Recherches financées

Co-Applicant(s):  Ann Bugeja, Ekaterina (Katya) Loban, Heather Badenoch, Marie-Chantal Fortin, Ngan Lam, Peter Nugus, Rahul Mainra, Rosemary Morgan

Lay Abstract

Background: Living kidney donors (LKDs) are healthy individuals who donate one of their kidneys to a patient with kidney failure. This helps the patient achieve a better survival and quality of life. They also help save the Canadian health system billions of dollars as patients no longer need dialysis. Getting more people interested in kidney donation is a priority for the nephrology community. However, LKDs have several needs from their healthcare teams that are currently poorly supported, and we are developing a care model to better support LKDs. While pursuing this work, we noted that there are more women than men LKDs in Canada with women representing 60% of all LKDs. We also noted that these trends have been globally reported by most countries for the past three decades yet the proportions of men LKDs are not increasing. Most speculate that this is because of systemic gender inequities in most societies that consider men as the primary income earners and women as the caregivers. However, this has not been systematically examined in different countries. Also, in our prior work, we noted that the experiences and needs of LKDs may also vary by their gender across their entire donation trajectory. For example, more women seemed to report fatigue after donation than men. Purpose: Thus, we now want to explain these observations: why there are more women and fewer men LKDs? Why do the experiences of LKDs vary by their gender? In particular, we want to explore how deep-entrenched gender inequities answer these questions. Methods: We will conduct a qualitative study using a systematic framework called a gender analysis matrix (GAM) developed by the World Health Organization. We will develop this GAM and use it to guide interviews with LKDs from Canada, India, Hong Kong and the Philippines. In India >70% of LKDs are women and in Hong Kong and the Philippines, the proportion of women and men LKDs are equal. Therefore, we are including LKDs from other countries to see how different resources, health systems and social structures contribute to these variable proportions. Anticipated outcomes: First, we will publish a GAM that can be used in the field of Nephrology and Transplantation. Then we will report our findings that answer our research questions. We will use this to develop strategies to address gender disparities in living kidney donation. Patient Engagement: Our core methodology team includes a patient partner who will be involved throughout our research process of developing the GAM, recruiting LKDs to interview and data analysis. We will identify another patient partner who is a man upon receipt of funding to support them using the CDTRP’s platform. They will also be a part of our core methodology team. We will conduct focus groups with patient partners to obtain their input while preparing the GAM. Relevance to Patients/Community: This will be the first comprehensive and systematic gender analysis to be undertaken in the field of living kidney donation. We are hoping to use findings to not just better support women LKDs but to also support more men who are interested in pursuing living donation but are perhaps ambivalent or discouraged to do so. Conclusion: Gender disparity in living kidney donation has been recognized for over three decades, yet little has been done to address this gap. We want to conduct a qualitative study to better explain this phenomenon and to potentially achieve gender equity in living kidney donation.