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Integration of Care in Management of CKD in Resource-Limited Settings
Ikechi G Okpechi1, Aminu K Bello2, Oluwatoyin I Ameh3
1Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.
Insights
Chronic kidney disease (CKD) is rising globally. Leveraging existing health systems and the WHO framework can improve CKD care in developing nations, despite resource limitations.
Area of Science:
- Global health
- Nephrology
- Public health policy
Background:
- Noncommunicable diseases, including chronic kidney disease (CKD), are increasing worldwide.
- CKD treatment is costly and often unavailable in developing countries.
- Existing healthcare systems in developing nations are ill-equipped for comprehensive chronic disease management.
Purpose of the Study:
- To explore strategies for improving chronic kidney disease (CKD) care in resource-limited settings.
- To identify how existing health systems can be adapted for CKD management.
- To highlight key factors for enhancing CKD patient outcomes in developing countries.
Main Methods:
- Review of the World Health Organization's Innovative Care for Chronic Conditions framework.
- Analysis of current healthcare system structures in developing countries.
- Examination of successful integration of communicable disease control systems for noncommunicable diseases.
Main Results:
- The WHO Innovative Care for Chronic Conditions framework offers a viable model for CKD care improvement.
- Existing health systems, particularly those for communicable diseases, can be adapted to manage CKD.
- Successful CKD care requires community prevention programs, political engagement, patient/family involvement, and efficient workforce utilization.
Conclusions:
- Improving CKD care in developing countries necessitates a multi-faceted approach.
- Leveraging established health infrastructure and policy frameworks is crucial for addressing the growing CKD burden.
- Strategic planning involving prevention, political will, patient engagement, and healthcare personnel is essential for better CKD outcomes.
Abstract:
The prevalence of noncommunicable diseases, including chronic kidney disease (CKD), continues to increase worldwide, and mortality from noncommunicable diseases is projected to surpass communicable disease-related mortality in developing countries. Although the treatment of CKD is expensive, unaffordable, and unavailable in many developing countries, the current structure of the health care system in such countries is not set up to deliver comprehensive care for patients with chronic conditions, including CKD. The World Health Organization Innovative Care for Chronic Conditions framework could be leveraged to improve the care of CKD patients worldwide, especially in resource-limited countries where high cost, low infrastructure, limited workforce, and a dearth of effective health policies exist. Some developing countries already are using established health systems for communicable disease control to tackle noncommunicable diseases such as hypertension and diabetes, therefore existing systems could be leveraged to integrate CKD care. Decision makers in developing countries must realize that to improve outcomes for patients with CKD, important factors should be considered, including enhancing CKD prevention programs in their communities, managing the political environment through involvement of the political class, involving patients and their families in CKD care delivery, and effective use of health care personnel.
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