􀀀
3 .What departments are you attending .................
now?
4. What class year are you attending? .................
5. What is your marital status? 1.Single 􀀀
2.Married 􀀀

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3.Separated 􀀀
4.Widowed 􀀀
5.Divorced 􀀀
6. What is your religion? 1. Orthodox 􀀀
2. Muslim 􀀀
3. Protestant 􀀀
4. Catholic 􀀀
5. Other (specify)………..
7. What was your previous area of residence? 1. Urban 􀀀
2. Rural 􀀀
8. Have your father ever attended school? 1 .Yes 􀀀 If
2. No 􀀀 “yes”,
Skip
to Q. 9
9. If “Yes” to Q.8, What is the highest level 1. Primary 􀀀
of school your father attended? 2. Secondary 􀀀
3.Technical/Vocational 􀀀
4.Higher (College/University) 􀀀
10. Have your mother ever attended school? 1 .Yes 􀀀 If
2. No 􀀀 “yes”,
Skip to
Q. 11
11. If “Yes” to Q.10, What is the highest 1. Primary 􀀀
Level of school your mother attended? 2. Secondary 􀀀
3. Technical/Vocational 􀀀
4. Higher (College/University)􀀀
Part two :Knowledge about blood donation
1. Have you heard or seen about blood 1. Yes􀀀 If no,
donation? 2. No 􀀀 skip
Q.2
2. If your answer to Q.1 is “yes”, from where 1.Health professionals/facility 􀀀
did you hear or see those messages? (More 2. Print media (Newspaper, leaflet,
than one answer is possible.) brusher, billboard) 􀀀

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3. Electronic media (TV, Radio) 􀀀
4. School/University 􀀀
5. Friends/ Family, relatives 􀀀
6. Religious worship place 􀀀
3. Do you know common blood groups? 1.Yes
2.No
4. Do you know your blood group? 1.Yes
2.No
5. What is your blood group 1.A+
2.B+
3.AB +
4.O+
5.A-
6.B-
7.AB-
8.O-
6. Can a person be infected by receiving blood 1.Yes If no
transfusion? 2.No skip Q.
7
7. What disease are transmissible by blood 1.HIV
transfuse? 2.HBV
3.HCV
4.Syphilis
5.Malaria
6.CMV
8. How often individual donate? 1.Weekly
2.Monthly
3.Three monthly
4.Six monthly
5.Annually
6.Don’t know
9. Who should not donate blood? 1.Men
2.Women

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3.Young<18yrs
4.Old >60yrs
5.Vulnerable groups
6.Healthy
7.Diseased
10. What volume of blood is collected during 1.<500mls
each donation 2.500-1000mls
3.Don’t know
11. What is the duration of a donation 1.20 min
process? 2.20-60min
3.don’t know
12. What is the minimum weight limit 1.<45 Kg
2.45Kg)
3.>45Kg
4.Don’t know
Part 3:Attitude towards blood donation
1. What do you think about blood donation? 1.Good 􀀀
2. Bad 􀀀
3.No idea 􀀀
2. What do you think is the best source of 1.Voluntary donor 􀀀
blood donation? 2.replacement donor 􀀀
3.remunerated donor 􀀀
4.self-donor 􀀀
5.don’t know 􀀀
3. Can something harmful happen to a blood 1.Yes 􀀀
donor during or after Blood donation? 2.No 􀀀
3.I don’t know 􀀀
4. What can happen to a blood donor during 1.Contract infection 􀀀
or after donation? 2.temporary weakness 􀀀
3 feel sick 􀀀
5. Do you think that patient’s relative Should 1.Yes
be asked to donate? 2.No
3.I don’t know

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6. Will you donate if called upon or reminded 1.Yes
to do so? 2. No
Part 4 - Practice of Blood Donation
1. Have you ever donated blood Before? 1.Yes 􀀀 If no
2. No 􀀀 Q.1
skip
Q.2
2. If your answer to Q.1 is “Yes”, how many 1. Once 􀀀
times do you donate? 2. Twice 􀀀
3.If more than two times(specify)______
3. If your answer to Q.1 is “Yes”, what 1. A sick person needed 􀀀
prompted you? (More than one answer is 2. Moral satisfaction, altruism 􀀀
Possible.) 3.Earning profit in cash / kind 􀀀
4. For free health check-up 􀀀
5. Motivated by friend /family donor 􀀀
6.Media appeal 􀀀
7.others(specify)
4. If your answer to Q.1 is “No”, what was the 1. I have no information 􀀀
reason? (More than one answer is Possible.) 2. Fear of blood donation 􀀀
3. Medically unfit 􀀀
4. Under age 􀀀
5. Cultural or religious rejection 􀀀
6. Lack of time 􀀀
7. It takes long time 􀀀
8. Inaccessibility of the service 􀀀
9. Never thought of it 􀀀
10. Parental or peer opposition 􀀀
11. Never had the opportunity 􀀀
12. My blood will be sold 􀀀
13. Others specify…………………
5. Have you taken part in Blood donation 1.Yes
campaigns? 2. No
6. Do you encourage relatives to donate? a. Yes_____

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b. No _____
c. No Response _____

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Annex IV: Sampling Procedure and Technique

Randomly selected three colleges

Natural and Computational Business and


Agricultural Science
Sciences Economics

Biology NARM

Biotechnology Plant science Economics

Chemistry Animal science Accounting

Physics RDA Tourism

Mathematics Food science Management

Sport science Horticulture Marketing

Statics Agro economics PADM

Industrial chemistry Environmental

Proportionate allocation to each year department =ni = (Ni/N)*no

Year III Year III Year III

SRS

Total sample size=M

324

Figure 5: Schematic representation of sampling method among different collage among


Non-Health Undergraduate Students of Wachemo University, Hosanna, Ethiopia, 2023

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Table 8: Sample size distribution of Natural and Computational Sciences students of
WCU, Hossana, Ethiopia, 2023
S.NO Department Numbers of Proportional Sample
students of III allocation for each
years year

1 Biology 44 3.4% 11
2 Biotechnology 36 2.8% 9
3 Chemistry 48 3.7% 12
4 Geology 23 1.9% 6
5 Industrial chemistry 32 2.5% 8
6 Mathematics 28 2.2% 7
7 Physics 31 2.8% 9
8 Sport Science 55 4.3% 14
9 Statistics 31 2.8% 9
Total 329 26% 85

Table 9: Sample size distribution of Agricultural Sciences students of WCU, Hossana,


Ethiopia, 2023
S.NO Department Number of Proportional Sample
Students III year allocation for each
year
1 NARM 25 1.9% 6
2 Plant science 38 3.1% 10
3 Animal science 26 2.2% 7
4 RDA 27 2.2% 7
5 Food science 36 2.8% 9
6 Horticulture 26 2.2% 7
7 Agro economics 79 6.2% 20
8 Environmental 36 2.8% 9
science
Total 292 23.4% 75

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Table 10: Sample size distribution of Business and Economics students of WCU,
Hossana, Ethiopia, 2023
S.NO Department Number of Proportional Sample
Students III year allocation for each
year
1 Economics 122 9.3% 30
2 Accounting 183 13.9% 45
3 Management 108 8.3% 27
4 Tourism 29 2.2% 7
5 Marketing 115 9% 29
6 PADM 103 8% 26
Total 660 50.6% 166

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