Why donors intend to return: Motivation, satisfaction and post‐donation intention in a high‐demand tertiary hospital setting in Lagos, Nigeria

Abstract

BACKGROUND AND OBJECTIVES: Maintaining safe and adequate blood supply in low- and middle-income countries requires understanding factors influencing donor return intentions. Nigeria faces chronic blood shortages, yet evidence on determinants of return intention among blood donors in tertiary hospitals remains limited. This study assessed donor motivation, satisfaction and intention to return among blood donors at Lagos University Teaching Hospital (LUTH) and identified factors independently associated with post-donation intention. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted among 1589 consecutive donors using a structured interviewer-administered questionnaire adapted from validated instruments. Motivation, satisfaction and intention to return were measured using Likert-scale items. Participants retrospectively reported pre-donation intention and current post-donation intention immediately after donation. Descriptive statistics, chi-square tests, McNemar's test, subgroup analyses and binary logistic regression were performed. RESULTS: Most donors were family-replacement (70.5%) and male (91.8%), with a mean age of 30.9 years. Motivation was high (84%), driven primarily by altruism, personal choice and perceived health benefits. Satisfaction was also high (mean 4.59 ± 0.64). Intention to return increased significantly after donation (56.1%-64.2%, p < 0.001). Motivation (odds ratio [OR] = 7.32, p < 0.001) and pre-donation intention (OR = 0.014, p < 0.001) were independently associated with post-donation intention, whereas satisfaction was not significant after adjustment. Family replacement and voluntary non-remunerated donors differed significantly in motivation, satisfaction and post-donation intention. CONCLUSION: Blood donors at LUTH demonstrated high motivation and satisfaction. Donation experience strengthened intention to return. Differences between donor types highlight the need for donor-specific retention strategies in replacement-dominated blood systems.