According to the first Ghana renal registry in 2017, 96.2% were on HD, 0.3% on PD and 3.5% had kidney transplant. Ghana does not have a sustainable kidney transplant program and haemodialysis (HD) is the most common modality for KF management. Limited access to KRT results from unavailability and high cost in most parts of Africa, including Ghana. According to the Global Kidney Health Atlas (GKHA), only 4–10% of patients with KF can access KRT in low- and lower middle income countries(LMIC). Globally, patients in Africa have the lowest access to KRT, with the lowest rates found in Central and Eastern Africa with1-3% of those requiring receiving it. Kidney transplantation is the best modality of KRT as it improves survival and quality of life compared dialysis. When CKD progresses to kidney failure (KF), kidney replacement therapy (KRT) is required for survival and to improve quality of life. In Ghana, the prevalence of CKD is 13.3%, with chronic glomerulonephritis, diabetes mellitus and hypertension as major causes. The prevalence of CKD in Africa and sub-Saharan Africa are 15.8% and 13.9% respectively. Globally, the incidence and prevalence of chronic kidney disease (CKD) are on the increase. The cost of haemodialysis remains prohibitive and mainly paid out-of-pocket limiting its utilization. There 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 mean cost of HD session is US $53.9 ± 8.8 in Ghana. Currently, 1195 patients receive HD, giving a prevalence of 38.8 patients pmp with 609(50.9%) in the private sector. 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. The private sector has twice as many HD centers ( n = 27, 67.5%) as the public sector ( n = 13,32.5%). The rest of the seven regions have one centre each. 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. Of these, only 40 centres are functioning, as 11 had shut down or are yet to operate. ![]() There are 51 HD centres located in 9 of the 16 regions of Ghana. 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. ![]() MethodsĪ 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 describe the state of HD, dialysis prevalence, its utilization and cost of HD after fifty years of dialysis initiation in Ghana. Although, HD has been available in Ghana for 50 years, the majority of patients who develop kidney failure cannot access it. Haemodialysis (HD) is the most common treatment modality for survival.
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