Barriers to kidney transplants in Indonesia: a literature review.
BACKGROUND
People living with chronic kidney disease will require renal dialysis or a kidney transplant to maintain life. Although Indonesia has a developing healthcare industry, Indonesia's kidney transplant rates are lower than comparable nations.


OBJECTIVE
To explore the healthcare literature to identify barriers to kidney transplants in particular in relation to Indonesia.


METHODS
Healthcare databases were searched (CINAHL, Medline, EBSCOhostEJS, Blackwell Synergy, Web of Science, PubMed, Google Scholar and Proquest 5000) using the search terms: transplant, kidney disease, renal, dialysis, haemodialysis, Indonesia and nursing. The search was limited to English and Indonesian language data sources from 1997 to 2007. Reference lists of salient academic articles were hand searched.


RESULTS
The results of our search identified six articles that met our criteria. Costs are the major barrier to kidney transplant in Indonesia, followed by cultural beliefs, perception of the law, lack of information and lack of infrastructure. In addition, kidney disease prevention strategies are required.


CONCLUSIONS
There are many complex socio-economic, geographical, legal, cultural and religious factors that contribute to low kidney transplant rates in Indonesia. Although an increase in transplantation rates will require strategies from various agencies, healthcare professionals, including nurses, can play a role in overcoming some barriers. Community education programmes, improving their own education levels and by increasing empowerment in nursing we may contribute to improved kidney transplant rates in Indonesia.
Bennett
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School of Nursing and Midwifery, Flinders University of South Australia, Adelaide, SA, Australia. paul.bennett@flinders.edu.au
Hany
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D001294:Attitude to Health / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007514:Islam / Q000523:psychology; D016030:Kidney Transplantation / Q000191:economics / Q000208:ethnology / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D009398:Nephrology; D024802:Nurse's Role; D015399:Nursing Research; D010353:Patient Education as Topic / Q000458:organization & administration*; D012069:Religion and Psychology; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D009927:Tissue and Organ Procurement / Q000458:organization & administration*