ABSTRACT:
Organ donation rates in South Africa are very low, despite the country's medical advancements. Many citizens lack awareness about organ failure and the importance of organ donation. Cultural and religious beliefs, along with limited understanding of brain-death and the organ donation process, contribute to this reluctance especially among African ethnic population groups. Purpose: The purpose of this study was to explore and describe Xhosa people’s understanding of organ donation uptake in the rural Eastern Cape province. that potentially influences the decision to donate.

METHODS:
This qualitative ethno-nursing study of Xhosa people regarding organ donation uptake was conducted in the rural districts of Eastern Cape Province, South Africa. Purposive sampling identified four focus groups of stakeholders for discussion in their natural settings. Included in the discussion were ten general community members; six traditional health practitioners; six ministers of religion and six traditional leaders. were included in the discussion. Data were analyses using four phase ethno-nursing data analysis.

RESULTS:
Three themes emerged, Limited Visibility of Organ Donation in Social and Media Platforms, Collective decision-making process to donate, Ethical and Cultural Concerns about Death and Organ Donation. Xhosa people expressed unfamiliarity on how organ donation works, uncertainty about the process. Further expressed no understanding of ethics surrounding organ donation and the implications of brain death. Lastly, invisibility of organ donation in community discussions which further exacerbate the issue.

CONCLUSIONS:
These themes convey information on potential reasons for the knowledge gap between Xhosa people and the information towards organ donation uptake. These findings suggest opportunities for healthcare professionals to include organ donation to the already existing Non-Communicable Disease’s awareness campaigns and to address certain target groups more adequately.