The demand for blood consistently outstrips supply, particularly in developing nations like India. Voluntary non-remunerated blood donation (VNRBD) is crucial for ensuring a safe blood supply, as advocated by the World Health Organization (WHO). India faces a significant shortfall in blood donations, partly due to misconceptions, perceived risks, and lack of motivation among potential donors. University students represent a large pool of potential volunteers, making it essential to understand their perceptions and behaviors regarding blood donation. Previous research has highlighted the influence of factors such as altruism, social pressure, fear of needles, and perceived risks of infection on blood donation practices. Studies have also noted inconsistencies between knowledge, attitude, and practice among students, with lower donation rates observed among female students. This study aimed to assess the knowledge, attitudes, and practices related to blood donation among university students, identifying factors influencing participation.

Existing literature reveals a global need for increased voluntary blood donation. In India, while voluntary blood donation began in 1942, a decline followed the Second World War, necessitating paid donations. The WHO emphasizes VNRBD as the cornerstone of a safe blood supply. A substantial gap exists between blood demand and supply in developing countries, including India, exacerbated by high anemia prevalence. Studies have identified various factors impacting blood donation, including altruism, social pressure, and fear of needles. Previous research has shown that positive knowledge, attitude, and practice towards blood donation are interlinked, suggesting that improving knowledge can enhance positive attitudes and behaviors. However, inconsistencies between knowledge and practice remain a concern among students. Female students have shown lower rates of participation compared to male counterparts. While India has made progress in voluntary blood donation, recruiting new donors, particularly from younger populations, is a continuing challenge.

A descriptive cross-sectional study was conducted among 354 university students in Manipal, South India, from January 2018 to January 2019. Convenience sampling was used to select participants. A two-part questionnaire assessed background information (gender, age, year of study, NGO membership, volunteer hours, family type, volunteer frequency) and knowledge, attitudes, and practices towards blood donation. Knowledge was assessed using six questions on blood donation eligibility criteria, blood volume, donation intervals, and blood screening. Attitude was assessed using eight questions regarding interest in donation, motivations, fear of needles, perceived risks and benefits, and willingness to donate with incentives. Practices, barriers, and suggestions for improvement were evaluated through seven questions on prior donation history, frequency of donation, difficulties encountered, recommendations to others, and reasons for not donating. Data analysis involved descriptive statistics (frequency and percentage) and logistic regression to assess adjusted associations between variables and blood donation. A p-value < 0.05 was considered significant. The study received ethical approval from the Institutional Research Committee and Institutional Ethics Committee.

Of the 354 participants, 38.98% (n=138) had donated blood at least once. Males (55.8%) were more likely to donate than females (28.44%). Significant predictors of blood donation included gender (females had 3.3 times higher odds of donating than males), NGO membership (non-members had 53% lower odds), frequency of volunteering (those volunteering once every six months had 68% lower odds compared to those volunteering weekly), fear of needles (46% lower odds), and the belief in acquiring a disease during donation (44% lower odds). Most participants had good knowledge about blood donation, but their attitudes and practices were not always consistent. A sense of social responsibility was the most common reason cited for donating blood. Fear of needles and side effects were major reasons for not donating. Weakness, lack of awareness, low haemoglobin, being underweight, personal choice, and medical conditions were also cited.

The findings highlight the complex interplay of factors influencing blood donation behavior among university students. The significantly higher odds of blood donation among females, contrary to some previous studies, require further investigation. The positive association between NGO membership and blood donation underscores the role of social responsibility and community involvement in promoting donation. The influence of volunteer activity frequency suggests that fostering a sense of civic engagement may encourage blood donation. Addressing fears and misconceptions related to needles and disease transmission is vital. Despite generally good knowledge, a considerable portion of students with positive attitudes and beliefs have not donated, highlighting the need for interventions targeting behavioral aspects. The most frequently cited reason for donation was social responsibility, suggesting that campaigns emphasizing this aspect might be effective.

This study reveals that while knowledge of blood donation is relatively high among university students, attitudes and practices are less consistent. NGO membership and regular volunteering positively impact donation rates. Fear of needles and disease acquisition remain substantial barriers. Future interventions should focus on addressing these concerns and leveraging the positive influence of social responsibility and civic engagement to increase voluntary blood donation rates. Incentivizing donation and targeting misconceptions through educational campaigns and digital platforms may be effective strategies.

The convenience sampling method limits the generalizability of the findings to other university student populations. The cross-sectional design restricts the ability to establish cause-and-effect relationships between variables. Future studies with larger, more representative samples and longitudinal designs are recommended to further investigate the factors influencing blood donation behaviors and evaluate the effectiveness of targeted interventions.