Barriers and facilitators of deceased organ donation among Pakistanis living globally: a systematic review

Britzer Paul Vincent; Zeeshan Ghaffar; Asmaa Al-Abdulghani; Ifza Taaruf; Grace Idam; Gurch Randhawa

doi:10.1136/bmjopen-2025-100943

Barriers and facilitators of deceased organ donation among Pakistanis living globally: a systematic review

Britzer Paul Vincent
, Zeeshan Ghaffar
, Asmaa Al-Abdulghani
, Ifza Taaruf
, Grace Idam
, Gurch Randhawa

Royal Oldham Hospital
University of Bedfordshire
The Christie NHS Foundation Trust
Luton and Dunstable University Hospital NHS Foundation Trust

Research output: Contribution to journal › Article › peer-review

1 Downloads (Pure)

Abstract

OBJECTIVE: To identify the barriers and facilitators towards deceased organ donation among Pakistanis living globally.

DESIGN: Systematic review using narrative synthesis.

DATA SOURCES: CINAHL, Medline with Full Text, Global Health and PsycINFO via EBSCO; Scopus via Elsevier; Web of Science via Clarivate; and PubMed through the US National Library of Medicine and the National Institutes of Health were searched between 1 January 1995 and 31 July 2024 and limited to English.

ELIGIBILITY CRITERIA: We included qualitative and cross-sectional studies involving Pakistani participants aged 18 years and above, conducted both within Pakistan and internationally across settings such as universities, religious venues, hospitals and workplaces.

DATA EXTRACTION AND SYNTHESIS: Four independent reviewers were involved in screening, quality assessment and data extraction. A narrative synthesis method was employed to synthesise and integrate the data from qualitative and cross-sectional studies. The Joanna Briggs Institute tool was used to assess the quality of the included studies.

RESULTS: Out of 11 944 studies retrieved, 26 studies were included in the current review. Based on the narrative synthesis, the findings are presented under the following five themes: (1) knowledge of deceased organ donation, (2) willingness towards deceased organ donation, (3) collective decision-making overriding individual's preferences, (4) religious uncertainty and its impact on deceased organ donation and (5) trust and the healthcare systems.

CONCLUSION: This review shows that decisions about deceased organ donation are shaped by family dynamics, religious beliefs and trust in healthcare. More diverse research is needed to uncover new gaps and improve donor registration and consent rates in Pakistan. A whole-systems approach, considering families, religion and trust, is essential for effective strategies.

PROSPERO REGISTRATION NUMBER: CRD42022346343.

Original language	English
Article number	e100943
Pages (from-to)	e100943
Journal	BMJ Open
Volume	15
Issue number	12
DOIs	https://doi.org/10.1136/bmjopen-2025-100943
Publication status	Published - 14 Dec 2025

Keywords

Humans
Tissue and Organ Procurement
Pakistan/ethnology
Health Knowledge, Attitudes, Practice
Cross-Sectional Studies
Tissue Donors/psychology
South Asian People
ETHICS (see Medical Ethics)
Transplant medicine
Health Equity

ASJC Scopus subject areas

General Medicine

Access to Document

10.1136/bmjopen-2025-100943

e100943.fullFinal published version, 1 MBLicence: CC BY-NC

https://bmjopen.bmj.com/content/15/12/e100943

Handle.net

Persistent link

Cite this

@article{d40295722a7e4022a15aeff4d5b8ee7b,

title = "Barriers and facilitators of deceased organ donation among Pakistanis living globally: a systematic review",

abstract = "OBJECTIVE: To identify the barriers and facilitators towards deceased organ donation among Pakistanis living globally.DESIGN: Systematic review using narrative synthesis.DATA SOURCES: CINAHL, Medline with Full Text, Global Health and PsycINFO via EBSCO; Scopus via Elsevier; Web of Science via Clarivate; and PubMed through the US National Library of Medicine and the National Institutes of Health were searched between 1 January 1995 and 31 July 2024 and limited to English.ELIGIBILITY CRITERIA: We included qualitative and cross-sectional studies involving Pakistani participants aged 18 years and above, conducted both within Pakistan and internationally across settings such as universities, religious venues, hospitals and workplaces.DATA EXTRACTION AND SYNTHESIS: Four independent reviewers were involved in screening, quality assessment and data extraction. A narrative synthesis method was employed to synthesise and integrate the data from qualitative and cross-sectional studies. The Joanna Briggs Institute tool was used to assess the quality of the included studies.RESULTS: Out of 11 944 studies retrieved, 26 studies were included in the current review. Based on the narrative synthesis, the findings are presented under the following five themes: (1) knowledge of deceased organ donation, (2) willingness towards deceased organ donation, (3) collective decision-making overriding individual's preferences, (4) religious uncertainty and its impact on deceased organ donation and (5) trust and the healthcare systems.CONCLUSION: This review shows that decisions about deceased organ donation are shaped by family dynamics, religious beliefs and trust in healthcare. More diverse research is needed to uncover new gaps and improve donor registration and consent rates in Pakistan. A whole-systems approach, considering families, religion and trust, is essential for effective strategies.PROSPERO REGISTRATION NUMBER: CRD42022346343.",

keywords = "Humans, Tissue and Organ Procurement, Pakistan/ethnology, Health Knowledge, Attitudes, Practice, Cross-Sectional Studies, Tissue Donors/psychology, South Asian People, ETHICS (see Medical Ethics), Transplant medicine, Health Equity",

author = "Vincent, \{Britzer Paul\} and Zeeshan Ghaffar and Asmaa Al-Abdulghani and Ifza Taaruf and Grace Idam and Gurch Randhawa",

note = "{\textcopyright} Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.",

year = "2025",

month = dec,

day = "14",

doi = "10.1136/bmjopen-2025-100943",

language = "English",

volume = "15",

pages = "e100943",

journal = "BMJ Open",

issn = "2044-6055",

publisher = "BMJ Publishing Group",

number = "12",

}

TY - JOUR

T1 - Barriers and facilitators of deceased organ donation among Pakistanis living globally

T2 - a systematic review

AU - Vincent, Britzer Paul

AU - Ghaffar, Zeeshan

AU - Al-Abdulghani, Asmaa

AU - Taaruf, Ifza

AU - Idam, Grace

AU - Randhawa, Gurch

N1 - © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.

PY - 2025/12/14

Y1 - 2025/12/14

N2 - OBJECTIVE: To identify the barriers and facilitators towards deceased organ donation among Pakistanis living globally.DESIGN: Systematic review using narrative synthesis.DATA SOURCES: CINAHL, Medline with Full Text, Global Health and PsycINFO via EBSCO; Scopus via Elsevier; Web of Science via Clarivate; and PubMed through the US National Library of Medicine and the National Institutes of Health were searched between 1 January 1995 and 31 July 2024 and limited to English.ELIGIBILITY CRITERIA: We included qualitative and cross-sectional studies involving Pakistani participants aged 18 years and above, conducted both within Pakistan and internationally across settings such as universities, religious venues, hospitals and workplaces.DATA EXTRACTION AND SYNTHESIS: Four independent reviewers were involved in screening, quality assessment and data extraction. A narrative synthesis method was employed to synthesise and integrate the data from qualitative and cross-sectional studies. The Joanna Briggs Institute tool was used to assess the quality of the included studies.RESULTS: Out of 11 944 studies retrieved, 26 studies were included in the current review. Based on the narrative synthesis, the findings are presented under the following five themes: (1) knowledge of deceased organ donation, (2) willingness towards deceased organ donation, (3) collective decision-making overriding individual's preferences, (4) religious uncertainty and its impact on deceased organ donation and (5) trust and the healthcare systems.CONCLUSION: This review shows that decisions about deceased organ donation are shaped by family dynamics, religious beliefs and trust in healthcare. More diverse research is needed to uncover new gaps and improve donor registration and consent rates in Pakistan. A whole-systems approach, considering families, religion and trust, is essential for effective strategies.PROSPERO REGISTRATION NUMBER: CRD42022346343.

AB - OBJECTIVE: To identify the barriers and facilitators towards deceased organ donation among Pakistanis living globally.DESIGN: Systematic review using narrative synthesis.DATA SOURCES: CINAHL, Medline with Full Text, Global Health and PsycINFO via EBSCO; Scopus via Elsevier; Web of Science via Clarivate; and PubMed through the US National Library of Medicine and the National Institutes of Health were searched between 1 January 1995 and 31 July 2024 and limited to English.ELIGIBILITY CRITERIA: We included qualitative and cross-sectional studies involving Pakistani participants aged 18 years and above, conducted both within Pakistan and internationally across settings such as universities, religious venues, hospitals and workplaces.DATA EXTRACTION AND SYNTHESIS: Four independent reviewers were involved in screening, quality assessment and data extraction. A narrative synthesis method was employed to synthesise and integrate the data from qualitative and cross-sectional studies. The Joanna Briggs Institute tool was used to assess the quality of the included studies.RESULTS: Out of 11 944 studies retrieved, 26 studies were included in the current review. Based on the narrative synthesis, the findings are presented under the following five themes: (1) knowledge of deceased organ donation, (2) willingness towards deceased organ donation, (3) collective decision-making overriding individual's preferences, (4) religious uncertainty and its impact on deceased organ donation and (5) trust and the healthcare systems.CONCLUSION: This review shows that decisions about deceased organ donation are shaped by family dynamics, religious beliefs and trust in healthcare. More diverse research is needed to uncover new gaps and improve donor registration and consent rates in Pakistan. A whole-systems approach, considering families, religion and trust, is essential for effective strategies.PROSPERO REGISTRATION NUMBER: CRD42022346343.

KW - Humans

KW - Tissue and Organ Procurement

KW - Pakistan/ethnology

KW - Health Knowledge, Attitudes, Practice

KW - Cross-Sectional Studies

KW - Tissue Donors/psychology

KW - South Asian People

KW - ETHICS (see Medical Ethics)

KW - Transplant medicine

KW - Health Equity

UR - https://www.scopus.com/pages/publications/105024983689

U2 - 10.1136/bmjopen-2025-100943

DO - 10.1136/bmjopen-2025-100943

M3 - Article

C2 - 41397745

SN - 2044-6055

VL - 15

SP - e100943

JO - BMJ Open

JF - BMJ Open

IS - 12

M1 - e100943

ER -

Barriers and facilitators of deceased organ donation among Pakistanis living globally: a systematic review

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Handle.net

Other files and links

Fingerprint

Cite this