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Barriers to eye donation in Aotearoa New Zealand: a novel qualitative analysis
Natalie Allen1, Akilesh Gokul1, Jie Zhang1
1Dept of Ophthalmology, Faculty of Medical & Health Sciences, The University of Auckland, Auckland, New Zealand.
Aim:
Aotearoa New Zealand has experienced declining eye donation rates despite high levels of corneal disease and strong capacity to perform corneal transplantation. Demand for donor corneal tissue far exceeds supply. This study explored public attitudes toward eye donation, which have not previously been evaluated in New Zealand.
Method:
Ten semi-structured focus groups were conducted, recorded and transcribed. Participant opinions were analysed using saturation and sentiment approaches. Transcripts were manually coded in NVivo15, with iterative thematic analysis until saturation was achieved.
Results:
A total of 44 participants were interviewed. Overall sentiment toward eye donation was positive, with 40 (90%) supporting donation for themselves or family. Barriers to donation included poor awareness (42, 96%), cultural considerations (41, 93%), feelings of disgust (23, 52%) and religious beliefs (13, 30%). Among Māori and Pacific participants (16, 44%), the absence of established tikanga (customary values/practices) around eye donation emerged as a key theme. Baseline knowledge was low: only 13 (30%) had prior awareness, and just two (5%) understood New Zealand's donation infrastructure.
Conclusion:
Most focus group participants supported eye donation; however, poor awareness, cultural uncertainty and limited infrastructure remain barriers. New Zealand has the population and capacity to achieve self-sufficiency, but system-level changes are needed to improve eye donation rates.
