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International Journal of Public Health and Epidemiology Research

Vol. 5(2), pp. 100-107, June, 2019. © www.premierpublishers.org. ISSN: 1406-089X

Research Article

A Community Survey of the Willingness, Perceptions and Practice

of Blood Donation Among Adults in Kano Metropolis
*Abdullahi Abduljaleel1, Taiwo Amole2, Lawal Kayode Olatunji3
1,2Department of Community Medicine, Bayero University, Kano, Nigeria
3Department of Community Medicine, Usmanu Dan Fodiyo University, Sokoto, Nigeria

Blood donation is the major way of acquiring blood in emergency situations, major surgeries and
blood related obstetric complications. The disparity between willingness to donate and the real
practice of blood donation has implication for the establishment of blood transfusion services in
Nigeria. This community survey of the willingness, perceptions and practice of blood donation
among adults in Kano metropolis identified factors associated with willingness to donate as well
as perceptions and practice of blood donation. This was a descriptive cross-sectional survey of
adults from four of the eight local Governments areas within Kano metropolis employing a mixed
method of data collection; i.e. comprising a quantitative and qualitative component, using a multi-
stage sampling method. Relevant history on the willingness, perceptions and practice of blood
donation were obtained using a structured interviewer administered questionnaires and in-depth
interviews. Data were entered and analyzed using the Statistical Package for Social Sciences (IBM
SPSS) version 20. A total of 215 out of 216 respondents were surveyed, giving a response rate of
99.5%. Their ages ranged from 18years to 65years, with a mean age of 30.5 (± 10.5) years. There
were 101 (46.8%) males and 113 (52.3%) females. Respondent’s willingness to donate blood was
94.9%, while practice of blood donation was 25.5%. All respondents had a good perception of
blood donation and indicated that it was a way of saving other peoples’ lives. Willingness to
donate blood was high in this study; however, this did not translate well to the practice of blood
donation. Efforts should be made by government and organizations involved in blood donation
to increase awareness and encourage people to donate blood voluntarily through efforts such as
signing blood donation card.

Keywords: community, willingness, perceptions, practice, blood donation


Blood donation; the process of removal of blood from one countries do not have structured blood donor programmes
person (donor) and transfusing to another person and cannot attract sufficient numbers of donors to meet the
(recipient) is the major way of acquiring blood in need for blood in emergencies, planned surgery or regular
emergency situations following road traffic accidents and transfusion for conditions such as sickle cell anaemia, thus
blood related obstetric complications. It is an voluntary blood donations remain a strong foundation for
indispensable component of the health care contributing to safe and sufficient blood supply. Although the demand for
saving millions of lives each year in both routine and blood transfusion far exceed the supply, advance medical
emergency situations, and permit complex medical and technologies and availability of more donors, have resulted
surgical interventions to improve life expectancy and in increase in number of people who live longer and
reduce human suffering (WHO, 2016). healthier annually (Bellomo and Zamperetti, 2007).

In developing and transitional countries, chronic blood *Corresponding Author: Abdullahi Abduljaleel,
shortage is not uncommon and blood donations are largely Department of Community Medicine, Bayero University,
dependent on blood provided by families or friends of Kano, Nigeria. E-mail: abdullahiabduljaleel27@gmail.com
patients who require transfusion. Generally, these Tel: +2347033879475

A Community Survey of the Willingness, Perceptions and Practice of Blood Donation Among Adults in Kano Metropolis
Abduljaleel et al. 101

Willingness to donate blood is mostly high worldwide In order to compensate for non- or incomplete responses,
unlike the practice which is high in few developed countries the sample size was increased by 10% giving a total of
and generally low in developing countries (WHO, 2009; 216.
WHO, 2010). Average blood donation rate in developed
countries is 38.1 donations/1000 population and 2.3 For the qualitative component, seven donors and seven
donations per 1000 population in developing countries non-donors were selected from each of the four LGAs
(Chester and Anthoney, 2004; WHO, 2007). In WHO totaling 28 each for donors and non-donors.
African region, blood requirements were estimated at
about 8 million units in 2006, but only 3.2 million units were A multi-stage sampling method was used to select the
collected – about 41.5% of the demand (WHO, 2009).The study subjects for the quantitative survey. In the first stage,
prevalence of voluntary blood donation in Nigeria is 10% four local governments’ areas (LGAs) namely; Tarauni,
(NBTS, 2013) i.e. only four in one thousand peoples are Dala, Nasarawa and Ungogo were selected randomly from
voluntary donors despite the fact that up to half of the total the list of eight local governments in Kano Metropolis. The
population are medically fit to donate (Chester and lists of settlements from the selected local governments
Anthoney, 2004). Although, it is the commonest form of served as the sampling frame for the second stage. One
tissue donation in our environment there is need for settlement was selected randomly from each of the
increase advocacy for voluntary blood donation to meet localities by drawing lots; the settlements in each of the
the overwhelming demand. This will go a long way in LGA were written separately on small pieces of papers,
achieving WHO goal for all countries to obtain all blood then folded and mixed-up on a table, a random selection
supplies from voluntary unpaid donors by the year 2020 in was then made. The houses in the selected settlements
accordance with the United Nation assembly resolution were then sampled proportionately. In houses with more
28.72 which was adopted since 1975. than one household, one was selected through a one-time
ballot. Finally, an adult was selected randomly from among
There are little published data on the status of blood the eligible adults in the selected household, and this
donation in different state across Nigeria. This study was person was administered the questionnaire.
conducted with the aim of finding out people’s willingness,
perceptions and practice of blood donation in order to For the qualitative survey; an in-depth interview was also
comprehend the situation and find ways to enhance blood conducted among 7 donors and 7 non-donors from each
donation in the Nigeria. of the 4 settlements selected. This provided insight about
specific areas that could not be captured in the quantitative
method described above so as to generally improve the
quality of the study and “create room” for more qualitative
The study was conducted in four of the eight local studies in future. Participants were selected by nomination
government areas (LGAs) of Kano metropolis, namely; from each of the settlements above. Donors were
Tarauni, Nasarawa, Dala and Ungogo. A descriptive regarded as those that had donated blood before and were
cross-sectional study was employed with a study willing to donate more while non-donors were those that
population that encompassed adults between the age of had never donated blood before and were not willing to
18 to 65years within the selected local government areas donate in future.
for the quantitative while adults who had previously
donated blood and those who had never donated blood An interviewer-administered structured questionnaire
were selected for the qualitative component. Those with adapted from previous studies, (Duboz et al, 2010; Ameen
certain chronic illnesses like viral hepatitis and HIV were et al, 2015) was used as data collection tool for the
excluded. Sample size was estimated for the quantitative quantitative while an in-depth interview was used for the
component using Fisher’s formula qualitative component; participants’ responses were
recorded using a tape recorder and/or note taking.
n = Z2pq/d2 Responses were graded on a 5-point Likert type scale
Where: namely; strongly agree, agree, undecided, disagree and
n = the desired sample size (when population is greater strongly disagree.
than 10,000)
Z = the standard normal deviate, usually 1.96 which Two research assistants; a midwife and a male X-ray
corresponds to the 95% confidence interval. technician were trained for the purpose of data collection.
P = prevalence of blood donation (willingness to donate) The research assistants worked as team with the female
as obtained from previous study is 85.0% (i.e 0.85) (NBTS, facilitating the participation of the female subject in each of
2000). the selected settlements. For the in-depth interview; the
Q = 1.0 – P researcher guided the discussion, introduce the topic and
d = degree of accuracy desired, usually set at 0.05 read out an open-ended question for the participants to
: . n = (1.96)2 x 0.85 x 0.15/0.052 respond. The research assistant records the conversation,
n = 0.4898/0.0025 takes note and wrote down his observations about any
n = 195.9, approximately 196 “body language” or any relevant subtle signs noticed
A Community Survey of the Willingness, Perceptions and Practice of Blood Donation Among Adults in Kano Metropolis
Int. J. Public Health Epidemiol. Res. 102

during the discussion. The research assistants underwent RESULTS

2 days training on how to carry out the survey and a pre-
testing done from an LGA not included in the final Table 1: Socio-Demographic Characteristics of the
selection. It took an average of 6minutes to interview each respondents
of the participants using the structured questionnaire and Socio-demographic Frequency Percentage
an average of 15minutes to conduct in-depth interview. Variables (n) (%)
The questionnaires along with participant’s responses Age group (years)
were reviewed and found to be culturally acceptable and
<20 18 8.4
free from ambiguity.
20 – 29 102 47.4
For the quantitative, data was analyzed using SPSS 30 – 39 57 26.5
statistical software; version 20. Respondents’ ages were ≥40 38 17.7
summarized using mean and standard deviation. Other
variables like level of education, marital status etc. were Sex
summarized using frequencies and percentages. Chi Male 101 46.8
square test was carried out to assess the level of Female 113 52.3
association between the socio-demographic
characteristics of respondents and willingness and Marital Status
practice of blood donation while for the qualitative; Single 71 32.9
responses were “boiled” to essential information using Married 131 60.6
systematic and verifiable process. These are then
Divorced 2 0.9
transcribed taking note of relevant quotes. Transcripts
were then clean up by stripping off non-essential words Widowed 7 3.2
and simultaneously assigning each new thought or idea Educational Qualification
therein. Participant’s responses were in row against their None 7 3.2
serial numbers in column, this is then entered as such to
Qur’anic 30 13.9
excel database.
Primary 14 6.5
Ethical clearance and approval were sought from Kano Secondary 95 44
State Research Ethics Committee. Thereafter a written Tertiary 64 29.6
informed consent was also obtained from each participant
prior to the interview after explaining the aims and Others 1 0.5
objectives of the study to them. Occupation
Farming 19 8.8
Limitations includes possibility of social desirability as
people tend to answer questions in a way society expect Civil Servant 52 24.1
them to answer when confronted with questions that has Trading/Business 115 53.2
moral and ethical implications, recall bias, and difficulty in House Wife 3 1.4
recruiting the non-blood donors.
Others (e.g students) 25 11
Hausa/Fulani 176 81.5
Yoruba 23 10.6
Igbo 16 7.4
Islam 169 78.2
Christianity 43 19.9
Atheist 3 1.4

Out of the 216 respondents approached, 215 consented to

participate in the study giving a response rate of 99.5%.
The age of respondents ranged from 18years to 65years
with a mean of 30.5 (± 10.5) years (table 1).

A Community Survey of the Willingness, Perceptions and Practice of Blood Donation Among Adults in Kano Metropolis
Abduljaleel et al. 103

Table 2: Respondents Willingness to Donate Blood among the respondents

Statement Agree Undecided Disagree
Blood donation is good and should be encouraged 208 (96.8%) 4 (1.8%) 3 (1.4%)
Religion support blood donation and transfusion 200 (93.0%) 14 (6.5%) 1 (0.5%)
Enough willing blood donors for those in need in the community 147 (68.3%) 62 (28.8%) 6 (2.8%)
Willingness to donate blood if required 200 (93.0%) 4 (1.9%) 11 (5.1%)
Willingness to sign blood donation card 187 (87.0%) 12 (5.6%) 16 (7.4%)
Willingness to receive blood transfusion if required 196 (91.1%) 13 (6.0%) 6 (2.9%)
Encouraging family and friends to donate blood if necessary 194 (90.3%) 13 (6.0%) 8 (3.7%)
Trusting the health workers to handle donated blood appropriately 143 (66.5%) 52 (24.2%) 20 (9.3%)
Knowing status as far as transfusion related infections are concern 207 (96.3%) 6 (2.8%) 2 (0.9%)
Overall, 204 (94.9%) of the respondents were willing to donate their blood. Of the respondents, 208(96.3%) agreed that
blood donation is good and should be encouraged, 3 (1.4%) disagree and 4 (1.9%) were undecided (table 2).
Table 3: Factors Associated with Willingness to
Donate Blood among the respondents
Characteristics Willing n Unwilling n ᵪ2 p-value
(%) (%)
Age group (years)
<30 113 (94.2) 7 (5.8) 0.1**
≥30 91 (95.8) 4 (4.2)
Male 96 (95.0) 5 (5.0) 0.01 1.0**
Female 108 (94.7) 6 (5.3)
Marital status
Unmarried 77 (92.8) 6 (7.2) 0.3**
Married 127 (96.2) 5 (3.8)
Figure 1: Practice of Blood Donation
Only 55 (25.5%) of the respondents have ever donated
Informal 36 (92.3) 3 (7.1) 0.4**
blood before while 161 (74.5%) have never donated blood
Formal 168 (95.5) 8 (4.5) in the past (figure 1).
Civil Servants 48 (90.6) 5 (9.4) 0.1** Table 4: Frequency of Blood Donation among the
Others 156 (96.3) 6 (3.7) respondents
Ethnicity Number of Blood Frequency Percentage
Hausa/Fulani 169 (96.0) 7 (4.0) 0.1** Donation (n) (%)
Others 35 (89.7) 4 (10.3) 1 31 14.2
Religion 2 19 8.7
Islam I60 (94.7) 9 (5.3) 1.0** 3 5 2.3
Christianity 44 (95.7) 2 (4.3)
5 4 1.8
** = Fisher’s Exact
Table 3 shows various factors associated with willingness 6 1 0.5
to donate blood; no factor shows association with 7 1 0.5
willingness to donate blood.
Of the people that had donated blood in the past, 31
participants donated only once so far, 19 of the
respondants had donated twice, 5 people donated three
times (table 4).

A Community Survey of the Willingness, Perceptions and Practice of Blood Donation Among Adults in Kano Metropolis
Int. J. Public Health Epidemiol. Res. 104

Table 5: Factors Associated with Practice of Blood Donation among the respondents
Characteristics Ever Donated n(%) Never Donated n(%) ᵪ2 p-value
Age group (years)
>30 29 (24.2) 91 (75.8) 0.30 0.60
≥30 26 (27.4) 69 (72.6)
Male 28 (27.7) 73 (72.3) 0.50 0.50
Female 27 (23.7) 87 (76.3)
Marital status
Unmarried 21 (25.3) 62 (74.7) 0.01 0.90
Married 34 (25.8) 98 (74.2)
Informal 13 (33.3) 26 (66.7) 1.50 0.20
Formal 42 (23.9) 134 (76.1)
Civil Servants 13 (24.5) 40 (75.5) 0.04 0.80
Others 42 (25.9) 120 (74.1)
Hausa/Fulani 47 (26.7) 129 (73.3) 0.60 0.40
Others 8 (20.5) 31 (79.5)
Islam 48 (28.4) 121 (71.6) 3.30 0.07
Christianity 7 (15.2) 39 (84.8)
From the table above it is clear that no factor shows significant association with practice of blood donation.

DISCUSSION In Lagos, Nigeria, willingness to donate blood to

family/friends is 77.8% while willingness to donate blood
Willingness to donate blood in this study is 94.9%, almost voluntarily is 46.8% (Sekoniet al, 2014). This disagrees
similar to the finding of a study conducted in Germany with finding of this study where most respondents donate
were willingness to donate was found to be 94.2%. The blood as a desire to help others. In Cross River, Nigeria; a
high willingness to donate blood is higher in younger age study was conducted to improve voluntary blood donation
groups in both studies. at the University of Calabar Teaching Hospital, 79.7% of
the respondent were willing to donate blood freely while
In Asia, willingness to donate blood as obtained in two less than one-third (20.3%) were not willing to donate
previous similar studies conducted in Saudi Arabia and blood at all (Tanyel, 2015). The most common reason for
India were 99% and 87.3% respectively (Dieter and Jorg, non-donation and non-acceptance of blood transfusion
2005; Abdel et al, 2011) close to the finding of this study. was religious belief. The little difference observed in the
Willingness to donate blood in this study was slightly finding of this study and that of the index study suggest
higher compare to what is seen in other African countries; that religious believe play a vital role in determining
for instance in Ghana and Ethiopia, willingness to donate willingness to donate blood.
blood were 86.6% and 77.5% respectively.(Sabu et al,
2011; Tanyel, 2015).The observed differences with this Similarly, willingness to donate blood is high as seen in
study could be as a result of differences in religions; i.e. another study conducted in University of Benin Teaching
more orthodox (88.9%) and Christian (87.6%) in Ethiopia Hospital, Nigeria (Okpara, 1989) where willingness to
and Ghana studies respectively in which there is likelihood donate blood was 81.6%. In Ilorin, North Central Nigeria,
of Jehovah witness and other sects been more willingness to support antenatal blood donation was found
represented in the studies. In another study conducted to be 85.8% (Salaudeen and Odeh, 2011) close to finding
among university students in Kilimanjaro, Tanzania of this study.
(Yenework et al, 2016). willingness to donate blood to
relatives was 94.5%, almost similar to finding of this study, The practice of blood donation according to finding of this
although willingness to donate blood generally was 89.3%, study is 25.5%, less than one-quarter of donors (n=31;
this was probably due to sampling method used which 14.2%) had donated once in their life times and much
involve voluntary participation of study participants as lower than that (n=19; 8.7%) had donated twice. Most of
opposed to the random selection method in this study, the donors (n =42; 14.8%) that had donated blood in the
couple with the fact that the study was done among past did so 1 -5years before the study was conducted. The
University students who are assumed to be more enlighten commonest reason for donating blood among donors is a
about blood donation. desire to help others. One hundred and sixty-one
participants (74.5%) had never donated blood before. This

A Community Survey of the Willingness, Perceptions and Practice of Blood Donation Among Adults in Kano Metropolis
Abduljaleel et al. 105

is much lower than 42.3 per 1000 population found in aspects of the blood donation such as in the perspective
another study conducted in Italy to determine state of the that blood donation is good as it is a way of assisting
art on promoting blood donation. (Grecuccio et al, 2017). others/save other people’s lives. They were also similar in
Practice of blood donation is slightly lower than it is in a the cultural belief that blood donation was not ideal for
previous similar study conducted in South India where women. It was noted that individual perceptions vary with
practice of blood donation was 29.5% out of which only different construe or interpretations for blood donation.
12% were voluntary blood donors (Abdel et al, 2011). In The perceptions of blood donors commonly revolved
two separate studies conducted in Addis Ababa, Ethiopia round their experiences with relations who were in need of
(Bantayehu, 2012) and La Dadekotopon, Ghana (Sabu et blood; for example, children, wives, parents and friends,
al, 2011) the practices of blood donation were 32.6% and while their relations who need the transfusion as medical
29.5% respectively, slightly higher than finding of this treatment see it as their means of survival. These
study. This could be due to more level of awareness experiences on both sides of the donors and recipients
among the study participants, as respondents with tertiary encompass history, culture and life itself and are
education constituted more than half in the two separate expressed in different languages. Despite the complexity
studies compare to the 29.6% in the present study. associated with blood donations, both donors and non-
donors believe that it is an act that prolongs life and they
In another study conducted in Lagos, South Western both hold on to their relatives and friends. The concepts of
Nigeria, a small proportion of the respondents (12%) had lives and death were both used or talked about during the
ever donated blood (Sekoni et al, 2014). The largest survey as they are related to blood donations and
proportion of those who had donated blood (81.3%) did so transfusions. Both blood donors and non-donors believe
because a relative needed a donor while only 12.4% of that blood donation is an act that prolongs live. The donors
donors had donated blood of their own volition. This is wish to donate their blood to their close relations so that
different from the finding of this study where donation they remain alive and continue to pursue their lifetime
practice is more than twice their own, this could be as a dreams, while the non-donors use other alternative of
result of religious and cultural differences, however, both getting blood for their relations including a plan to “buy”
study shows that larger proportion of blood donation goes blood for them. Some blood donors present to the blood
to donor’s relations. bank regularly and claim to be part of the recipient’s
relation, they however donate their blood for money, at
Donation practice of 25.5% in this study is almost similar times they connive with some staffs in the blood bank so
to (22.1%) that of a study conducted among health care they are called upon when the need to donate blood arise.
workers at the university of Benin Teaching Hospital, This is most likely due to poverty and ignorance. Blood
Nigeria in which all the study participants were within the donation is good as it “saves lives” and this was a popular
age range of potential donors just like in this study statement among majority of the respondents surveyed
(Elionora et al, 2016).This could be due to religious and has also remained an important component of blood
differences; as a number of respondents in their study donation campaign slogans adopted by many countries
were Jehovah witness compares to more Muslims in this including Nigeria. This is a strategy that is supposed to be
study. Finding of this study is slightly higher than 22.6% used to encourage donors to donate blood voluntarily
obtained in a study done in Ilorin, North Central Nigeria without offering them any material reward aside little re-
(Ameen et al, 2015). imbursement in the form of transport fair or time off work.
As such, donating blood will be a socio-cultural act that will
There is no statistically significant association between enable people to play their social role in the process of
predictor variables and the outcome variable (Practice of protecting life. Donating blood actually makes one feel he
blood donation). This clearly means that people donate is being kind to others and he is being seen as somebody
their blood only when the need to do so arise; regardless supportive in the society. Blood donors also benefit from
of their age, sex, marital status, occupation, ethnicity and being screened for blood related infections and knowing
religion. their blood groups, this boosts their moral as it is a prove
that they are not just supportive but also free from those
The in-depth interview conducted in this study was aimed diseases, especially those associated with social stigma.
at retrieving participants thought, experiences and beliefs Therefore, blood donation remains an important process
about blood donation. Most of the donors interviewed were as donors’ health statuses are conveyed to them to provide
actually potential donors as they have never donated their them the opportunity to further take care of themselves.
blood before but claimed positive attitude towards the
process. The donors had only donated once and only a Respondents’ knowledge on blood donation and blood
few of them had donated multiple times. The non-donors bank in Kano aimed to explore indications for blood
had never donated blood in the past and had no intent to donation, eligibility for donation, when and where blood
do so even in future. should be donated. Most of them had average knowledge
of blood donation; they believed that blood donation
In this survey it was discovered that both the blood donors becomes indicated when there is shortage from whatever
and the non-donors held similar perceptions in some cause, they also know that blood is donated by any healthy
A Community Survey of the Willingness, Perceptions and Practice of Blood Donation Among Adults in Kano Metropolis
Int. J. Public Health Epidemiol. Res. 106

adult except for the fact that a number of them quoted that On the factors that should be put in place to encourage
“it’s only those whose blood matches that of the recipient people to donate blood; most of them claimed that there
that should donate blood” this means that they believed should be increased awareness. Awareness had no doubt
blood is being donated only when it is indicated and increased people’s knowledge of blood donation and many
voluntary donation is still obscure. Both the blood donors have claimed to be willing donors but once it comes to the
and the non-donors also knew that blood is donated in real practice of blood donation majority decline. This
hospitals, laboratories and some even went further to state complexity associated with blood donation is in
that blood can also be collected by civil society accordance with theory of planned behavior; people’s
organizations during massive campaign. This knowledge initial beliefs are changed by knowledge/information about
of where blood is to be donated is very important as it blood donation, they then develop positive attitude towards
means that participants know where to go and donate their it, then intention and finally the real practice of blood
blood and equally seek for information regarding their donation. It is at this last stage that many people “turn
infection status among others. Regarding when should back” therefore it becomes important to develop measures
blood be donated; varying responses were recorded, of breaking this barrier so that more blood donors can be
some believed it should be 3monthly, for every 6 months, recruited.
very few reported anytime and others said annually.
Therefore, responses ranged from once to 4 times in a
year. This is close to what is allowed annually, but too CONCLUSION
frequent blood donation might appear overwhelming for
potential donors. Willingness of blood donation was high in this study;
however, this does not translate to the practice of blood
Both the donors and the non-donors admitted the fact that donation. Blood donors mostly donate when there is a
blood donation is an issue that concerned them. This need or eventuality and the concept of voluntary blood
response by all the respondents might be to abate the donation is still obscure. The donors and non-donors
social stigma often associated with being negative about perceived blood donation as a good practice even though
social responsibilities like the act of donating blood. some of them had reasons such as health issues and
cultural beliefs that prevented them from donating blood.
On the question have you ever taken a choice to be a In view of this the following were recommended;
blood donor? The regular blood donors responded freely, 1. Government and civil society organization: Effort
while most of the non-donors claimed various reasons for should be made to promote the practice of blood
not taking any step to become blood donors. Some donation. This can be through incentives in form of
claimed they had medical illnesses like typhoid, viral encouraging willing donors, reducing waiting time at
hepatitis, not having enough blood, pregnancy and breast blood banks, giving and signing of blood donation
feeding among others. This category of respondents cards.
probably lacked good knowledge of the concept of blood 2. Researchers: Future researchers would need to use
donation, because typhoid is not one of the infections qualitative methods to explore people’s socio-
routinely screened for prior to blood donation. Those who demographic characteristics and other factors
claimed viral hepatitis infection probably knew this during informing their decisions regarding blood donation to
their previous attempt to donate blood. narrow the gap between willingness to donate and
practice of blood donation.
The blood donors believed that blood donation fitted their
life style generally, since it’s not a daily exercise and that
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A Community Survey of the Willingness, Perceptions and Practice of Blood Donation Among Adults in Kano Metropolis