Global health
Access to dialysis in sub-Saharan Africa: what the evidence shows
· Dr James Tataw Ashu · Medically reviewed
Cost, distance and workforce shortages remain the main barriers to sustained dialysis in the region.
Where dialysis is available in sub-Saharan Africa, the limiting factor is rarely the machine. It is the sustainability of treatment over months and years.
Out-of-pocket payment remains the dominant funding model in several countries, and dropout after the first months of treatment is common once family resources are exhausted.
Geography compounds cost. Units concentrated in capital cities require patients to travel repeatedly, or to relocate, with the associated loss of income for the household.
Workforce is the third constraint: nephrologists, dialysis nurses and biomedical technicians are all in short supply, and technician shortages in particular cause avoidable machine downtime.
Realistic progress combines prevention of kidney failure, selective expansion of peritoneal dialysis, transplant programmes with living donors, and honest conversations about conservative care where treatment cannot be sustained.
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