Increasing South Asian organ donation through strategic intervention
Agimol Pradeep, PhD student, University of Salford, Transplant Co-ordinator, Central
Manchester Foundation Trust)
Paula Ormandy, Professor Long-Term Conditions Research, University of Salford;
Titus Augustine, Transplant Surgeon, Central Manchester Foundation Trust
Background: Kidney organ donation continues to be low among ethnic minorities
especially within South Asian community leading to a disproportionate number of
Asian patients waiting for transplants, because most often suitable matches are
found between people of same ethnic group. This paper describes an interventional
study to test strategies to increase the number of registered kidney donors from SA
community and increase ethnic minority cadaver organs available.
Method: Phase 1: Survey to understand the beliefs and awareness of organ
donation, translated into three key languages, to generate evidence of potential
barriers to organ donation. Chi-squared tests explored the existence of associations
between outcomes, demographic characteristics and attitudes.
Phase 2: Implementation of three strategic interventions:
1. Five GP study practices were recruited, with a high South Asian patient
population. Practice Managers and GP’s were educated regarding the study and
provided with publicity materials and posters advertising the need for more Asian
organ donors. Organ donors recruited through GPs are identified on the organ
donor register by a specific form tracked to the specific intervention.
2. Education in collaboration with religious and political Asian leaders of ITU staff (in
particular Specialist Nurses in Organ Donation), in ten study sites, to develop
skills and confidence of clinicians to approach South Asian families for cadaver
organ donation. Before and after intervention audit of 12-months to measure the
impact on the number of organs donated.
3. Peer education events started in May 2012 and so far the researcher attended 42
Asian events delivering outreach education sessions to encourage organ
donation within the South Asian community, supported by appropriate information
and media campaign (using Asian publications/press and radio). Organ donors
recruited through peer-education are identified on the organ donor register by a
specific form tracked to the specific intervention.
Results: Phase 1: Questionnaire response rate = 907, 55% of people did not know
about organ donor registration, despite 88% of the total sample having higher
education. Concerns included that donated organs might be used without consent for
other purposes, or that medical staff may not work hard to save their life. Some
indicated that donation was a way of serving God, but others believed their body may
need to remain whole for life hereafter. Over 50% supported an opt-out system for
organ donation and 60% in favour of living related donation. These baseline findings
informed the education campaign. Phase 2: Peer education and awareness
campaign, have successfully registered more than 1500 potential donors over 94
community gatherings/events. Further 3000 donors registered from the BME
community after a collaborative ITV program promoting organ donation within the
Asian community. Initial findings indicate GP recruitment to the organ donor register
is very poor, not seen as a priority. SNOD nurse education increased the number of
families approached in ICU, using specific targeted cultural information leaflet.
Conclusion: This study extends current research undertaken and measures the
impact of different interventions to provide intelligence and a deeper understanding of
the South Asian community in the North West of England. The findings will directly
inform a national strategy for sustained organ donation from the South Asian
community to commensurate with their population footprint.