Factors Influencing Blood Donation Intentions among Adults in the East Gojjam Zone, Northwest Ethiopia

Background: Blood donation is a critical component of health systems, yet many countries, including Ethiopia, face ongoing challenges in maintaining an adequate and safe blood supply. Understanding the factors influencing individuals' intention to donate blood is essential for designing effective public health interventions. This study examined the socio-demographic, psychological, and contextual determinants of blood donation intention among adults in the East Gojjam Zone, Ethiopia. Methods: A cross-sectional community-based survey was conducted among 1,332 adults selected through multistage cluster sampling. Data were collected using a structured, pre-tested questionnaire. Descriptive statistics summarized participants' characteristics and donation intentions. Binary logistic regression identified significant predictors of donation intention. Structural Equation Modeling (SEM) was employed to explore the pathways linking beliefs, attitudes, and behavioral intention. Results: Among the respondents, 74.8% (95% CI: 72.5%–77.1%) reported an intention to donate blood. Significant socio-demographic predictors included male gender, higher educational attainment, employment in the healthcare or education sectors, and higher income levels. Psychological factors—positive attitudes toward blood donation (β = 0.46), self-efficacy (β = 0.53), and knowledge of donation practices (β = 0.38)—were strongly associated with intention. Common barriers included fear of needles, perceived discomfort, and lack of awareness. SEM analysis revealed that positive family influence (β = 0.28) also significantly contributed to the intention to donate. Conclusions: Intention to donate blood is shaped by a complex interplay of socio-demographic, psychological, and social factors. Public health strategies should focus on increasing awareness, addressing psychological barriers, and strengthening family and community support systems. Special attention should be given to women, older adults, individuals with lower educational levels, and those outside the healthcare and education sectors. Strengthening these targeted efforts is essential for promoting voluntary blood donation and ensuring a sustainable blood supply in Ethiopia.