Blood Donation: Beliefs And Perceptions in Western Cameroon

 Corresponding author: DJOKO Ernest Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0. Blood Donation: Beliefs And Perceptions in Western Cameroon DJOKO Ernest 1, *, KAPCHE Belviane 2, SIMO Josué 2 and FOTSING KWETCHE Pierre Réné 3 1 Laboratory of Galenic pharmacy, Faculty of pharmacy, Université des Montagnes –Bangangté, Republic.of Cameroon. 2 Laboratory of Hematology, Faculty of pharmacy, Université des Montagnes –Bangangté, Republic of Cameroon. 3 Laboratory of Bacteriology, Faculty of pharmacy, Université des Montagnes –Bangangté, Republic of Cameroon. World Journal of Advanced Research and Reviews, 2025, 27(02), 1639-1651 Publication history: Received on 13 July 2025; revised on 20 August; accepted on 23 August 2025 Article DOI: https://doi.org/10.30574/wjarr.2025.27.2.3014 Abstract The need for blood and blood products is universal, but access to them is a major public health issue, particularly in lowand middle-income countries such as Cameroon, where demand far exceeds supply. Blood donation practices vary around the world, which affects the availability of blood when needed. These differences are partly due to the different beliefs and perceptions that populations have about blood donation. This study was initiated with the aim of contributing to improving the availability of blood in health facilities in western Cameroon by assessing the beliefs and perceptions that people in this region have about blood donation. This was a descriptive cross-sectional study conducted from November 20, 2023, to June 7, 2024, in five selected health facilities and among the population of the city of Bangangté. It included people aged 18 to 65 who were encountered at the time of the survey and who gave their free and informed consent. Data were collected using a pre-established questionnaire. Statistical analysis was performed using statistical tools provided by Excel 2016. 400 participants were recruited, and the results show that: the predominant gender was female (55.2%); 72.3% of participants were between 18 and 35 years of age; 52.8% of them were single. University and secondary education levels were the most represented, with 47.8% and 46.8% respectively. The assessment of knowledge, perceptions, and beliefs showed that in the study population, 34% had good knowledge about blood, 49% had good knowledge about blood donation; 71% had good beliefs, as they believed that blood donation saves lives, and 74.5% had good perceptions and believed that it is a humanitarian or civic act. The main barriers to blood donation identified were the misconception that blood is sold after donation (23%), fear of needles (20.5%), and fear of disease transmission (16.2%). Taking into account these different beliefs, perceptions, and barriers to blood donation provides advantage for implementing a policy to improve voluntary blood donation. Keywords: Blood donation; Beliefs; Perceptions; Barriers 1. Introduction Blood donation is the voluntary transfer of blood or blood components by a person for therapeutic purposes [1]. This activity therefore depends on voluntary, unpaid donors; it is based on the principles of anonymity, voluntariness, and altruism. There are three types of blood donation: voluntary unpaid donation, family donation (which may be replacement or directed), and paid donation [2]. The type of donation is an important factor because of its direct impact on the transfusion safety of the recipient and even the safety of the donor. Blood donations are used in many emergency medical procedures, and an adequate blood supply is an essential part of any health service. In addition, hospital blood banks responsible for maintaining an adequate blood supply rely on the voluntary and active participation of the public in blood donation. However, in the literature, most studies on blood donation practices report that it is mostly family-oriented in developing countries and anonymous in developed countries [3]; this situation influences, first, the timely availability of blood and, second, transfusion safety. This World Journal of Advanced Research and Reviews, 2025, 27(02), 1639-1651 1640 difference could be due in part to the different beliefs and perceptions that populations have about blood donation. Indeed, in the literature, blood is considered in some communities as an object of socio-cultural representations [4]. Some authors report that in Africa, blood has a paradoxical dimension in that it carries the soul, personality, or character of the individual; it symbolizes the feeling of belonging to a family or community [5]. According to other authors, blood retains symbolic aspects despite scientific treatment and medical use. In Cameroon in particular, cultural and religious diversity could lead to perceptions, representations, and beliefs that may influence the availability of blood in hospitals. Cameroon has only 10% voluntary donors, compared to 90% family or directed donors [6]. Furthermore, between 2016 and 2022, the number of blood bags collected annually rose from 70,000 to 147,000 according to the National Blood Transfusion Program, which remains insufficient as the number of blood bags needed annually is estimated at 400,000 [7]. The result is multiple deaths each year, with pregnant women, children, and road accident victims being the most affected. In West Cameroon in particular, blood needs were estimated at 34,756.19 bags in 2016, compared to 2,961 bags collected in the same year, resulting in a significant difference; Coverage of needs was only 8.41% [8]. Thus, in 91.59% of cases, the lives of people requiring blood transfusions were put at risk in this region [9]. Given the increase in life expectancy, which will be followed by an increase in demand, it is therefore imperative and necessary to anticipate future situations in the field of blood transfusion, and this requires the recruitment and retention of a sufficient number of donors. It is necessary to understand the beliefs and perceptions that influence the behavior of adult voluntary and unpaid blood donors. The purpose of this study is to contribute to improving the availability of blood in health facilities in western Cameroon by assessing the beliefs and perceptions that the populations of western Cameroon have about blood donation through their experience and lived reality, which will enable the implementation of effective strategies to motivate donors and reduce barriers to blood donation. 2. Methodology 2.1. Study population This cross-sectional, descriptive study targeted the population of the town of Bangangté and patients admitted to five health facilities in the West Region: Bangoua Protestant Hospital, Bangangté District Hospital, “Cliniques Universitaires des Montagnes”, Kouekong Regional Hospital Center, and Foumban Regional Annex Hospital. These health centers were chosen for their accessibility, location, attendance, quality of care, and the good reputation and renown they enjoy among the populations of West Cameroon. The study covered the general population aged between 18 and 65 who attended the selected hospitals between November 20, 2023, and June 7, 2024. It also included all people in the same age group encountered during the same period in the town of Bangangté. The study included individuals aged 18 to 65 encountered at the time of the survey who agreed to cooperate by signing the informed consent form in the city of Bangangté and in the targeted health facilities. Individuals who were unable to complete the questionnaire were excluded from the study. 2.2. Data collection tool The informations was collected using a questionnaire containing 34 questions on: sociodemographic characteristics, knowledge about blood, knowledge about blood donation, perceptions of blood donation, beliefs about blood donation, factors preventing blood donation, and personal recommendations regarding blood donation. Other studies were used as a basis for the design of this survey form, notably those by Aoulou in 2013[10], Salaudeen et al in 2011[11], and Doumbia in 2021[12], supplemented by a few questions specific to the current context. 2.3. Data collection procedure • -Within hospitals After obtaining ethical clearance from the institutional ethics committee of the “Université des Montagnes” and research authorizations from the management of the recruiting institutions, the study followed the following procedure: o Contacting participants; o Presentation of the study and its purpose by the principal investigator; o Distribution of the survey and consent form; World Journal of Advanced Research and Reviews, 2025, 27(02), 1639-1651 1641 o Signing of the consent form and completion of the survey form by each participant; o Registration of each participant with the assignment of an anonymous code number; o Return of the questionnaires in person. o The meeting with participants took place in various hospital departments; a presentation of the study was given before participants were asked to take part. • -Within the community of the town of Bangangté After obtaining ethical clearance from the institutional ethics committee of the Université des Montagnes and research authorization from the prefect of the department of Ndé, the study proceeded as follows: o Contacting participants; o Distributing the survey and consent form; o Signing of the consent form and completion of the survey form by each participant; o Registration of each participant with assignment of an anonymous code number; Meetings with participants took place in gathering places such as markets and places of worship. 2.4. Ethical considerations The study did not involve any human manipulation; the dignity of the interviewees was protected by the anonymity of their responses. The questionnaires were kept secret to ensure confidentiality. In accordance with medical ethics, the various research authorizations were obtained before the start of the work; they were made available to the Ethics Committee of the University of the Mountains with a copy of the research protocol and then to the management of the hospitals concerned with letters requesting consent. 2.4.1. Data processing and analysis Software used Data management (compilation, quality control, and coding) and graphing were performed using Microsoft Excel 2016 software. Categorical variables were described using frequencies. A 95% confidence level was accepted for statistical analyses, and significance was set at P values less than 0.05. Data rating • -Definition of operational terms Knowledge: this refers to having a relevant idea or being informed about something, knowing that it exists. It constitutes all the information acquired by individuals on a given subject. Beliefs: This refers to adherence to ideas, opinions, and values without rational, empirical, or theoretical evidence leading to the development and adoption of the beliefs in question [13]. Representations: These could be defined in general terms as “the idea we have of...”, also referred to as common sense or naive knowledge. This form of knowledge is distinguished, among other things, from scientific knowledge [13]. • -Knowledge rating grid on blood The data was rated by assigning scores based on variables. Table 1 specifies the scores based on the variables. Table1 Data rating Points Percentages Blood knowledge Insufficient 0 à 3,4 0 à 49 Sufficient 3,5 à 4,9 50 à 75 good 5 à 7 76 à 100 Insufficient 0 à 2,9 0 à 49 World Journal of Advanced Research and Reviews, 2025, 27(02), 1639-1651 1642 Knowledge bout Blood donation Sufficient 3 à 4,9 50 à 75 good 5 à 6 76 à 100 Representations Insufficient 0 à 1,9 0 à 49 Sufficient 2 à 2,9 50 à 75 good 3 à 4 76 à 100 Beliefs Insufficient 0 à 1,9 0 à 49 Sufficient 2 à 2,9 50 à 75 good 3 à 4 76 à 100 The questionnaire consisted of seven questions about blood. Each correct answer was worth one point and each incorrect answer was worth zero points. The maximum number of points was seven, corresponding to 100%. There were six questions about blood donation, with one point for each correct answer and zero points for each incorrect answer; six points corresponded to 100%. For representations, there were four questions, each worth one point; thus, four points corresponded to 100%. For beliefs, there were also four questions, each worth one point, so that four points corresponded to 100%. 3. Results The survey analyzed information obtained from 400 people who met the inclusion criteria. The results were presented sequentially. 3.1. Socio-Demographic Characteristics Of Participants The analysis of the questionnaires highlighted gender, age group, educational level, marital status, religion, department of residence, religion, and profession. The results obtained are presented in Tables II. Table 2 Distribution of participants according to their sociodemographic characteristics Modalities Number (n) Frequency (%) Gender Female 221 55,2 Male 179 44,8 Age 18-25 years 167 41,8 26-35 years 122 30,5 36-45 years 67 18,8 46-65 years 44 11 Educational level Primary 21 5,2 Secondary 187 46,8 University 191 47,8 No Level 1 0,2 Marital status Single 211 52,8 married 184 46 widowed 5 1,2 Religion Christian 338 84,5 Muslim 25 6,2 Jehovah’s Witness 18 4,5 World Journal of Advanced Research and Reviews, 2025, 27(02), 1639-1651 1643 Animist 19 4,8 Occupation Housewife 35 8,8 Worker 133 33,2 Civil Servant 44 11 Student 134 33,5 Medical Staff 54 12,6 Division of residence Mifi 95 23,8 Ndé 215 53,8 Noun 90 22,3 Participants were aged between 18 and 65. Women predominated, accounting for 52.2% of participants; more than half of participants (72.3%) were aged between 18 and 35. The majority of participants had a university education (47.8%) and were single (52.8%). The department with the highest representation was Ndé. Christian participants were the most represented in terms of religion; in terms of socio-professional status, students and pupils were the most represented. 3.2. Assessment of levels of knowledge, perceptions, and beliefs. 3.2.1. Assessment of knowledge levels Table 3 presents the results of the assessment of knowledge levels about blood, blood donation, beliefs, and perceptions about blood donation. Table 3 Assessment of levels Number (n) Frequency (%) Level of Knowledge about blood Insufficient 91 22,8 Sufficient 173 43,2 Good 136 34 Level of knowledge about blood donation Insufficient 19 4,8 Sufficient 185 46,2 Good 192 49 Level of beliefs about blood donation Insufficient 11 2,8 Sufficient 105 26,2 Good 284 71 Level of perceptions about blood donation Insufficient 42 10,05 Sufficient 60 15 Good 298 74,5 In accordance with the rating procedure described above, the number of points awarded was grouped into three levels (insufficient, sufficient, and good). In terms of participants' knowledge of blood, only 34% had a good level of knowledge. However, only 4.8% had an insufficient level of knowledge about blood donation. 71% of participants had good beliefs about blood donation, and 74.5% had good representations. World Journal of Advanced Research and Reviews, 2025, 27(02), 1639-1651 1644 3.2.2. Knowledge about blood Data relating to participants' knowledge about blood are summarized in Figure 1. Data relating to participants' knowledge about blood are summarized in Figure 1. Figure 1 Distribution of participants according to their knowledge about blood The data from Figure 1 show that: • -Knowledge about the definition of blood is incorrect among 66.5% of participants; However: • -Knowledge about the origin of blood in the body is correct among 54% of participants; • -Knowledge of the origin of blood in blood banks is correct among 95.8% of participants; • -Knowledge of the uses of blood in general is correct among 90.5% of participants; • -Knowledge of the signs of anemia is correct among all participants. 3.2.3. Knowledge about blood donation The level of knowledge of the data relating to participants' knowledge about blood donation is presented in Figure 2. Figure 2 Distribution of participants according to their knowledge of blood donation Figure 2 shows that: • 95.2% of participants have heard of blood donation; World Journal of Advanced Research and Reviews, 2025, 27(02), 1639-1651 1645 • 97% of participants know what blood donation is; • 95.2% know who receives blood donations; • 90.2% of participants know how often blood donations are made; • 79.2% of participants know where to donate blood; However: • 50.2% of participants believe that blood donation can harm the recipient or the donor; • 81.8% are unaware of the criteria for becoming a blood donor 3.2.4. Beliefs about blood donation Data on participants' beliefs about blood donation are summarized in Figure 3. Figure 3 Distribution of participants based on their beliefs about blood donation Figure 3 shows that 75% of participants do not have a positive belief about the destination of the collected blood; On the other hand: • 93% have a positive belief about donating blood • Beliefs about donating blood are positive among 93% of participants; • Beliefs about the perception of blood donation according to religion or tradition are positive among 95.2% of participants; • Beliefs about the use of donated blood are positive among 69.8% of participants. 3.2.5. Representations of Blood Donation The analysis of data relating to participants' representations about blood donation yielded the results summarized in Figure 4. World Journal of Advanced Research and Reviews, 2025, 27(02), 1639-1651 1646 Figure 4 Distribution of participants according to their perceptions of blood donation The data from Figure 4 allow to distinguish that among the participants' perceptions of blood donation: • Perceptions of blood donation are positive among all participants; • Perceptions of whether blood donation is bad or not are positive among 89.5% of participants; • Perceptions of being able to accept blood from a stranger are positive among 78.8% of participants. 3.3. Barriers to blood donation Figure 5 summarizes the various reasons that may motivate people to donate blood. Figure 5 Distribution of participants according to their motivation for donating blood The data in this figure shows that the majority of participants (65%) justify their willingness to donate blood by the desire to save a life. The frequency of blood donations is shown in Figure 3. World Journal of Advanced Research and Reviews, 2025, 27(02), 1639-1651 1647 Figure 6 Distribution of participants according to frequency of blood donation As shown in Figure 6, of the 400 participants, more than half had never donated blood, and the majority of those who had donated had done so only once. Participants gave many reasons to justify their refusal to donate blood. The most salient of these reasons were extracted, grouped, and presented in Figure 7: Figure 7 Barriers to blood donation The data collected in Figure 7 show that six reasons are the main barriers to blood donation for at least 80% of participants. Among these, the sale of blood after collection, fear of needles, and fear of disease transmission were of concern to more than 50% of participants. 3.4. Analysis of socio-demographic characteristics associated with blood donation The analysis of socio-demographic characteristics associated with blood donation is presented in Table 4.