Introduction:
The domain of nephrology encompasses the preservation of kidney health and the treatment of kidney disease. This treatment could range from dietary adjustments and medication to renal replacement therapies such as dialysis and renal transplantation. In low-income countries, managing kidney disease presents a significant challenge. Despite the high number of patients suffering from renal failure, access to renal replacement therapy remains limited. This disparity underscores the urgent need for innovative solutions and strategies to improve kidney care in these regions.
Methods:
Prior to 2015, Rwanda had four dialysis centers, which were not evenly distributed across the country. Three of these centers were located in Kigali, the capital city, and one was in the Southern Province. All of these centers were housed within tertiary hospitals. However, after 2015, the number of dialysis centers doubled with the addition of four more. Three of these new centers were established in remote areas through public-private partnerships (PPPs) and were located within district hospitals. The fourth center, which operates independently, was opened in Kigali city. This expansion has significantly increased the accessibility of dialysis treatment in Rwanda.
Results:
Through the implementation of public-private partnerships (PPPs), approximately 100 patients are now receiving chronic maintenance hemodialysis outside of Kigali city. This includes patients with acute renal failure. The establishment of these centers has significantly reduced travel times for patients, eliminating the need for long-distance commutes. For instance, patients from Rusizi in the Southern Western Province, who previously had to travel 7 hours to Kigali city or 4 hours to Huye, can now access services locally. Similarly, patients from the Northern Province and Rwamagana in the Eastern Province, who previously had to travel 5 hours and 3 hours respectively to Kigali city, now have access to local services. These centers provide 2 to 3 sessions per week until patients can undergo renal transplantation, if they are eligible. This development has removed a significant barrier to treatment and improved the quality of life for these patients.
Conclusions:
Public-private partnerships (PPP) are aiding Rwanda's government in expanding dialysis services, including to remote regions, benefiting local and neighboring patients. This is an innovative strategy to support nephrology development in low-income countries by establishing more centers, with government facilitation of PPP processes.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.