医療システムと政策研究

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Assessment of the Legal Framework and Participant Perceptions on Organ Donation in Tshwane, South Africa

Bongani Ndhlovu*

Background: To review the legal framework governing organ donation and to get insight into the knowledge, attitudes and perceptions of participants on organ donation at Eersterust Community Health Centre (ECHC).

Methods: A desktop literature review with the aid of a legal expert and a cross sectional, descriptive study was conducted. The study population comprised of adult patients who consulted at ECHC. Data collected using a validated structured interview schedule. Socio-demographic factors associated with a positive or negative attitude towards organ donation were evaluated. Data were analysed by means of logistic regression in stata version 14.

Results: A total of 123 people were interviewed. A large proportion (50/123–40.7%) had never heard of organ donation. Of 73 (59.3%) participants were aware of organ donation, 70 (95.89%) said organ donation should be encouraged, 39 (53.42%) said an ‘opt-out’ (presumed consent) law would encourage people to donate organs, and 46 (63.02%) had a positive attitude towards the introduction of an ‘opt-out’ law. There was a significant association between both the level of education and occupation, and having a positive attitude towards the introduction of an ‘opt-out’ law. The South African (SA) health system currently follows the ‘opt-in’ organ procurement method, which differs from countries with higher organ donation rates.

Conclusion: The opt-in organ procurement system in SA sets the donation status as ‘refusal to donate’. Participants demonstrated a positive attitude towards organ donation and the introduction of an ‘opt-out’ law on organ donation.

Recommendations: There is a need for increasing awareness about organ donation. A larger study should be conducted to get a more holistic perspective on a larger range of participants.