As a foundational discipline of medicine, human anatomy has historically been built around dissection. In many cultural contexts, particularly in sub-Saharan Africa, representations of the body and death may limit post-mortem body donation and restrict access to dissection for educational purposes.

To analyze perceptions of body donation after death and human dissection in a Bantu context, to assess their stability over time, to situate them within an international comparative perspective, and to explore appropriate pedagogical alternatives.

Two successive cross-sectional surveys were conducted in Gabon among participants from the Université des Sciences de la Santé (USS, Libreville) and three regional hospitals: the first in 2013 ( n = 187) and the second between 2020 and 2025 ( n = 218). The same questionnaire, comprising 16 items grouped into five domains (motivations, perceptions of medical systems, representations of the body, attitudes toward body donation, and pedagogical resources), was used. A descriptive comparison of anatomy teaching modalities was performed with Cheikh Anta Diop University of Dakar (Senegal) and the University of Burgundy – Europe in Dijon (France).

In both surveys, donation of one's own body after death was overwhelmingly rejected (more than 95% of participants), while a majority acknowledged the educational value of human dissection. In the absence of available bodies, the most frequently cited alternative resources were medical imaging, digital tools, and observation of surgical procedures. International comparison revealed marked differences: supervised and systematic dissection in France, occasional practices in Senegal, and the absence of dissection in Gabon.

The study highlights the stability of representations related to body donation in Gabon, characterized by a persistent rejection of post-mortem donation despite recognition of the pedagogical value of dissection. This dissociation reflects a coexistence of cultural and biomedical rationalities observed in various international contexts. Organizational differences between Gabon, Senegal, and France underscore the need to adapt teaching practices to local constraints by integrating complementary alternatives to dissection.

In contexts where access to human dissection remains limited, the progressive development of alternative pedagogical solutions combining digital tools, medical imaging, and anatomical simulation appears to be a pragmatic approach to strengthening anatomy education. In the longer term, the structuring of teaching and simulation facilities adapted to local cultural and institutional specificities could contribute to sustainable improvement in medical training.

The findings demonstrate the lasting coexistence of cultural representations of the body and a shared recognition of the pedagogical value of dissection. In contexts where body donation remains limited, anatomy teaching should rely on a pluralistic and contextualized approach, combining descriptive rigor, functional reasoning, clinical grounding, and a reasoned use of pedagogical innovations.