The geographical distribution of dialysis services in Ghana

Background: Chronic kidney disease (CKD) is an important global health challenge with increasing burden worldwide. CKD and acute kidney injury (AKI) may require renal replacement therapy (RRT) at some stages of the disease. Ghana currently has no renal transplant program. Dialysis services still remain a mirage to many chronic kidney disease patients in Ghana due to cost and paucity of hemodialysis machines. This survey highlights the geographical distribution of dialysis services in Ghana. Methods: A cross-sectional situational survey of dialysis centers in the ten regions of Ghana was conducted by interviewing doctors and other health care professionals in all health institutions. Information on dialysis services, staff status, and number of hemodialysis machines and presence of peritoneal dialysis services in both private and government facilities was obtained and mapped out. Results: Fifteen dialysis centers with a total of 103 hemodialysis machines were identified with majority 59 (57.2%) in state-owned facilities. One half of regions in Ghana do not have any form of dialysis facilities. Majority 65 (63.1%) of hemodialysis machines are in the Greater Accra region. Private hemodialysis services are available only in Greater Accra and Ashanti regions. There is no chronic peritoneal dialysis in Ghana but limited acute peritoneal dialysis. Ghana currently has eight nephrologists found only in the three government teaching hospitals. Most dialysis units across the country are supported by non-nephrologists. Conclusion: There are few hemodialysis centers in Ghana; the distribution of which is skewed to few regions across the country. There is a need to improve dialysis services and equitable distribution across the country.