Assessing Countries’ Deceased Organ Donation and Transplantation Performance

@#Introduction: Donors per million population and transplantations per million population are standardized, widely used indicators to assess and compare countries’ performance in organ donation and transplantation. This study aims to investigate these two particular metrics of organ donation and transplantation performance, and to introduce a new index, namely, ‘transplantations per patients on the waiting list’. Methods: Secondary analyses of data on 23 countries in 2016 were used to construct the transplantations per patients on the waiting list indicator for kidney, liver, pancreas, heart, and lung transplantation, as well as for the transplantation of any of the five aforementioned organs. Results: According to the transplantations per patients on the waiting list, the best-performing countries in terms of organ donation and transplantation are Belarus for kidney transplantation, Finland for liver and pancreas transplantation, Australia for heart transplantation, and France for lung transplantation. Considering all five organs together, Sweden, Australia, Finland, Austria, and Poland were the top five best-performing countries, followed by Spain in the sixth position. Conclusion: The deceased transplantations per patients on the waiting list can be an alternative indicator to assess performance, along with the widely-used donors and transplantations per million population, but still has its limitations in certain scenarios.

Gender, citizenship and health-related quality of life: An overall perspective from Malaysia

Objectives: Health-related quality of life (HRQoL) is an essential dimension of overall human quality of life, in which disparities have been hypothesised between women and men, as well as between citizens and non-citizens of a country in past literatures. This study is to evaluate and compare the HRQoL of citizens and non-citizens living in greater Kuala Lumpur and Johor Bahru, as well as comparing HRQoL between genders. Materials and Methods: The SF-8 questionnaire was used to collect information from 1,708 respondents (1,032 Malaysian citizens and 676 non-citizens), via face-to-face interview between October and December 2015. Results: Overall, respondents reported moderate HRQoL. Non-citizens reported better HRQoL than the Malaysian citizens, while men reported better HRQoL compared to women (for both citizens and non-citizens). Conclusions: The HRQoL of both citizens and noncitizens’ in Malaysia could be improved. Measures should be taken to remove the disparity in HRQoL between men and women, aiming to achieve equal health status for both genders.

Muslims’ views on the permissibility of organ donation: The case of Malaysia

Background: Some argue that Malaysia’s extremely low organ donation rate is attributed to religion, specifically Islam. Testing this argument, this study asked Malaysian Muslims their views regarding various issues on organ donation and examined whether their decisions to donate organs are framed by religious beliefs. Materials and Methods: This study investigated the perspectives of Malaysian Muslims between October and December 2013 in Kuala Lumpur. Self-administered questionnaires were distributed to 900 people, with 829 responses collected (92% response rate). Respondents’ verbal consent was taken before proceeding with the survey. Results: The survey found that more than half of respondents felt that organ donation is permitted in Islam and that it is a communal responsibility. However, the same proportions were unsure on the issues of rewards for organs or on whether Islam permits the procuring of organs from brain dead patients. Conclusions: Malaysian Muslims are not against organ donation; however, encouraging organ donation requires the state to address public concerns on Islam’s views on this sensitive issue through effective policy tools to help address these gaps in Malaysian Muslims’ understanding of organ donation. The organ donation rate could improve by using Islamic scholars as ambassadors for an organ donation drive to convey the message of Malaysia’s urgent need for organ donation.

Practice and barriers of family planning: A comparison among muslim women in three main cities, viz. New York City, Tehran and Kuala Lumpur

Background: There is a lack of information on the practice of family planning among Muslim women in New York City in the United States of America (USA) [hereinafter known as “Muslim women residing in the United States” (MWRIU)], Tehran in the Islamic Republic of Iran (IRI) and Kuala Lumpur, Malaysia. The limited figures on this issue are either outdated or mere estimates. The importance of sexual and reproductive health of Muslim women is expected to have massive effects on the social and economic progress of developing countries like the IRI and Malaysia. It is also expected to have imperative impacts on the attempts to empower the MWRIU community and enhance their health status to meet the national standards. Objective: The study objective is to explore and compare the practice of family planning, namely on contraceptive use and abortion among Muslim women in 3 major cities of different countries. Methodology: A survey of 379, 377 and 380 respondents from New York City, Tehran and Kuala Lumpur respectively was conducted in 2013 using self-administered questionnaires. Results: There were significant differences in contraceptive and abortion practices across these countries (P<0.01). While a significant 86.6% of Iranian and 66.2% of the MWRIU used contraception, only 22.9% of the Malaysian women did so. For abortion, 13.6% of the MWRIU and 6.3% of the Malaysian respondents had abortion at least once; while only 22% of Iranians revealed their abortion history, totaling 32.1% of them who had abortion. Financial problems and having an unsupportive husband were among the major factors hindering their practice of healthy family planning. Conclusion: Educational campaigns should be promoted to increase the awareness on the permissibility of family planning in Islam, as well as on sexual and reproductive rights.

Family response to presume consent system on organ donation from a review of literature

Background: Most countries around the world have experienced a shortage in organs needed for transplantation. Organ donation performance is widely attributed to two important factors: the legislation and the role of the family. Thus, this literature review aims to examine the willingness of people for organ donation while highlighting the importance of having a presumed consent system. Methodology: In this study, we explored many papers of which 10 articles were studied to gain conclusive understanding of the two factors and their interactions. Results: Our analysis of literature regarding the legislation and family response showed that the presumed consent system for organ donation accounted for 21 – 30% higher organ donation rates than the informed consent system. We also found a gap between the willingness of people to donate their own and their relatives’ organs. The ratio of people willing to donate their organs after death was estimated to be 10 – 12% higher than the ratio of those willing to donate their relatives’ organs. Furthermore, the study revealed the importance of a presumed consent system in raising the willingness of the people and their relatives for donation, but that did not eliminate the gap. Conclusion: Countries seeking to overcome organ shortage and increase organ donation rates by moving towards the presumed consent system should consider the importance of providing families with proper information about this system. The fact that a gap between the willingness of the people to donate their own as well as their deceased relatives’ organs exists, has to be conveyed to the governments, which will be helpful in optimising organ donation rates.

Organ donation campaigns: perspective of dialysis patient's family members

Solving the dilemma of the organ shortage in Malaysia requires educating Malaysians about organ donation and transplantation. This paper aims at exploring the average Malaysian households' preferred channels of campaigns and the preferred campaigners in a family setting, targeting at the dialysis family members. We analyzed the responses of 350 respondents regarding organ donation campaigns. The respondents are 2 family members of 175 dialysis patients from 3 different institutions. The information on respondents' willingness to donate and preferred method and channel of organ donation campaign were collected through questionnaire. Malaysian families have a good tendency to welcome campaigns in both the public and private [their homes] spheres. We also found that campaigns facilitated by the electronic media [Television and Radio] and executed by experienced doctors are expected to optimize the outcomes of organ donation, in general. Chi-square tests show that there are no significant differences in welcoming campaigns among ethnics. However, ethnics preferences over the campaign methods and campaigners are significantly different [P<0.05]. Ethnic differences imply that necessary modifications on the campaign channels and campaigners should also be taken under consideration. By identifying the preferred channel and campaigners, this study hopes to shed some light on the ways to overcome the problem of organ shortage in Malaysia