Public attitudes toward eye donation in Northwestern India
Article Outline
There are 12 million blind people in India, and nearly 2.5 million suffer from corneal blindness. To combat this problem in India, eye banks were established. However, they have not been able to function properly owing to the general apathy of the population toward eye donations after death.1 Relatively few studies have appeared in the literature on the characteristics and the motivation of potential donors of body parts, especially eye donation.2, 3 A need was thus felt to address the issue of the knowledge, attitudes, and behavior of the general Indian public concerning eye donation.
Materials and methods
Data for this study were obtained through a multi-stage cluster sampling of people in the Bhatinda district in the state of Punjab in Northwestern India. The sample comprised of 2000 respondents above 18 years of age. A sample size of 2000 was calculated to estimate the prevalence of knowledge among the rural population to be 15% and a precision of 15%. The demographic data from the 1991 census became the frame for the sampling design. Twenty-five clusters were selected from the sampling frame; 80 persons were interviewed in each cluster after obtaining their written consent. The objectives of the study were to assess the awareness of organ donation in the study population and to assess socio- and demographic differences associated with the willingness to donate eyes.
Results
Sociodemographic profile of respondents
A total of 2000 subjects more than 18 years of age were interviewed. Mean age was 39.9 years (SD, 15.7), with a range of 18 to 99 years. Men constituted 1154 (57.7%). Forty-eight percent of the subjects had a primary education and 2.3% of the subjects were illiterate. Schedule castes constituted 41.5%, the majority of respondents (73.5%) belonged to the Sikh religion; 14.7% had never been married (Table 1).
Table 1. Influence of Sociodemographic Factors on Willingness to Donate Eyes
| Sociodemographic Factors | No. of Respondents | No. (and %) of Individuals Willing to Donate |
|---|---|---|
| Age (years) | ||
| 18–24 | 253 | 173 (68.4) |
| 25–34 | 596 | 372 (62.4) |
| 35–44 | 422 | 243 (57.8) |
| 45–54 | 355 | 156 (43.9) |
| 55–64 | 166 | 45 (27.1) |
| 65+ | 208 | 50 (24.0) |
| χ2 = 173.95, P < .05* | ||
| Gender | ||
| Male | 1154 | 648 (62.4) |
| Female | 846 | 391 (53.8) |
| χ2 = 16.9, P < .05* | ||
| Marital Status | ||
| Unmarried | 293 | 168 (57.3) |
| Ever married | 1707 | 871 (51.0) |
| χ2 = 3.74, P < .05* | ||
| Education | ||
| Illiterate | 46 | 9 (19.6) |
| Primary | 959 | 237 (22.8) |
| Secondary | 192 | 108 (56.3) |
| Matriculated | 556 | 462 (83.1) |
| Higher secondary | 174 | 155 (89.1) |
| University | 73 | 68 (93.2) |
| χ2 = 667.54, P < .05* | ||
| Religion | ||
| Hindu | 527 | 327 (62.0) |
| Sikh | 1473 | 712 (48.3) |
| χ2 = 29.24, P < .05* | ||
| Total | 2000 | 1039 (100.0) |
Previous knowledge regarding organ transplantation
Nearly 1409 (70.5%) of the respondents had heard about eye donation and an equal number knew about corneal transplantation.
Willingness and reasons to donate body parts
A total of 1039 (52%) respondents expressed willingness to donate their own eyes. The procedures cited for donating their eyes included informing friends or family 274 (26.3%) respondents; 403 (38.8%), informing the doctor; only 17 (1.6%) respondents were aware of the donation card and 346 (33.3%) persons were not aware of the procedure to donate eyes. Ninety-four percent of respondents indicated the possibility of “living on” after death was an important reason for them to donate their eyes. The other reasons described were doing some good to humanity after death (24.0%), need of a friend or relative (6.0%), previous donation by a friend or relative (3.3%), and financial reasons (1.3%).
Reasons for unwillingness to donate
Among the 964 respondents who were not willing to donate organs after death, the most common reasons cited were that it hurts the family member (45.5%), religious reasons (24.0%), and damage to the body (10.0%) followed by not sure whether the eye will be used properly (6.3%) and reluctance to contemplate death in 3.8% of the responses.
Influence of demographic factors on willingness to donate
The influence of various demographic factors on willingness to donate the eyes is depicted in Table 1. The difference in willingness to donate one’s eyes was statistically associated with gender, age, and educational, religious, and marital status.
Discussion
Seventy percent of respondents had heard about organ donation and transplantation. Fifty-two percent expressed their willingness to donate eyes. These results are in congruence with the awareness of eye donation in an urban population of Hyderabad3 and much lower than the telephonic survey conducted in the West.2, 4
People were willing to donate the eyes because of the possibility of living on after death and doing some good to humanity. In the Toronto study, the personal experience of organ and tissue transplantation was cited by 22% of respondents as an important reason for willingness to donate.4 The difference could be due to the lower transplantation rates and inferior educational status in India. The belief that donation hurts the family members and damages the body were the main reasons for refusal to donate in our series. The findings in the Toronto-based study showed that insecurity about the use of donated body parts was the main reason why 37% of the respondents were unwilling to donate.4
Our analysis revealed lower rates of willingness for donation among women, older age groups, people who never married, illiterate people and people of lower education, and among Sikhs. These differences were all statistically significant. In general, the findings corroborate other studies performed in India and in the West.2, 3, 4
Conclusion
The Information, Education, and Communication (IEC) activities in India should be enhanced, and messages should not only incorporate knowledge about the procedure of eye donation, but also counter the negative messages. The activities should focus on women, older age groups, those who never married, illiterate people, and all religious communities.
References
PII: S0041-1345(02)03826-5
doi:10.1016/S0041-1345(02)03826-5
© 2003 Elsevier Science Inc. All rights reserved.
