A roadmap for kidney care in Africa
An analysis of International Society of Nephrology–Global Kidney Health Atlas Africa data describing current gaps and opportunities
Delivery of kidney care in Africa is significantly constrained by various factors. In this review, we used International Society of Nephrology–Global Kidney Health Atlas (ISN–GKHA) data for Africa to address sub-regional differences in care delivery in the continent with focus on infrastructure, workforce, and the economic aspects of kidney care. Forty two African countries participated in the survey conducted in 2018. North Africa had the highest proportions of nephrologists [12.53 per million population (pmp)], nephrology trainees (2.19 pmp) and haemodialysis (HD) centres (8.58 pmp); whereas southern Africa had the highest proportions of peritoneal dialysis (PD) centres (0.89 pmp) and kidney transplant (KT) centres (0.29 pmp); West Africa had the greatest nephrology workforce shortages. The annual median costs of HD (US$22,731 [interquartile range (IQR): US$1,560–43,902]) and PD (US$34,165 [US$34,165–34,165]) were highest in Central Africa and only Algeria, Egypt and South Africa reported zero co-payment for all modalities of kidney replacement therapy in the public sector. Policies on chronic kidney disease and non-communicable diseases were scarcely available across all African sub-regions. The ISN–GKHA African data highlight a stark difference in kidney care measures between North and sub-Saharan Africa and also suggest the need for a more cohesive approach to policy formulations that support and protect patients with kidney disease in the continent, especially from the excessive costs associated with care. Using the World Health Organization (WHO) Global Action Plan for noncommunicable diseases, this paper proposes an African roadmap for optimal kidney care.
Copyright (c) 2022 Ikechi Okpechi, Abdou Niang, Mohammed Hafez, Gloria Ashuntantang, Deenaz Zaidi, Feng Ye, Aliyu Abdu, Adanze Asinobi, Rasheed Balogun, Innocent Chukwuonye, Hassane Diongole, Emmanuel Effa, Udeme Ekrikpo, Zaghloul Gouda, Jibrin Hussaini, Francois Kaze, Kajiru Kilonzo, Robert Kalyesubula, Amna Kununa, Muhammad Makusidi, Ikechukwu Mbah, Mignon McCullough, Yewondwossen Mengistu, Mothusi Moloi, George Moturi, Kwazi Ndlovu, John Ngigi, Yannick Nklandu, Joseph Ntarindwa, Julius Okel, Timothy Olanrewaju, Charlotte Osafo, Ugochi Samuel-Okpechi, Mazin Shigidi, Ernest Sumaili, Ifeoma Ulasi, Theophilus Umeizudike, Nicola Wearne, Vivekanand Jha, Adeera Levin, David Johnson, Aminu Bello
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