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Report reveals acute shortage of kidney treatment services amid growing demand

 Kidney specialists Dr Philip Cheptinga attends at patients at the Haemodiafiltration Kidney room at Moi Teaching and Referral Hospital in Eldoret on March 10, 2022. [Peter Ochieng, Standard]

Kidney patients in Kenya are struggling to access care despite increasing demand for the services in the country, a report by the Ministry of Health has revealed.

In the report titled Kenya Health Facility Census, only two per cent of hospitals in the country offer renal (kidney) services. At least 12,384 hospitals across the country were assessed to reveal the state of renal services.

The report noted that less than half of the hospitals across the country providing renal services had all the necessary equipment, services and infrastructure.

Revelation of the report comes amid a rising burden of Non-communicable diseases in the country.

It further states that Kenya faces a triple burden of disease, where communicable diseases still dominate all causes of morbidity and mortality.

Infectious diseases and injuries contribute more than half of the deaths but with an estimated 39 per cent due to non-communicable diseases.

"It is projected that in the coming years the share of deaths from non-communicable diseases and injuries will continue to increase,” reads the report.

The report further revealed that about four million Kenyans have chronic kidney disease, with a significant proportion of this population progressing to kidney failure.

Out of the four million, about 10,000 people have end-stage renal disease and require dialysis, yet only 10 per cent access dialysis. Kidney patients are required to undertake dialysis three times a week.

According to the census, an increase in the burden of non-communicable diseases with kidney failure has resulted to an increase in the demand for renal services.

Among key services include diagnosis, management and treatment of complications for patients with kidney impairment or disease.

Dialysis services were readily available in facilities providing renal services at 85 per cent, with nine out of ten facilities providing having dialysis machines and dialysis beds.

Other parameters looked at were infrastructure, equipment (dialysis bed, machine, oxygen source, electrocardiogram for heart tests, suction machine, defibrillator, endotracheal tubes, laryngoscope and bag valve mask).

“Overall readiness to provide renal services was 42 per cent; all facilities providing renal services had all the tracer equipment, while almost three quarters (71 per cent) had all the tracer infrastructure,” reads the report.

Tracer personnel were least readily available, with only half of the facilities having all the required personnel.

Despite shortage of facilities offering kidney services, during the census, it was established that availability of renal services among the government owned hospitals increased from level 4 at 11 per cent, to 79 per cent, at level 5 and 80 per cent at level 6.

Speaking during the release of the report at Afya House on Thursday, the Acting Director General of Health Dr Patrick Amoth said there is need to improve the services.

Despite high demand for renal service, Dr Amoth drummed up support for kidney transplant, saying it is more effective.

“Kidney transplant and post-transplant services should be enhanced to reduce the burden of population needing dialysis, and improve quality of life for patients with renal failure,” he said.

Health Cabinet Secretary (CS) Susan Nakhumicha said the report will be used to improve healthcare in the country amid plans for implementation of Universal Health Coverage (UHC).

“The identified gaps and inefficiencies shall also guide investments within the sector to ensure optimal delivery of quality health care and accelerate the attainment of UHC,” she said.

The CS directed Public Health Pricipal Secretary Mary Muthoni and Kenya Medical Practitioners and Dentist Council CEO Dr David Kariuki to investigate hospitals that declined assessment. During assessment conducted by Ministry of Health and partners, at least 203 facilities denied access whereas 1,560 were closed at time of assessment.

PS Muthoni attributed mortality rates in the country to misdiagnosis, inaccurate human resource and lack of infrastructure to support services.

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