AUTHOR=Sazonov Vitaliy , Asanova Aruzhan , Bolatov Aidos , Shaisultanova Saule , Abdiorazova Aigerim , Pya Yuriy TITLE=Attitudes toward posthumous organ donation in Kazakhstan: a qualitative analysis JOURNAL=Frontiers in Public Health VOLUME=Volume 13 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1602268 DOI=10.3389/fpubh.2025.1602268 ISSN=2296-2565 ABSTRACT=IntroductionThe present study aims to examine the attitudes of the Kazakhstani population toward posthumous organ donation using a mixed-methods approach.MethodsA cross-sectional survey of 1,345 participants representing diverse demographic backgrounds was conducted alongside a qualitative thematic analysis of open-ended responses to explore underlying motivations and barriers. Quantitative results indicate that more than one-third of respondents expressed willingness to donate, while approximately one-fifth declined, and the remaining participants preferred to leave the decision to their loved ones. Multinomial logistic regression revealed that factors such as increasing age, lower education level, higher religiosity, and language preference significantly influenced attitudes toward donation.Results and discussionQualitative analysis identified recurring themes, including religious and cultural concerns about the afterlife, uncertainty in decision making, ethical opposition rooted in tradition, distrust of the health care system, and the role of personal altruism. These findings underscore the complex interplay of socio-cultural and systemic factors that shape public perceptions of organ donation in Kazakhstan. Key barriers, such as religious concerns and mistrust of health care and cultural opposition, are identified, and potential solutions through education, policy change, and media engagement are outlined.