Knowledge and Attitude Towards Blood Donation Among Non-Donors in Kuala Terengganu

Blood shortages continue to pose a critical challenge in healthcare systems globally. Malaysia, like many other countries, faces persistent issues with maintaining an adequate blood supply. The state of Terengganu, located on the east coast of Peninsular Malaysia, consistently reports some of the lowest blood donation rates in the country. Between 2011 and 2015, the state recorded only 14 to 16 donations per 1,000 population, compared to 92 to 99 donations in Kuala Lumpur. This disparity reflects not only a lack of awareness but also various cultural, educational, and attitudinal barriers that deter people from donating blood.

The study, conducted at Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu, aims to investigate the knowledge and attitudes towards blood donation among non-donor residents. Understanding the reasons behind the low donation rates, especially among those who have never donated blood, could provide valuable insights into designing targeted interventions to increase participation in blood donation activities.

This research was carried out in February 2017 through a cross-sectional survey involving 320 non-blood donors residing in Kuala Terengganu. The participants were selected using systematic random sampling from hospital attendees who visited HSNZ during the study period. The inclusion criteria were Malaysian citizens aged between 18 and 60, who resided in Kuala Terengganu and had no history of blood donation. Participants with documented medical or psychiatric illnesses, healthcare workers, and individuals unfamiliar with blood donation were excluded to ensure the focus remained on the general population.

The questionnaire used in the study was adapted from a validated instrument that measures knowledge and attitudes about blood donation. The survey consisted of two sections: one assessing knowledge with eight questions and another evaluating attitudes with 20 items on a Likert scale. Scores in the knowledge section ranged from 0 to 8, with participants scoring five or more considered to have good knowledge. Attitudes were rated on a scale of 20 to 100, with scores of 61 and above reflecting positive attitudes towards blood donation.

The results revealed a relatively high level of awareness about blood donation among the participants, despite their status as non-donors. Around 64.69% of respondents had good knowledge, with an average score of 5.19 out of 8. This suggests that a majority of non-donors in Kuala Terengganu are well-informed about the basic aspects of blood donation. The attitude scores were even more encouraging, with 92.81% of participants showing a positive attitude towards blood donation, reflected in a mean score of 70.79 out of 100.

However, it is important to note that while knowledge and attitude were generally favorable, they did not necessarily translate into practice. This indicates that there are other factors, beyond awareness, that influence the decision to donate blood.

Several demographic factors were found to significantly impact knowledge and attitudes towards blood donation:

• Gender: Males were more likely to have better knowledge about blood donation than females. The study found that females were 43.6% less likely to have good knowledge compared to their male counterparts. This could be attributed to societal roles, as many women in the region may have less exposure to information or social opportunities related to health matters.

• Education Level: Participants with higher education, particularly those who attended college or university, were significantly more knowledgeable about blood donation. In fact, individuals with a college or university education were 11 times more likely to have good knowledge compared to those with a lower education level. This highlights the importance of educational outreach in raising awareness about blood donation.

• Occupation: Those working in the private sector were more knowledgeable and had better attitudes towards blood donation compared to government employees. Self-employed individuals also had better knowledge compared to those in government sectors, which could be due to their exposure to more diverse sources of information and health promotion campaigns in private settings.

Despite the generally positive attitudes towards blood donation, the study identified several barriers that prevent individuals from donating blood. The most prominent obstacles were cultural and religious concerns. Approximately 73.1% of participants expressed reluctance to donate blood if it would be given to someone of a different religion, and 67.8% felt similarly about donating to people of other races. These findings highlight deep-seated cultural beliefs that act as significant barriers to increasing blood donation rates in the region.

Other common barriers included fear of needles (55.9%) and concerns about the pain associated with blood donation (55.0%). Some participants also cited lack of time and modesty as reasons for not donating.

The study found that social media was the primary source of information about blood donation for 42.2% of participants. This underscores the potential of digital platforms in raising awareness and dispelling myths about blood donation. However, the persistence of cultural and religious misconceptions suggests that more targeted educational campaigns, possibly involving religious and community leaders, are needed to address these specific barriers.

The study highlights that while a majority of non-donors in Kuala Terengganu have good knowledge and attitudes towards blood donation, cultural and religious barriers, as well as misconceptions about the process, prevent them from donating. To increase the blood donation rate in this region, health authorities should focus on addressing these barriers through culturally sensitive education campaigns. Collaboration with religious institutions and leveraging social media could help dispel myths and promote a more inclusive and informed perspective on blood donation. Additionally, targeted efforts to engage women and unemployed individuals could further broaden the donor pool in the region.

Malaysian Journal of Medicine and Health Sciences, 2019;15(1):53-62