Factors Influencing Blood Donation Behavior of University Level Students in Bangladesh

Transcription

1 JU Journal of Information Technology (JIT), ol. 1, June Factors Influencing Blood Donation Behavior of University Level Students in Bangladesh Abstract Youngsters are the most potential blood donors in every society and students constitute a huge portion of them. Our research focuses on the student s attitude and practice towards blood donation. A survey was conducted using a structured questionnaire on 490 students selected by four stage cluster sampling design. Only 34.3% of survey participants donated blood in the past and among the non-donor respondents, most of the students (73.3%) showed positive attitude towards blood donation. We observed that Blood donation behavior of the students is positively associated with their parent s levels of education. On the other hand, willingness of the students to donate blood is related to their sex. It has been identified that factors which influence to donate blood are Family background, Physical status, Urgency for family, Awareness/Knowledge, Maturity level. The only factor that influences not to donate blood is Fear. Since the university students are one of the potential sources of voluntary blood donors in Bangladesh and most of the students have positive attitude towards blood donation. By launching appropriate motivational campaign by university administration or government or by voluntary organizations, this positive attitude might be converted into a regular practice and might help fulfill the annual demand of the blood in Bangladesh. Index Terms Blood donation practice, Screening process, Misconceptions, Bivariate analysis, Factor analysis B Md. Rezaul Karim 1, Morshed Alam 1, Md. Manzur Rahman Farazi 1 and Rubiyat Jafrine Labone 2 I. INTRODUCTION LOOD donation process consists of collecting blood from a voluntary donor and then transfused into another person s body actually needs it. In this process the major source of safe blood is blood donation. However, selection of self motivated, non-remunerated blood donors is the remarkable hurdles across the world. The most effective way of creating an inventory with safe and sufficient blood is to put forward non-remunerated blood donors, however, there has been a downturn in self-motivated blood donors, and selection of minimum-risk donors, especially in underdeveloped countries, is challenging [1]-[7]. The necessity for blood and blood products (such as red blood cells, platelet, blood plasma etc.) are growing at a rate higher than the collection rate. It is a matter of regrets that; worldwide there is an insufficiency of active blood donors to meet the rushing demand for blood [8]-[13]. 1 Lecturer, Department of Statistics, Jahangirnagar University, Savar, Dhaka Institute of Business Administration (IBA) of Jahangirnagar University, Jahangirnagar University, Savar, Dhaka Available literature reveals that in recent years the annual demand for blood is around 2.5 million units in Bangladesh. Currently, only 40% of the demand is captured by the existing supply. Among this, 80% of blood comes from the professional donors who are mostly drug addicted and carry Hepatitis A, B, C, Syphilis, Gonoria and HI/AIDS. It causes an alarming threat of spreading blood borne diseases among the people who receive bloods from others. The rest 20% is fulfilled by the party donors (those who give blood to relatives) and voluntary donors. Safe blood transfusion is still a great challenge for us. Safe Blood Transfusion Act 2002 was enacted with a view to ensuring safe blood collection management and regulation along with creating an environment for increasing voluntary blood donation. To assess the attitude and motivations of blood donors, a good number of research and investigations have taken place in many countries [14] where it has been found that blood donation is influenced by a variety of factors like beliefs, attitudes and motivations of the potential donors. The study of these factors is vital for the continuation of the safe blood collection from the donors and to motivate the non-donors to start donating blood [15]-[17]. Blood donation decision is tempted by some covariates like altruism, social behavior, social pressure and replacement [18]-[19]. A number of NGOs, have been working in this field, but improvement is not remarkable at all. Studies have also been carried out to examine how blood donors differ from non-donors with respect to their socio economic and demographic characteristics: such as gender, age, marital status, ethnicity, levels of education and income level [19]-[22]. Studies carried out among university students of Kerman City, depicted no significant difference in students attitude by gender, while males were more aware than females [23]. There are some evidences to note that the more one s knowledge regarding blood donation process and the need for blood increases, the more likely one is to donate blood [24]- [25]. Another investigation, administered among the students of Thai university evidenced that greater knowledge about blood donation does not necessarily lead to donation [26]. Although enormous personality traits have been noted, no clear glimpse has emerged to notify a typical donor or potential donor [27]. A good number of researches have been done to identify the underlying factors that instigate the people to be motivated towards blood donation [28]-[31]. Experience of prior blood donation, number of previous donations, and duration from last donation are correlated with forecasting future behavior [32]-[34]. The covariates that influence willingness of blood donation consists of individual attachment with someone who

2 JU Journal of Information Technology (JIT), ol. 1, June donates blood, received donated blood or know the people who have received donated blood, convenience and satisfaction regarding donation time and location of the donors and positive attitude to become a potential organ donor [35]- [37]. Among the non-donor respondents, possibility of physical complicacy and fear were found to be the common reasons for not donating blood [38]-[39]. Experience shows that most of the medical students who are capable of donating blood do the practice regularly. The other part of the students needs to be motivated towards blood donation. As the students of universities could be a potential part of blood donors, we have conducted a study to evaluate their awareness and attitude towards blood donation and to identify factors which may motivate the students towards blood donation. Section-2 of this study contains the methodology of this research including the target population, sample size determination, questionnaire design and survey method for primary data collection. Section-3 includes results of univariate, bivariate and multivariate data analysis. In multivariate data analysis, we have identified the factors influencing blood donation behavior of the university level students in Bangladesh. A summary of the research with recommendation has been presented in section-4 which is followed by a list of references. II. METHODOLOGY The target population of the study is the university level students in Bangladesh. The primary data have been collected by using four stage cluster sampling design. From a pilot survey, it has been found that around 43% students (p = 0.43) donated blood in some occasions, considering 5% alpha level (z = 1.96) and 4% acceptable error margin (d = 0.04), the desired sample size has been estimated by Cochran s formula (n = z 2 p(1-p)/ d 2 ) as 490. At the first stage four universities were randomly selected. The selected universities are Jahangirnagar University, Stamford University Bangladesh, Comilla University and Ahsanullah University of Science and Technology. Different faculties from the selected universities were selected at the second stage and some of the departments from the selected faculties were selected at the third stage. In fourth stage, required numbers of students were selected randomly following proportional allocation scheme. Primary data were collected via a structured questionnaire consist of three types of questions: Close, open ended and of contingent type. The Basic information section included questions about personal information. Blood Donation section included 14 questions about their attitude & performance regarding blood donation. For Attitude Scaling Likert Scale is used with five response categories ranging from strongly disagree to strongly agree, which requires the respondents to indicate a degree of agreement or disagreement with each of a series of statements related to the objects. The questionnaire was pretested using a small sample of size 40 respondents to observe respondents reactions and attitudes and necessary editing has been done accordingly. arious univariate, bivariate and multivariate statistical techniques have been used for the analysis of the data of this study. In multivariate analysis, we have performed Factor Analysis using a Orthogonal factor model to extract factors related to blood donating behavior of students in Bangladesh. III. DATA ANALYSIS AND RESULTS A. Univariate Analysis In this research, data were collected from 490 students among them 304 (62%) students were male. Only 8% selected students do not know their own blood group. More than half of the students are from Urban areas (62.7%). About half of the students (50.80%) said that their fathers completed graduation and only 1.8% said that their fathers are illiterate. Among the respondents 32.9% said that their mothers passed SSC examination while only few students (2.7%) said that their mothers are illiterate. About half of the students (49.8%) said that their fathers are service holders, 29.6% said that their fathers are doing business. On the other hand, 20% said that their mothers are doing service, 0.6% said that their mothers are doing business, only 3% said that their mothers are doctors. Our survey reveals that 34.3% participants donated blood in some occasions and among the non-donor participants, 73.3% showed positive attitude towards blood donation. Among the blood donors, 42.3% who are involved with some blood donation organizations. Most of the students have misconception (65.9%) about the universal donor blood group while only 10.4% students have the correct knowledge about the universal donor blood group. 23.7% respondents reported that they don t have any knowledge about this. About 62.4% are aware of the universal receiver blood group and 26.7% students are unaware of this. A small proportion of students (10.9%) have misconception about the universal receiver blood group. Most of the students (84.9%) have correct knowledge about the minimum age of blood donation. The time interval between two successive blood donations must be 3 months and 57.6% students were aware of this statement. Among donor students who ever donated blood, 7.2% said that they donated blood at blood bank, 37.5% said that they donated blood at hospital, 8.9% said that they donated blood at blood donation organization and a good portion of students (46.4%) said that they donated blood to patients directly and 16.1% reported that they donated blood by responding to any advertisement while 83.9% revealed that they never donated blood by responding to any advertisement. Among the graduate student blood donors, 54.8% were gone through the screening process all the time and 37.5% never gone through any screening process. 7.7% were sometimes gone through the screening process. Among non-donor students, 28.6% students informed that they are not able to donate blood, where 21.1% noted that the reason is fear, 39.8% said that they were not ever asked to donate blood and 4.7% think that it is time consuming. 4.0% students reported that they do not want to donate blood.

3 JU Journal of Information Technology (JIT), ol. 1, June B. Bivariate analysis In bivariate analysis part, cross tabulation technique has been applied to identify the pair-wise relation between blood donation practice and other concomitant variables. The results of the bivariate analysis are presented in table-1 of this section. TABLE-1 ASSOCIATION BETWEEN BLOOD DONATION PRACTICES WITH OTHER ARIABLES (PAIR WISE). ariables Blood donation practice vs. father s educational level Blood donation practice vs. mother s educational level Blood donation practice vs. father s occupation Blood donation practice vs. mother s occupation Blood donation practice vs. involvement with any blood donation organization Blood donation practice vs. who take donated blood Blood donation practice vs. fear to donate blood Willingness of the students to donate blood vs. gender Reason of not donating blood vs. gender alue of Chi- Square P-value Decision Significant Significant Insignificant Insignificant Significant Significant Significant Significant Insignificant Note: The variable Blood donation practice indicates whether an individual donate blood or does not donate blood. From Table-1, the blood donation practice of the students is significantly associated with their parent s educational level which means that parental education level has a remarkable influence on blood donation practice. Blood donation practice of the students is significantly related with their involvement with any blood donation organization. The person who takes donated blood is aware of donating blood and his/her blood donation practice is significantly different from those who did not receive blood ever. Fear to donate blood is another influencing factor of blood donation practice of the university level students. Willingness of the students to donate blood is depends on gender while the reasons for not donating blood do not depend on gender. Parental occupation status seems to have no significant impact on blood donation practice. C. Multivariate Analysis To identify the factors influencing blood donation behavior of the university level students, we used factor analysis technique. The most important aspect of the factor analysis is the extraction of crucial factors. It is a statistical technique that attempt to represent relationships among sets of interrelated variables by a smaller set of relatively independent and interpretable, but not directly observable. One of the goals of factor analysis is to represent relationships among sets of variables parsimoniously. In this analysis we have consider variables from 1 through 15. Which are, Year of study of the students ( 1 ), Sex of the students ( 2 ), Height of the students ( 3 ), Weight of the students ( 4 ), Blood group of the students ( 5 ), Father s education of the students ( 6 ), Mother s education of the students ( 7 ), Family residential area ( 8 ), Involvement in blood donation organization ( 9 ), Donation blood is very fearful ( 10 ), I would be willing to donate blood at least once in every three months ( 11 ), If I witnessed a traffic accident, I would not be willing to donate blood to a victim if needed ( 12 ), If needed, I am willing to give blood to a relative or close friend ( 13 ), Inspiration to donate blood ( 14 ), Did you ever donate blood responding to any advertisement ( 15 )? Construction of correlation matrix A correlation matrix is a lower triangle matrix showing the simple correlations between all possible pairs of variables included in the analysis. Correlation matrix= Testing appropriateness of factor model The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy tests whether the partial correlations among variables are small. Bartlett's test of sphericity tests whether the correlation matrix is an identity matrix, which would indicate that the factor model is inappropriate. Both Bartlett s test of Sphericity (p<0.05) and Kaiser-Meyer-Olkin measure of sampling adequacy (0.579) testimony to the appropriateness of use of factor analysis for the concerned data. Identification of the factor model We have used Scree plot to determine the appropriate number of factors, an elbow has been observed in the Scree Plot (Figure-1). The number of components is taken to be the point at which the remaining Eigen values are relatively small and all about the same size. It is observed that an elbow occurs at component number 6, in this case, it appears that 6 sample principal components effectively summarize the total sample variance. Here a model with six factors appears to be reasonable. We have used principal component solution for identification of the factors.

4 JU Journal of Information Technology (JIT), ol. 1, June coefficients for variables Willingness to donate blood at least once in every three months; willingness to give blood to a relative or close friend, Factor 4 has high coefficients for variables Fear to donate blood, willingness to donate blood to a victim if witnessed a traffic accident, Factor 5 has high coefficients for variables blood group of the students, involvement in blood donation organizations, donating blood responding to any advertisement in media, Factor 6 has high coefficients for variables Year of study of the students, weight and inspiration towards donating blood. We can indicate these factors by Family background, Physical status, Urgency for family, Fear, Awareness/Knowledge, Maturity level respectively Fig. 1: Scree plot for determination of number of factors Rotation of factors The factor matrix contains the coefficients used to express the standardized variables in terms of factors. These coefficients, factor loadings, represent the correlation between the factors and variables. A coefficient with a large absolute value indicates that the factor and variables are closely related. The coefficients of the factor matrix can be used to interpret the factors. In this type of complex matrix, it is difficult to interpret the factors. Therefore, through rotation, the factor matrix is transformed into a simpler one that is easier to interpret. The most commonly used method for rotation is the arimax procedure. Here we have used arimax with Kaiser Normalization as rotation method. We have used the following rotated matrix to identify variables involved in each factor. R ota ted fa ctor m a trix = F F F F F F The elements of factors matrix are called factor loadings, since they indicate how much weight is assigned to each factor. Interpretation is facilitated by identifying the variables that have large loadings on the same factor. In the rotated factor matrix, Factor 1 has high coefficients for variables father s education of the students, mother s education of the students and family residential area, Factor 2 has high coefficients for variables Height of the students, weight of the students, and sex of the students. Factor 3 has high I. SUMMARY AND CONCLUSIONS In spite of significant advancement in medical technology in recent years, there is no artificial alternative to human blood so far. Society has to depend on donated blood as a whole. Young people are the main source of donated blood and students are the larger portion of them. Students are well organized institutionally and prone to cooperative to social work, but sometimes they do not have sufficient information and motivation to donate blood. There are many factors that influence blood donation behavior (to donate blood or not to donate blood). However, this study intends to articulate and to summarize student s awareness and attitude towards blood donation. Only 34.3% of survey participants donated blood in the past and among the non-donor respondents, most of the students (73.3%) showed positive attitude towards blood donation. We found that Blood donation behavior of the students is positively associated with their parental level of education. We also found that Blood donation behavior of the students is related with their involvement with any blood donation organization, association with the person who ever received donated blood, with the fact that blood donation is very fearful. Finally, we identified the six factors which influence blood donation behavior of the graduate students of Bangladesh. The factors which influence to donate bloods are Family background, Physical status, Urgency for family, Awareness/Knowledge, Maturity level and the major factor which influences not to donate blood is Fear. Education statistics by Ministry of Education shows that the number of graduate level students in Bangladesh is around 1.7 million all are of ages 18 to 28 years. We do believe that most of them are capable of donating blood. In our research we found that among the non-donor respondents, around 73% students opined that they have strong desire to donate blood, means that 1.24 (1.7*0.73) million potential donors are ready to give blood in every four months. The supply comes to 3.72 (1.24*3) million units per year which inundates our existing demand. Here, we can suggest that as most of the students have positive attitude towards blood donation, by launching appropriate motivational campaign from university administration or government, this positive attitude might be

5 JU Journal of Information Technology (JIT), ol. 1, June converted into a regular practice. If we are able to convert the positive attitude of the students towards blood donation into a regular practice and might help fulfill the yearly requirement of blood in Bangladesh. REFERENCES [1] M. A. Olaiya, A., Ajala, R. O. Olatunji, Knowledge, attitudes, beliefs and motivations towards blood donations among blood donors in Lagos, Nigeria. Transfusion Medicine, 14: 13-7, [2] Misje A.H., Bosnes., Heier H.E., (2009): Gender differences in presentation rates, deferals and return behaviour among Norwegian blood donors. ox Sanguinis. [3] Zaller, N., Nelson, K.E., Ness, P., Wen, G., Bai, X. & Shan, H. (2005): Knowledge, attitude and practice survey regarding blood donation in a Northwestern Chinese city. Transfusion Medicine, 15, 277. [4] Watanabe, K.K., Screiber, G.B., Hayes, A. & Williams, A.E., (1999): Factors influencing the recruitment and retention of young donors. Transfusion, 39, A3 A20. 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J., 74: [38] Hossein Safizadeh, Nasim Pourdamghan, Batool Mohamadi, (2007): University Students Awareness and Attitude towards Blood Donation in Kerman City, IJBC, 3: [39] WHO., (2004): Developing countries face safe blood shortage. Bull. World Health Organ, 82: Md. Rezaul Karim is currently working as a faculty member of the Department of Statistics, Jahangirnagar University, Savar, Dhaka, Bangladesh. He has completed 4 years B.Sc. (Hons.) in Statistics and M.S. in Statistics from Jahangirnagar University. His research interest covers mainly in Applied-statistical field. Morshed Alam is currently working as a lecturer in the department of statistics, Jahangiragar University, Savar, Dhaka, Bangladesh. He did his B.Sc. (honors) and M.Sc in statistics from Jahangirnagar University and MBA (Master of Business Administration) from the department of Banking, University of Dhaka. He also passed Banking Diploma part I of Institute of Bankers Bangladesh. His research interest covers mainly in Bio-statistical field.

6 JU Journal of Information Technology (JIT), ol. 1, June M. M. R. Farazi is currently working as a lecturer in the Department of Statistics, Jahangiragar University, Savar, Dhaka, Bangladesh. He did his B.Sc.(honors) and M.Sc. in Statistics from Jahangirnagar University and MBA (Master of Business Administration) from the department of Banking, University of Dhaka. His research interest covers mainly in Applied-statistical field. Rubiyat Jafrine Labone has completed M.S. in Statistics (2010) from Jahangirnagar University, Savar, Bangladesh.Currently. Now she is pursuing her MBA at Institute of Business Administration (IBA) of Jahangirnagar University, Savar, Bangladesh.