In Lagos State, Nigeria, people with end-stage kidney disease who need dialysis face difficulties. Lagos, which has a population of over 16.5 million, only has 18 operational dialysis machines spread throughout its public secondary healthcare institutions. This results in lengthy wait times, exorbitant expenses, and major discomfort for patients and their carers. Patients frequently travel long distances and pay up to ₦70,000 every session, which includes consumables and fees. The Lagos State Cardiac and Renal Centre (CRC), which was put into service in 2015 with 24 dialysis machines and sophisticated renal care in mind, has been largely abandoned since then.
Under-dialysis shortens patient lifespans due to a lack of equipment and qualified nephrologists. Only six dialysis sessions for acute renal damage are covered by the National Health Insurance Scheme (NHIS), which does not cover chronic kidney illness. To lessen the burden on patients, experts recommend expanding health insurance, subsidised treatment, local production of consumables, and increased Investment in dialysis infrastructure. The growing need for reasonably priced renal treatment is difficult for public facilities to provide, even with the help of private hospitals and donations.
Renal Centre’s operational viability has been problematic.
Then-Governor Babatunde Fashola officially opened the Lagos State Cardiac and Renal Centre (CRC) in March 2015. It is situated next to the General Hospital in Gbagada, Lagos. The hospital, which was built at an estimated cost of ₦5 billion, was intended to be a cutting-edge facility to address the rising incidence of renal and cardiac disorders in Nigeria. To offer a wide range of services, including outpatient consultations, diagnostic imaging (CT, ultrasound), echocardiography, stress electrocardiography, laboratory services, and both cardiac and renal surgeries, the CRC was outfitted with cutting-edge medical technology, including 24 dialysis machines.
For the management of serious situations, the centre additionally included high-dependency wards and an intensive care unit (ICU). The CRC’s operational viability has been problematic, despite its promise to drastically lower Medical Tourism and offer necessary healthcare services locally. It has been reported that the facility has been underutilised and occasionally abandoned and that the equipment has become outdated as a result of idleness. Investigating the center’s underutilisation, the Lagos State House of Assembly raised concerns in 2019 about the waste of public funds and the lost chance to offer Nigerians vital healthcare services.
Dialysis equipment is scarce compared to the needs of the populace.
More so, the CRC’s underutilisation highlights the larger issues with Nigeria’s healthcare system, especially with regard to properly maintaining and running specialised medical facilities. To guarantee that healthcare investments result in easily accessible and high-quality services for the populace, these problems must be resolved. Dialysis equipment is scarce in Nigeria compared to the needs of the populace. A population of about 213 million people was served by about 565 dialysis machines as of 2021, or roughly 2.65 machines per million.
As a matter of fact, dialysis costs differ across the nation. Sessions typically cost between ₦20,000 and ₦30,000, therefore for patients who need more than one session, weekly costs could range from ₦80,000 to ₦120,000. Given Nigeria’s Minimum Wage of ₦30,000 per month, this amounts to monthly expenses that range from ₦340,000 to ₦400,000, creating a substantial financial hardship. Patients and carers frequently talk about how difficult it is to get dialysis due to its high costs and restricted availability. One patient at Renaissance-renhealth LLC, for example, stated that the initial charges for each session were ₦65,000 without access and ₦40,000 with access, highlighting the financial difficulties that many people experience.
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Many models have been used around the world to address the accessibility of dialysis. The treatments are subsidised by the government in India, for instance, which drastically lowers patient expenditures. Similar to this, nations like Brazil have made dialysis services more widely accessible by incorporating them into their Public Health systems. The goal of recent projects in Nigeria is to enhance care. By providing training and resource sharing among Nigerian healthcare facilities, the Sister Renal Centres Program of the International Society of Nephrology has improved kidney care services. In an effort to ease patient financial strains, the federal government also announced a 20% cut in dialysis expenses at significant federal hospitals in eight states.