Fostering institutional trust and organ donation: Evidence from a randomized informational intervention in Tunisia

Organ transplantation saves lives and improves the quality of life of patients who would otherwise depend on costly and invasive treatments. The technology is becoming available in low- and middle-income countries, but the gap between the demand for and the supply of organ transplants remains large. In a randomized controlled trial at a Tunisian university, we evaluate an expert-led intervention designed to inform about organ donation and strengthen trust in medical institutions. The intervention consists of a short video testimonial from a heart transplant survivor, a presentation led by a medical doctor and a short Q&A session. We find that the intervention significantly increases deceased donor registration, with suggestive evidence of positive spillover effects on the control group. The survey data provides little support for changes in attitudes and social expectations as potential mechanisms. Instead, it reveals large and statistically significant increases in medical and legal knowledge, religious beliefs supportive of donation, and institutional trust among treated students. Finally, we show that treatment effects on organ donor registration are driven by male students and those whose families likely support organ donation. Targeting older segments of the population may further increase the impact and cost-effectiveness of this intervention.