African Journal of Reproductive Health Vol. 9 No.3 December 2005
In Nigeria the average maternal
mortality ratio (MMR) is 1,000 per 100,000
Obstetric haemorrhage accounts
largely for these mortalities. Massive blood loss
results rapidly in mortality if prompt and ad-
equate life-saving measures, including blood trans-
fusion, are not taken on time.
Blood for transfusion is not readily available
The wastage implicit in the inability
to separate available blood into various useful
components further compounds the scarcity.
Most blood bank operators in the country are
also known to rely on touts for their supply.
the high prevalence of HIV in Nigeria (5.4%)
and the increasing number of HIV positive blood
donors, the obstetric patient in need of blood
transfusion faces a precarious situation.
More often, blood bank operators turn to
patients’ relatives for blood donation during
emergencies. Studies from some parts of Africa
have revealed attitudinal barriers to such donations.
Few studies on the subject have been undertaken
in Nigeria. This study, therefore, aimed at
identifying the socio-cultural barriers to blood
transfusion in a rural village in south-east Nigeria.
This study was conducted at St Vincent’s Catholic
Hospital, Ndubia, an agrarian community in rural
Ebonyi State of Nigeria, over a 12-month period
(September 1, 2003 to August 31, 2004). The
hospital serves both as a primary contact with
orthodox medicine and a referral centre for the
community and surrounding towns in Ebonyi
and neighbouring Cross River State. Staffed with
medical officers and a resident consultant
obstetrician and gynaecologist, the hospital
attends to numerous obstetric and gynaecologi-
cal cases including those requiring blood transfu-
sion. Patients’ relations and friends are often called
upon for blood donation whenever the need
arises. Blood from donors are screened for in-
fectious diseases including HIV/AIDS before
Patients’ relations and friends who declined
blood donation were randomly recruited into the
study. Informed consent was obtained in each
case before subsequent interview by the
investigators. Pre-tested questionnaire was
administered to the respondents in Igbo or Eng-
lish language to ensure adequate understanding.
Reasons given by the respondents were ranked
according to frequency of response.
A total of 143 respondents were recruited into
the study, out of which 118 (82.5%) were males
and the remaining (17.5%) females. Seventy-two
(50.3%) of them were aged between 25 and 34
years, an overwhelming majority 109 (76.2%) had
no formal education. None of the respondents
had post-secondary education. Majority (71.3%)
of the respondents were farmers and petty
traders, while 80.4% of them were Christians.
Jehovah’s Witnesses were excluded from the study
because of their religious aversion to blood
donation and transfusion.
The two commonest reasons for not
donating blood (Table 2) were ‘not feeling well/
strong enough’ (63.6%) and ‘not having enough
blood’ (58%). Seventy-eight respondents (54.5%)
believed that they would collapse if they donated
blood, while 46 (32.1%) of them felt that it could
shorten their lifespan. Other reasons included for
not wanting to donate blood included loss of
‘manhood’ (libido) (27.1% of the men), increased
risk of illness/infection (35.7%) and possibility
of blood being exposed to rituals/witchcraft
(28.7%). Sixteen respondents (11.2%) had no
particular reason for refusing to donate blood.
Level of awareness about HIV/AIDS was
appreciable among the respondents but none of
them was aware of his/her HIV status. Twenty-
four of the respondents (16.8%) feared that their
HIV status might be positive and could be exposed
because of lack of confidentiality by the medical
personnel. Almost 19% of the respondents be-
lieved that cases requiring blood transfusion are
Socio-Cultural Barriers to Voluntary Blood Donation for Obstetric Use in a Rural Nigerian Village