Structures, Organization, and Delivery of Kidney Care to Children Living in Low-Resource Settings
Introduction: There is a disparity in the availability of health care for children in resource-constrained countries. The International Pediatric Nephrology Association (IPNA) commissioned an initiative exploring the challenges in the care of children with kidney disease in low- or middle-income cou...
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| Language: | English |
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Elsevier
2024-07-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024924016954 |
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| author | Nivedita Kamath Robin L. Erickson Sangeeta Hingorani Nilzete Bresolin Ali Duzova Adrian Lungu Erica C. Bjornstad Risky Prasetyo Sampson Antwi Hesham Safouh Giovanni Montini Melvin Bonilla-Félix |
| author_facet | Nivedita Kamath Robin L. Erickson Sangeeta Hingorani Nilzete Bresolin Ali Duzova Adrian Lungu Erica C. Bjornstad Risky Prasetyo Sampson Antwi Hesham Safouh Giovanni Montini Melvin Bonilla-Félix |
| author_sort | Nivedita Kamath |
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| description | Introduction: There is a disparity in the availability of health care for children in resource-constrained countries. The International Pediatric Nephrology Association (IPNA) commissioned an initiative exploring the challenges in the care of children with kidney disease in low- or middle-income countries (LMICs) with a focus on human, diagnostic, and therapeutic resources. Methods: A survey was sent by e-mail to all members of IPNA and its affiliated regional or national societies residing in LMICs. Data were extracted from individual responses after merging duplicate data. Descriptive analysis was done using Microsoft Excel. Results: Responses were obtained from 245 centers across 62 countries representing 88% of the LMIC pediatric population. Regional disparity in the availability of basic diagnostic and therapeutic resources was noted. Even when resources were available, they were not accessible or affordable in 15% to 20% of centers. Acute and chronic dialysis were available in 85% and 75% of centers respectively. Lack of trained nurses, pediatric-specific supplies, and high costs were barriers to providing dialysis in these regions. Kidney transplantation was available in 32% of centers, with the cost of transplantation and lack of surgical expertise reported as barriers. About 65% of centers reported that families with chronic disease opted to discontinue care, with financial burden as the most common reason cited. Conclusion: The survey highlights the existing gaps in workforce, diagnostic, and therapeutic resources for pediatric kidney care in resource-constrained regions. We need to strengthen the health care workforce, address disparities in health care resources and funding, and advocate for equitable access to medications, and kidney replacement therapy (KRT). |
| format | Article |
| id | doaj-art-af68e2dbfb6c46bfb0205e4770cbe95b |
| institution | OA Journals |
| issn | 2468-0249 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-af68e2dbfb6c46bfb0205e4770cbe95b2025-08-20T02:06:12ZengElsevierKidney International Reports2468-02492024-07-01972084209510.1016/j.ekir.2024.04.060Structures, Organization, and Delivery of Kidney Care to Children Living in Low-Resource SettingsNivedita Kamath0Robin L. Erickson1Sangeeta Hingorani2Nilzete Bresolin3Ali Duzova4Adrian Lungu5Erica C. Bjornstad6Risky Prasetyo7Sampson Antwi8Hesham Safouh9Giovanni Montini10Melvin Bonilla-Félix11Pediatric Nephrology Department, St John’s Medical College Hospital, Bengaluru, India; Correspondence: Nivedita Kamath, Department of Pediatric Nephrology, St John’s Medical College Hospital, Sarjapura Road, Bangalore 560034, India.Department of Paediatric Nephrology, Starship Children’s Hospital-Te Whatu Ora, University of Auckland, Auckland, New ZealandDivision of Nephrology, University of Washington Department of Pediatrics and Seattle Children’s Hospital, Seattle, Washington, USAFaculty of Medicine of Federal University of Santa Catarina, Florianopolis, Santa Catarina, BrazilDivision of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, TurkiyeInstitutul Clinic Fundeni, Bucharest, RomaniaDivision of Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USADivision of Nephrology, Department of Child Health, Faculty of Medicine Universitas Airlangga, Surabaya, IndonesiaDepartment of Child Health and Pediatric Nephrology, Kwame Nkrumah University of Science and Technology, Komfo Anokye Teaching Hospital, Kumasi, GhanaPediatric Nephrology Unit, Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, EgyptFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Nephrology, Dialysis and Transplant Unit, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, ItalyDepartment of Pediatrics, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico, USAIntroduction: There is a disparity in the availability of health care for children in resource-constrained countries. The International Pediatric Nephrology Association (IPNA) commissioned an initiative exploring the challenges in the care of children with kidney disease in low- or middle-income countries (LMICs) with a focus on human, diagnostic, and therapeutic resources. Methods: A survey was sent by e-mail to all members of IPNA and its affiliated regional or national societies residing in LMICs. Data were extracted from individual responses after merging duplicate data. Descriptive analysis was done using Microsoft Excel. Results: Responses were obtained from 245 centers across 62 countries representing 88% of the LMIC pediatric population. Regional disparity in the availability of basic diagnostic and therapeutic resources was noted. Even when resources were available, they were not accessible or affordable in 15% to 20% of centers. Acute and chronic dialysis were available in 85% and 75% of centers respectively. Lack of trained nurses, pediatric-specific supplies, and high costs were barriers to providing dialysis in these regions. Kidney transplantation was available in 32% of centers, with the cost of transplantation and lack of surgical expertise reported as barriers. About 65% of centers reported that families with chronic disease opted to discontinue care, with financial burden as the most common reason cited. Conclusion: The survey highlights the existing gaps in workforce, diagnostic, and therapeutic resources for pediatric kidney care in resource-constrained regions. We need to strengthen the health care workforce, address disparities in health care resources and funding, and advocate for equitable access to medications, and kidney replacement therapy (KRT).http://www.sciencedirect.com/science/article/pii/S2468024924016954barrierschallengesdialysislow and middle-income countriespediatric kidney care resources |
| spellingShingle | Nivedita Kamath Robin L. Erickson Sangeeta Hingorani Nilzete Bresolin Ali Duzova Adrian Lungu Erica C. Bjornstad Risky Prasetyo Sampson Antwi Hesham Safouh Giovanni Montini Melvin Bonilla-Félix Structures, Organization, and Delivery of Kidney Care to Children Living in Low-Resource Settings Kidney International Reports barriers challenges dialysis low and middle-income countries pediatric kidney care resources |
| title | Structures, Organization, and Delivery of Kidney Care to Children Living in Low-Resource Settings |
| title_full | Structures, Organization, and Delivery of Kidney Care to Children Living in Low-Resource Settings |
| title_fullStr | Structures, Organization, and Delivery of Kidney Care to Children Living in Low-Resource Settings |
| title_full_unstemmed | Structures, Organization, and Delivery of Kidney Care to Children Living in Low-Resource Settings |
| title_short | Structures, Organization, and Delivery of Kidney Care to Children Living in Low-Resource Settings |
| title_sort | structures organization and delivery of kidney care to children living in low resource settings |
| topic | barriers challenges dialysis low and middle-income countries pediatric kidney care resources |
| url | http://www.sciencedirect.com/science/article/pii/S2468024924016954 |
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