ORIGINAL ARTICLE

Factors Affecting Voluntary Blood Donations

among Adults in Metro Manila, Philippines, as a
Basis for Policy Improvement on Donor Recruitment
Arnold Christian A. Mappala, Chloie Anne L. Alican, Daphne Cherlott T. Dulay,
Sophia Catherine A. Mancita, Beatrice Ysabel G. Utanes and Benjie M. Clemente, RMT, MPH

Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas - Manila, Philippines

ABSTRACT

Background. Blood donation practice in the Philippines is low despite numerous efforts to recruit potential donors
and increase blood supply.

Objectives. This study aimed to explore the sociodemographic profile of potential donors and their perceived level
of knowledge, motivators, and hindrances on blood donation practice to recommend improvements in policies and
strategies regarding blood donation recruitment.

Methods. A descriptive study design was utilized to attain the objectives of the study. A piloted questionnaire was
floated through various social media platforms to gather data. Data were analyzed using descriptive statistics and
Pearson's product-moment correlation.

Results. We included 260 Metro Manila residents, 18 to 65 years old and without conditions that merited permanent
deferral in blood donation. Overall, the respondents had an adequate perceived level of knowledge (x̄ = 3.13,
SD = 0.70) on blood donation but the lowest level of knowledge on the interval between successive blood donations
(x̄ = 2.71, SD = 1.04). Furthermore, respondents were considerably motivated to donate blood (x̄ = 2.67, SD = 0.42)
mainly due to relatives and friends requiring blood (x̄ = 3.73, SD = 0.60), and have minimal discernment of being
discouraged from blood donation (x̄ = 2.09, SD = 0.48) mainly due to time constraints (x̄ = 3.23, SD = 0.78). Moreover,
there is a significant but low inverse correlation (r = -0.151, p = 0.015) between age and motivation, suggesting
younger individuals have more motivation to donate blood . Thus, policies and strategies that target young donors
are highly suggested.

Conclusion. Poor blood donation practices in the Philippines suggest recalibration of policies and strategies by
targeting young individuals and showcasing altruism to improve donor recruitment. Moreover, it is recommended
to strategically establish blood service facilities in accessible areas with flexible operating hours to accommodate
potential donors with hectic schedules.

Keywords: blood donation, Philippines, donor recruitment

INTRODUCTION
Blood is a crucial and life-giving force that saves lives.
Paper presented in the 4th European Conference on Donor Health Blood products from voluntary and non-remunerated donors
and Management on September 16, 2021, at the University of are considered the safest, but bridging the gap between
Hamburg, Germany.
demand and supply of blood products is still a challenge.
Corresponding author: Arnold Christian A. Mappala Developed countries can meet these requirements because
Department of Medical Technology of their well-structured health and blood transfusion
Faculty of Pharmacy services,1 while most low- and middle-income countries,
University of Santo Tomas
España Blvd, Sampaloc, Manila City 1008
including the Philippines, continue to struggle in donor
Metro Manila, Philippines recruitment and retention.2 According to the World Health
Email: [email protected] Organization (WHO), the Philippines should have at least

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Factors affecting voluntary blood donations among adults in Metro Manila

one percent of its population as donors to garner the most time,17,19,20 insufficient knowledge on blood donation,3,8
basic requirements for blood.1 Despite continuous efforts in inability to meet eligibility requirements,4 civic duty, self-
blood donor recruitment and retention, the country is still realization,10 poor attitudes of staff, inadequate level of
far behind in fulfilling its blood requirements in response privacy during pre-donation screening, concerns on the
to the increasing demands for blood. possibility of commercial use of their donated blood,9 fear
Several studies have shown that blood donation is affected of discrimination, social exclusion, and distrust.21,22 A study
by different factors such as knowledge, sociodemographic in Australia suggested that donors are less likely to return
characteristics, motivators, hindrances, and blood donation after a temporary deferral because they misinterpret it as
practice.3,4 Blood donation practice refers to the frequency a permanent deferral.17 Lastly, studies in the Philippines
or extent to which individuals practice donating blood. showed that deferral due to existing health conditions was
For instance, men donate more often than women,3,5,6 the most common barrier to blood donation.23,24
possibly due to anemia, which is common among women.5 Considering the findings of these studies, they imply
In terms of educational attainment, it was observed that that factors affecting blood donation were diverse and
higher educational attainment could be correlated with the variable. Moreover, these studies were conducted in different
frequency of blood donation,3,6–8 yet a contrasting study in countries such as Saudi Arabia, Brazil, Hong Kong, and
Ghana showed that the majority of repeat donors have no others, in which perspectives, behaviors, and cultures of
formal education.9 Age could also be a factor10 in which each of these settings may account for the variability of the
other studies noted less frequent blood donation among factors. Thus, it may be timely and valuable to investigate the
older age groups,11 but another study stated otherwise.12 relationship between such factors to shed light on why the
Another factor is employment status as majority of repeat blood supply in the Philippines remains insufficient despite
donors were observed among formal sector employees,9 the continuous efforts to increase blood supply and blood
while another study in India argued that the servicing donor recruitment. Through this research, the respondents'
sector and unemployed people were the foundation of depth of knowledge and self-perceptions regarding blood
the blood donation program.13 One study in Brazil said donation were assessed, which can aid local blood services
that religion could influence blood donation,14 such as the in the recruitment of more blood donors in the Philippines.
Jehovah’s Witnesses’ prohibition on blood transfusion and Therefore, this research aimed to determine the relationship
donation.15 However, other studies reported the contrary.4,6,16 between the level of knowledge, motivators, and hindrances
Furthermore, knowledge or lack thereof,11 about the blood to the sociodemographic profile and how these factors affect
donation process may influence blood donation practice.3,6 the blood donation practice of the respondents to recommend
Knowledge or information and understanding about policy improvements on donor recruitment.
donation could be acquired by different means such as
previous experiences in blood donation,4 advocacies and METHODS
discussions regarding blood donation,10 and through the
efforts of different organizations.13 However, blood donation Study design and subjects
advocacies and discussions do not always ensure increased The study employed a descriptive study design that
knowledge.3,4 For example, two studies in India revealed described and determined the relationships among variables.
that knowledge of risks associated with blood donation does Convenience sampling was utilized to recruit respondents
not affect donors’ decisions, and knowledge was inversely for an online survey. The respondents were residing in Metro
related to blood donation.5,13 Despite that, blood donation Manila and were 18 to 65 years old because this age group
practice remained low.3,4,6,8,10 is the same age group for eligible donors. Moreover, they
Motivators are conditions that urge people to donate must not have any underlying condition that would merit
blood willingly. Altruism was one of the most influential permanent deferral from donating blood, such as cancer,
motivators in the blood donation practice.17–19 Often, donors cardiac disease, severe lung disease, Hepatitis B and C, HIV
were stimulated to donate if an acquaintance was in need of infection, acquired immunodeficiency syndrome (AIDS),
blood,9 such as family members.7 Other motivations explored sexually transmitted disease (STD), and others. Individuals
were a sense of social responsibility, advertisement or blood with and without prior experience in blood donation were
donation drive campaign,7 convenience of donation facilities both eligible to participate. Respondents of this study were
with regards to time and availability,19 desire to support recruited via social media platforms due to the restrictions
blood banks maintain their target supply,4 improved contact and risks brought about by the COVID-19 pandemic.
between the blood bank and the donors, increased knowledge
on blood donation, and incentives and rewards.3 Various Instrumentation
hindrances—reasons that discourage people from donating To assess the perceived level of knowledge, the study
blood, were also a common observation in numerous studies. utilized an adapted questionnaire with questions about
This includes fear of needles and blood,3,4,6,8 health reasons, sociodemographic data and knowledge referenced from
fear of adverse reactions,3,4,6,20 lack of interest,3,10 lack of the Brazilian Blood Donation Knowledge Questionnaire

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 Factors affecting voluntary blood donations among adults in Metro Manila

(BDKQ-Brazil)25,26 released by the Brazilian Ministry of RESULTS

Health. Another questionnaire4 was modified to determine
the level of practice, and questions regarding motivators A total of 263 respondents could access the online
and hindrances were also altered from various published survey, but only 260 respondents consented to participate.
studies.3,7,9,10,17–19,27 Questions lifted from the adapted Out of the 260 respondents, 75 were donors, and 185 were
questionnaires were tailored to fit the Filipino respondents non-donors.
of this study and were modified to be answerable using a
Likert scale. Respondents answered sets of questions based Sociodemographic profile
on their perceived level of knowledge of the questions. The The majority of the respondents were females (64.2%),
questionnaire was divided into six parts consisting of the of which 40 (53.3%) were donors, and 127 (68.6%) were
letter of request for participation, sociodemographic profiling, non-donors. In terms of age, most of the respondents were
frequency of blood donation, knowledge of blood donation, 18–27 years old (86.5%), of which 58 (77.3%) were donors,
motivators, and hindrances to blood donation, respectively. and 167 (90.3%) were non-donors. Most of the respondents
Multiple-choice questions were used for sociodemographic were students (75.8%) or graduates of tertiary level education
characteristics, while sections for knowledge, motivators, and (65.8%), with a monthly income of less than ₱10,000.00
hindrances were constructed as Likert-type questions. The (65.5%), and majority identified themselves as Christians
4-point Likert scale used was interpreted as strongly agree (93.8%) (Table 1).
for “4”, agree for “3”, disagree for “2”, and strongly disagree
for “1”. This was done to assess the respondents' perceived Table 1. Sociodemographic profile of the respondents
level of knowledge on blood donation and how likely they Donors Non-Donors Total
were to donate blood based on the given motivators or (n=75) (n=185) (n=260)
hindrances. The test item quality was assured through f % f % f %
reliability testing under the review of three experts in the Gender
field of blood donation. The questionnaire subjected to pilot Male 34 45.3 54 29.2 88 33.8
testing was administered to 25 individuals aged 18 to 65 Female 40 53.3 127 68.6 167 64.2
years old who were not included as respondents of the study. Others 1 1.3 4 2.2 5 1.9
Internal consistency was deemed acceptable (Cronbach’s Age (years)
alpha = 0.75). 18-27 58 77.3 167 90.3 225 86.5
28-37 8 10.7 5 2.7 13 5.0
Data collection and analysis 38-47 6 8.0 6 3.2 12 4.6
Due to the COVID-19 pandemic, data was collected 48-57 2 2.7 5 2.7 7 2.7
online using a Google Form disseminated via a public post 58-65 1 1.3 2 1.1 3 1.2
on personal social media platforms (e.g., Facebook, Twitter, Highest Educational Attainment
and Instagram). The link remained open for a month. Data Primary Level 0 0 1 0.5 1 0.4
collected from the four-point Likert scale were encoded in a Secondary Level 16 21.3 49 26.5 65 25.0
Microsoft Excel spreadsheet and were analyzed using SPSS Tertiary Level 50 66.7 121 65.4 171 65.8
software. The sociodemographic profile was analyzed by Postgraduate Level 9 12.0 13 7.0 22 8.5
Vocational 0 0 1 0.5 1 0.4
computing frequencies and percentages. Moreover, the level
of perception of the respondents according to knowledge, Religion
motivators, and hindrances was analyzed using mean and Christian 68 90.7 176 95.1 244 93.8
Non-Christian 7 9.3 9 4.9 16 6.2
standard deviation. Lastly, the significant relationship
between sociodemographic profile and the knowledge, Occupation
Self-employed 5 6.7 7 3.8 12 4.6
motivators, and hindrances was determined using Pearson
White-collar job 18 24.0 14 7.6 32 12.3
product-moment correlation.
Blue-collar job 6 8.0 5 2.7 11 4.2
Retired 0 0 1 0.5 1 0.4
Ethical Considerations Student 45 60.0 152 82.2 197 75.8
The Research Ethics Committee of the University Unemployed 1 1.3 6 3.2 7 2.7
of Santo Tomas Faculty of Pharmacy, with the approval Monthly Income (Php)
number FOP-ERC-2021-02-016, approved this study. In < 10,000 40 53.3 130 70.3 170 65.5
addition, participation was voluntary in which respondents 10,001 - 30,000 18 24.0 24 13.0 42 16.2
were assured that all information collected shall remain 30,001 - 50,000 7 9.3 11 5.9 18 6.9
confidential and would not be used for any other purposes. 50,001 - 70,000 4 5.3 6 3.2 10 3.8
Compensation was not provided to the respondents, and 70,001 - 90,000 6 8.0 4 2.2 10 3.8
there was no known harm involved in participating in 90,001 - 110,000 0 0 4 2.2 4 1.5
this study. > 110,000 0 0 6 3.2 6 2.3

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Factors affecting voluntary blood donations among adults in Metro Manila

lost from donation (x̄ = 2.94, SD = 0.98), the fact that blood
donation does not endanger the donor into contracting a
disease (x̄ = 3.13, SD = 0.99), and deferral of pregnant or
21%  Once a year breastfeeding women (x̄ = 3.15, SD = 0.97) (Table 2).
28% The weighted mean of all aforementioned requirements
 Twice a year
was interpreted as moderately perceived. The value of the
 Thrice a year weighted mean was measured to get the mean response of the
respondents. Meanwhile, the rest of the other information
 Donated only
15% about blood donation was found to be highly perceived,
when needed
meaning that the respondents have highly satisfactory
 Never donated levels of knowledge regarding other information about
4% blood again
32% donating blood, such as one’s blood type, the importance
of health history questionnaire, the eligible age range for
donation, and deferral of patients with certain conditions
and body modifications. Overall, the average weighted
Figure 1. Frequency of blood donation of blood donor res- mean of the level of perception of the respondents with
pondents. regards to knowledge (x̄ = 3.13, SD = 0.70) was interpreted
as moderately perceived, indicating that the respondents are
In this study, only 75 out of the 260 total respondents sufficiently knowledgeable of the eligibility requirements
were blood donors (Figure 1). Majority (24 or 32%) of and other information about blood donation.
these blood donor respondents donated only when needed.
Meanwhile, 21 (28%) blood donor respondents never Motivators
donated blood again after their initial blood donation. The general perception of the respondents regarding
factors that motivate them to donate blood (x̄ = 2.67, SD =
Perceived Level of Knowledge 0.42) was moderate, which could mean that the respondents
Respondents possessed a fairly adequate knowledge are considerably motivated to donate blood (Table 3).
regarding the eligibility requirements for blood donation, However, looking at the data closely, the respondents highly
which included the recommended interval between two perceived that they were more inclined to donate because
successive donations (x̄ = 2.71, SD = 1.04), amount of blood of altruistic reasons, specifically when the person in need
taken per donation (x̄ = 2.85, SD = 1.01), the prohibition is related to or close to them (x̄ = 3.73, SD = 0.60), and
against commercial blood use (x̄ = 2.86, SD = 1.04), minimum when they were aware of an existing blood supply shortage
weight (x̄ = 2.93, SD = 1.07), time it takes to replenish blood (x̄ = 3.31, SD = 0.72). Another reason that the respondents

Table 2. Level of perception of respondents according to knowledge

Weighted Standard
Items Interpretation
Mean Deviation
I know my blood type. 3.33 0.99 Highly perceived
I am aware that health history questions are necessary to be asked for in every donation. 3.60 0.78 Highly perceived
I am aware that the minimum weight for blood donation is 50 kg (100 lbs). 2.93 1.07 Moderately perceived
I am aware that individuals aged 18 to 65 years old are eligible to donate blood. 3.36 0.82 Highly perceived
I am aware that the approximate amount of blood taken from a donor is 450 ml (one blood bag). 2.85 1.01 Moderately perceived
I am aware that it only takes 24-48 hours for the body to replace the amount of blood lost from 2.94 0.98 Moderately perceived
a blood donation.
I am aware that a person with diabetes/hypertension/recent menstruation or surgery cannot 3.35 0.93 Highly perceived
donate blood.
I am aware that the recommended interval between two successive donations is three months. 2.71 1.04 Moderately perceived
I am aware that a pregnant or breastfeeding woman cannot donate blood. 3.15 0.97 Moderately perceived
I am aware that in the Philippines, it is illegal to pay a person for blood donation. 2.86 1.04 Moderately perceived
I am aware that individuals who smoke, and those who had tattoos/piercings done within less 3.42 0.86 Highly perceived
than a year are not allowed to donate blood.
I am aware that donating blood does not pose a risk in giving the donor a disease. 3.13 0.99 Moderately perceived
Average 3.13 0.70 Moderately perceived
Legend: 1.00-1.75 = No perception at all; 1.76-2.50 = Slightly perceived; 2.51-3.25 = Moderately perceived; 3.26-4.00 = Highly perceived

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 Factors affecting voluntary blood donations among adults in Metro Manila

Table 3. Level of perception of respondents according to motivators

Weighted Standard
Items Interpretation
Mean Deviation
Social
I will donate blood because of peer pressure. 1.68 0.77 No perception at all
I will donate blood because everyone is doing it. 1.77 0.79 Slightly perceived
I will donate blood because I’m associated with some organization. 2.12 0.94 Slightly perceived
Accessibility/Blood Service Facility
I will donate blood if the blood donation centers can be easily contacted for inquiries. 3.30 0.69 Highly perceived
I will donate blood if the staff of the blood donation facilities are hospitable, welcoming, and 3.35 0.74 Highly perceived
have high quality of care.
I will donate blood because there are donation facilities near me. 3.15 0.85 Moderately perceived
Altruism
I will donate blood because it is my social responsibility to help unknown people who need it. 3.23 0.73 Moderately perceived
I will donate blood because I am aware of the shortage of blood supply, so I want to support 3.31 0.72 Highly perceived
them to maintain their target supply.
I will donate blood if my family, relatives or friends need it. 3.73 0.60 Highly perceived
Financial
I will donate blood for monetary rewards. 1.70 0.86 No perception at all
I will donate blood for incentives (raffle tickets, movie passes, certificate, free food, etc.) 1.76 0.92 Slightly perceived
Advertisement
I will donate blood after a blood donation campaign (e.g., posters, TV ads, etc.) 2.58 0.87 Moderately perceived
I will donate blood if there’s an urgent call for blood posted on social media. 2.90 0.84 Moderately perceived
Beneficial
I will donate blood because of the health benefits of donation. 3.03 0.80 Moderately perceived
I will donate blood because I am aware of the advantages of blood donation brought about by 2.93 0.83 Moderately perceived
the free tests (e.g., blood tests, HIV tests, etc.)
Personal
I will donate blood because I am curious. 2.48 0.85 Slightly perceived
I will donate blood because I have time to spare. 2.67 0.87 Moderately perceived
I will donate blood because it feels good. 2.60 0.92 Moderately perceived
I will donate blood because I have increased knowledge about blood donation. 3.05 0.82 Moderately perceived
I will donate blood because I’m guilty that I am not regularly donating blood. 2.07 0.89 Slightly perceived
Average 2.67 0.42 Moderately perceived
Legend: 1.00-1.75 = No perception at all; 1.76-2.50 = Slightly perceived; 2.51-3.25 = Moderately perceived; 3.26-4.00 = Highly perceived

highly perceived as a motivator is the accessibility of the to personal reasons such as time limitations due to work,
blood service facility (BSF), especially if it could easily be studies, family responsibilities, and volunteer activities (x̄ =
contacted (x̄ = 3.30, SD = 0.69), if the staff was hospitable, 3.23, SD = 0.78) were interpreted as moderately perceived.
and if they offered high-quality service (x̄ = 3.35, SD = 0.74). In other words, respondents have adequate discernment that
hindrances relating to the BSF and personal reasons, such
Hindrances as time and schedule constraints, may discourage them from
Overall, the average weighted mean of the level of donating blood. Most of the respondents have not donated
perception of the respondents in terms of hindrances (x̄ = 2.09, blood yet, despite having only minimal or faint discernment
SD = 0.48) was interpreted as slightly perceived, meaning that that they can be discouraged from donating blood.
the respondents generally have minimal or faint discernment
that said hindrances can dissuade them from donating blood Correlation between sociodemographic profile
(Table 4). However, hindrances relating to the BSF, such as and knowledge, motivators, and hindrances
poor behavior and treatment of BSF staff (x̄ = 2.52, SD = There was a significant but low negative correlation
0.91), difficulty in accessing the BSF (x̄ = 2.56, SD = 0.85), between age and motivation (r = -0.151, p = 0.015) (Table
and absence of BSF within the area (x̄ = 2.58, SD = 0.86) 5). Therefore, only age has a significant relationship with
were all moderately perceived. Likewise, hindrances relating motivation among the sociodemographic factors presented.

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Factors affecting voluntary blood donations among adults in Metro Manila

Table 4. Level of perception of respondents according to hindrances

Weighted Standard Verbal
Items
Mean Deviation Interpretation
Personal Reasons
Time limitations due to work, studies, family responsibilities, and/or voluntary activities may 3.23 0.78 Moderately perceived
hinder me from donating blood.
I will not donate blood because of fear. 1.96 0.90 Slightly perceived
I will not donate blood because I am afraid of needles. 1.77 0.85 Slightly perceived
I will not donate blood because I am afraid of blood. 1.64 0.80 No perception at all
I will not donate blood because I am afraid of pain that could be felt while donating blood. 1.83 0.90 Slightly perceived
I will not donate because I am afraid of fainting. 1.75 0.83 No perception at all
I will not donate blood because of previous painful experiences during blood donation. 1.53 0.68 No perception at all
I will not donate blood because it does not interest me for no particular reason. 1.55 0.67 No perception at all
I will not donate blood as it does not interest me because I lack some information regarding the 1.68 0.78 No perception at all
blood donation process.
Health-related reasons
I will not donate due to health-related concerns such as pregnancy, acute fever, recent alcoholic 2.40 1.07 Slightly perceived
intake, ear or body piercing and tattooing, and/or surgery.
I will not donate blood because I am unaware if my health problem/s will prevent me from 2.39 1.01 Slightly perceived
donating blood.
Accessibility/Blood Service Facility
I will not donate blood because of the difficulty in accessing the blood service facility. 2.56 0.85 Moderately perceived
I will not donate blood because there is no blood service facility in the area. 2.58 0.86 Moderately perceived
I will not donate blood due to the behavior and/or poor treatment of staff towards the donors. 2.52 0.91 Moderately perceived
I will not donate blood due to the strict restrictions and numerous requirements needed of 2.18 0.81 Slightly perceived
blood donors.
I will not donate blood because I often travel from one country/area to another which excludes 1.87 0.75 Slightly perceived
me from donating blood.
Average 2.09 0.48 Slightly perceived
Legend: 1.00-1.75 = No perception at all; 1.76-2.50 = Slightly perceived; 2.51-3.25 = Moderately perceived; 3.26-4.00 = Highly perceived

Table 5. Significant correlation between the sociodemographic per donation, the prohibition of using blood commercially,
profile and knowledge, motivators, and hindrances minimum weight, the time it takes to replenish blood lost
Knowledge Motivation Hindrance from donation, blood donation does not endanger the
r p-value r p-value r p-value donor into contracting a disease, and deferral of pregnant
Gender 0.025 0.689 0.045 0.469 -0.021 0.741 or breastfeeding women. A similar study showed that
Age -0.098 0.117 -0.151 0.015* 0.057 0.361 the respondents had fairly adequate knowledge about the
Religion -0.057 0.357 0.108 0.082 -0.042 0.496 permissible interval for blood donations and eligible age,28
Education -0.040 0.521 -0.079 0.206 -0.010 0.871
while others noted that, in general, the respondents had
highly satisfactory scores about their knowledge of common
Occupation 0.080 0.199 0.078 0.211 0.031 0.620
blood types and their individual blood groups, the volume
Monthly 0.032 0.602 0.038 0.547 0.107 0.085
Income
of blood donated, and allowable frequency of donations.5,29,30
However, not everyone has satisfactory levels of knowledge
*p-value considered statistically significant, α = 0.05
regarding the basics of blood donation since other studies
revealed that their respondents answered poorly about,
DISCUSSION among others, the donation interval,7,31 blood volume
donated,30,31 and minimum weight required.30 Lack of
This study found that, in general, the respondents are knowledge may be explained by inadequate information and
sufficiently knowledgeable about the eligibility requirements inaccessibility of credible sources, which can be considered
and other information about blood donation. They major contributors to self-deferral.32 In this study, the
specifically have fairly adequate knowledge of the following respondents have satisfactory levels of knowledge regarding
blood donation information: the recommended interval blood donation, but it is essential to translate this existing
between two successive donations, amount of blood taken knowledge into practice. Therefore, the results suggest a need

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 Factors affecting voluntary blood donations among adults in Metro Manila

for improvements in information dissemination to reinforce a positive attitude towards blood donation.36,37 Second, it
knowledge about blood donation. might be because certain motivational strategies might not
Concerning hindrances, this study found out that, be universally appealing across all age groups.19 Third, as age
in general, the respondents only have minimal or faint increases, blood pressure abnormalities might arise, which
discernment that hindrances can dissuade them from may cause temporary blood donor deferral in the aging
donating blood. Specifically, however, hindrances relating to population.38,39 Fourth, age groups of 18 years and above may
BSF accessibility, BSF staff behavior, and time and schedule have more motivation to donate because of this age group’s
constraints may discourage them from donating blood. The newly discovered capacity to donate and social pressure.40
results were similar to previous studies,8,12,17,19 such that time Conversely, a study posited that having the intention to
limitations due to several reasons were major hindrances donate and/or return for blood donation was associated
that discouraged blood donors from donating. Meanwhile, with older age,7,12,35 which may be due to older age groups
hindrances due to poor treatment and behavior of BSF staff having more experiences in blood donation35 or due to them
were seen in other studies.9,19 Moreover, a study explained placing greater importance on family and friends who are
that the length of time spent in the entire blood donation starting to need blood products themselves.40
process might hinder donors from donating blood because This study also aimed to recommend improvements in
it may not be amenable for those with tight schedules.8 existing strategies or policies in blood donor recruitment in
Meanwhile, another study tried to explain that staff behavior the Philippines. The Department of Health has put up policies
and treatment may contribute to donors having a pleasant to promote safe and quality blood collection and recruit more
experience and a positive attitude towards blood donation.9 blood donors for the National Voluntary Blood Services
On the contrary, other studies suggested alternative reasons (NVBS). One example is DOH administrative order 2010-
that can dissuade people from donating blood, such as, 0002, which organizes local blood donation drives for the
among others, fear of needles, blood, and fainting,6,33 and general population rather than focusing on a target population.
lack of sufficient information about blood donation.11 Other This study showed an inverse relationship between age and
studies in the Philippines had shown that the respondents’ motivation to donate, inferring that recruitment and retention
existing health conditions were the major hindrance to strategies focused on younger individuals are appealing since
blood donation.23,24 Therefore, these results may imply they have a stronger urge to donate. The WHO suggested that
developing BSF schedules permissible to potential donors targeting specific sub-groups can educate prospective donors,
with restrictive schedules and initiating training and other maximize blood donation resources, formulate suitable
activities to improve BSF staff behavior to provide a better strategies, and minimize deferrals.1 Studies recommended
quality of treatment for blood donors. targeting younger age groups as they were more likely to
When it comes to motivators, this study revealed the donate blood,41,42 and as they can be candidates for long-term
respondents’ perception of personal motivation to donate repeated blood donation.41 Furthermore, younger donors
blood leaned towards altruistic reasons. First, providing might need more effort in blood donor recruitment. First,
for a family member in need was congruent with several while other studies noticed that blood donation practice
studies.7,9,24,28,31 Second, a sense of responsibility to provide has shifted toward the baby boomer generation,40,43 such
for the community when there is blood supply shortage may pose challenges in the future because said generation
was similarly seen in other studies.4,5,19,34 Another motivator will eventually be no longer able to donate blood because of
described in this study was the accessibility of BSFs attributed deferrals44–46 due to health reasons. Their increasing age may
to inquiries and quality of service provided by the staff, which further decrease the blood donor pool.43,45 In these cases, a
was seen similarly in another study.19 Therefore, formulating study said that younger donors are relied upon to replenish
blood donor recruitment strategies with altruistic messaging the lost donor pool.44 Second, younger non-blood donors lose
at its core and making BSFs more accessible by placing them their interest in starting donating blood as they age,47 despite
in convenient locations and adjusting operating hours to studies showing that younger individuals compose most of
accommodate potential donors with hectic schedules can the first-time blood donors.12,40 Another study expounded
be suggested. that there was low blood donor retention in donors aged
Meanwhile, regarding the level of practice, this study has 24 years and younger at the initial blood donation.48
shown that there is an inverse relationship between age and One strategy for blood recruitment is technology,
motivation to donate. That is, younger individuals may have but strategies may differ among countries. Several studies
more motivation to donate compared to older individuals. suggested the use of technology, such as WhatsApp, which is
This is in line with a study that said that age affects the the preferred platform in Saudi Arabia,49 email,19,50 telephone
practice of blood donation.10,35 Similarly, a study had shown calls which show a higher success rate for donors to most
that blood donation was less common among older people.11 likely return,51 Facebook alerts for young donors less than 28
One possible reason for this is that the younger age group years of age, and SMS for respondents older than 28 years
are college students who might have sufficient knowledge of of age and for contacting inactive donors.19,51 Meanwhile, a
the blood donation process, which may translate into having study suggested a non-technological method of recruitment

7
Factors affecting voluntary blood donations among adults in Metro Manila

in younger age groups involving their acquaintances and Author Disclosure

those deemed as an expert and respected figures in their All authors declared no conflicts of interest.
schools.52 Another suggested changing donation hours and
mobile donation drives by lessening the time consumed Funding Source
in the process53 or placing blood collection facilities on This study has no funding support.
campuses where operational hours should be adjusted.19
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