Blood Donation Practices and Associated Factors among Adults in East Gojjam Zone, Northwest Ethiopia

Abstract Background : Blood donation is a critical healthcare activity that saves millions of lives globally, yet access to timely donations remains a challenge in Ethiopia, particularly during emergencies. Identifying the socio-demographic, psychological, and contextual factors that influence blood donation is essential for developing strategies to improve donation rates and ensure a sustainable blood supply. This study investigates the factors influencing blood donation practices among adults in East Gojjam Zone, Ethiopia, over the past two years. Methods : A cross-sectional survey was conducted with 1,332 adults selected through multistage cluster sampling in East Gojjam Zone. Descriptive statistics were used to summarize donation behaviors, while Zero-Inflated Negative Binomial (ZINB) regression identified factors associated with donation frequency. Structural Equation Modeling (SEM) explored the relationships between donation behaviors and key predictors. Results : Among participants, 28.8% (95% CI: 26.4%-31.2%) had donated blood at least once, and 20.7% (95% CI: 18.5%-22.9%) had donated in the past two years. Frequent donation was positively associated with younger age, male gender, higher education, and employment in healthcare or education. Altruism, specifically the desire to help others, was the primary motivation for donation. Psychological barriers, including fear of needles, health concerns, and lack of awareness, were significant deterrents. ZINB regression revealed that psychological barriers negatively influenced donation frequency, while previous donation experience, awareness, and participation in campaigns were positive predictors. SEM analysis showed that donation intention had the strongest direct effect on donation behavior, with self-efficacy, positive attitudes, and social norms also contributing significantly. Conclusions : Donation rates were lower than expected, with few participants donating repeatedly. This study highlights the complex interaction of socio-demographic, psychological, and contextual factors influencing blood donation behavior. Interventions should address psychological barriers, enhance awareness, and foster altruism to increase donation rates. Public health campaigns should target vulnerable groups, including women, older adults, and individuals with lower educational attainment. Additionally, improving donation site accessibility, offering incentives, and leveraging social networks can help boost donations. Continuous evaluation and adaptation of strategies are essential to meet the growing demand for blood.