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2017 ; 5
(3
): ä Nephropedia Template TP
gab.com Text
Twit Text FOAVip
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English Wikipedia
Challenges in Expanding Access to Dialysis in South Africa-Expensive Modalities,
Cost Constraints and Human Rights
#MMPMID28758959
Etheredge H
; Fabian J
Healthcare (Basel)
2017[Jul]; 5
(3
): ä PMID28758959
show ga
South Africa is a country with two distinct health sectors, which are both
characterised by inequalities. Within this context, patients with end stage renal
disease face unique and sometimes impenetrable barriers to accessing dialysis.
There are a number of reasons for this situation. These include: the South
African government's endorsement of discordant, unequal policies, which
disadvantage the most vulnerable; a lack of robust national guidelines; and
divisive rationing practices, which are ad hoc and place the burden of
responsibility for rationing dialysis on the clinician. In this paper, we trace
the socio-economic mechanisms of how we have come to be in this situation, and
overlay this with a detailed examination of South African legislation. Finally,
we make comprehensive practical recommendations for rectifying the situation,
which include engagement with key stakeholders, public-private partnerships, and
more equitable funding mechanisms.