Fifty years of hemodialysis in Ghana—current status, utilization and cost of dialysis services

BMC Health Services Research

Research

Abdul-Jalil Inusah¹  Martin Kofi Agyei²  Elliot Koranteng Tannor³  Kwabena Amo-Antwi⁴  Beatrice Irene Nyann⁵  Ikechi Okpechi⁶  Valerie Luyckx⁷  Priscilla Opare-Addo⁸  Kojo Hutton-Mensah⁸  Kwadwo Faka Gyan⁸ 

[1] Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, Accra, Ghana;Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;Renal Unit, Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana;Department of Obstetrics and Gynaecology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;Department of Paediatric, University of Ghana Medical Centre, Accra, Ghana;Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa;Department of Medicine, Division of Nephrology and Immunology, University of Alberta, Edmonton, Canada;Renal Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA;Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa;Department of Public and Global Health, Epidemiology, Biostatistics and Preventive Institute, University of Zurich, Zürich, Switzerland;Renal Unit, Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana;

关键词: Haemodialysis;    Cost of dialysis;    Regional distribution;    Ghana;   

DOI  :  10.1186/s12913-023-10154-x

 received in 2023-06-03, accepted in 2023-10-16,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundKidney failure is common in Ghana. Haemodialysis (HD) is the most common treatment modality for survival. Although, HD has been available in Ghana for 50 years, the majority of patients who develop kidney failure cannot access it. We describe the state of HD, dialysis prevalence, its utilization and cost of HD after fifty years of dialysis initiation in Ghana.MethodsA situational assessment of HDs centres in Ghana was conducted by surveying nephrologists, doctors, nurses and other health care professionals in HD centres from August to October 2022. We assessed the density of HD centres, number of HD machines, prevalence of nephrologists, number of patients receiving HD treatment and the cost of dialysis in private and government facilities in Ghana.ResultsThere are 51 HD centres located in 9 of the 16 regions of Ghana. Of these, only 40 centres are functioning, as 11 had shut down or are yet to operate. Of the functioning centres most (n = 26, 65%) are in the Greater Accra region serving 17.7% of the population and 7(17.5%) in the Ashanti region serving 17.5% of the population in Ghana. The rest of the seven regions have one centre each. The private sector has twice as many HD centers (n = 27, 67.5%) as the public sector (n = 13,32.5%). There are 299 HD machines yielding 9.7 HD machines per million population (pmp) with a median of 6 (IQR 4–10) machines per centre. Ghana has 0.44 nephrologists pmp. Currently, 1195 patients receive HD, giving a prevalence of 38.8 patients pmp with 609(50.9%) in the private sector. The mean cost of HD session is US $53.9 ± 8.8 in Ghana.ConclusionThere are gross inequities in the regional distribution of HD centres in Ghana, with a low HD prevalence and nephrology workforce despite a high burden of CKD. The cost of haemodialysis remains prohibitive and mainly paid out-of-pocket limiting its utilization.

【 授权许可】

CC BY   
© The Author(s) 2023

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