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Considerations on equity in management of end-stage kidney disease in low- and middle-income countries


Van Biesen, Wim; Jha, Vivekanand; Abu-Alfa, Ali K; et al; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified; Luyckx, Valerie A; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified; Unspecified (2020). Considerations on equity in management of end-stage kidney disease in low- and middle-income countries. Kidney International Supplements, 10(1):e63-e71.

Abstract

Achievement of equity in health requires development of a health system in which everyone has a fair opportunity to attain their full health potential. The current, large country-level variation in the reported incidence and prevalence of treated end-stage kidney disease indicates the existence of system-level inequities. Equitable implementation of kidney replacement therapy (KRT) programs must address issues of availability, affordability, and acceptability. The major structural factors that impact equity in KRT in different countries are the organization of health systems, overall health care spending, funding and delivery models, and nature of KRT prioritization (transplantation, hemodialysis or peritoneal dialysis, and conservative care). Implementation of KRT programs has the potential to exacerbate inequity unless equity is deliberately addressed. In this review, we summarize discussions on equitable provision of KRT in low- and middle-income countries and suggest areas for future research.

Abstract

Achievement of equity in health requires development of a health system in which everyone has a fair opportunity to attain their full health potential. The current, large country-level variation in the reported incidence and prevalence of treated end-stage kidney disease indicates the existence of system-level inequities. Equitable implementation of kidney replacement therapy (KRT) programs must address issues of availability, affordability, and acceptability. The major structural factors that impact equity in KRT in different countries are the organization of health systems, overall health care spending, funding and delivery models, and nature of KRT prioritization (transplantation, hemodialysis or peritoneal dialysis, and conservative care). Implementation of KRT programs has the potential to exacerbate inequity unless equity is deliberately addressed. In this review, we summarize discussions on equitable provision of KRT in low- and middle-income countries and suggest areas for future research.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Institute of Biomedical Ethics and History of Medicine
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Nephrology
Language:English
Date:March 2020
Deposited On:23 Mar 2020 08:04
Last Modified:31 Aug 2020 07:16
Publisher:Elsevier
ISSN:2157-1716
OA Status:Closed
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.kisu.2019.11.004
PubMed ID:32149010

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