Income Distribution and Sources of Funding for Maintenance Haemodialysis of Patients in the University of Port Harcourt Teaching Hospital

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FS Wokoma
PC Emem-Chioma

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Abstract

End stage renal disease (ESRD) is prevalent in Nigeria, with attendant high morbidity and mortality rates. In Nigeria, there have been reports of low affordability of haemodialysis and dialysis inadequacy. There is however, no formal study of the sources of funding for dialysis in the country. Such studies when replicated across the country will provide an evidence based tool with which to engage Government on the need for a Government driven ESRD program.A prospective direct questionnaire based study of End stage renal disease patients receiving maintenance haemodialysis was conducted at the University of Port Harcourt teaching hospital. Twenty four (24) males and 16 females(M/F=1.4:1) were studied, with mean age of 40.62 + 14.9 years, mean e-GFR , 6.53 + 1.6 ml/min. and mean duration on dialysis of 5.03 + 1.6(3-12) months. The mean annual income of the patients was N1, 147, 172.02 (N60, 000.00 to N3,200,000.00).The estimated annual cost of haemodialysis in Port Harcourt per patient is N2,340,000.00. Sixty (60) percent of the patients earned below one million Naira per annum. Only 10 percent of the patients earned over 3 million naira p.a .The annual incomes of 62.5% of the patients were less than fifty percent the annual cost of dialysis. Annual incomes showed positive correlation with the duration on dialysis(r= + 0.14) and number of dialysis sessions received (r= +0.3).
Dialysis was funded from family income in 65 percent of the cases. Funding was from extended family members in 17.5% and philanthropic sources in 10% of cases. There was no Government support to any patient or funding through insurance. The annual incomes of the great majority of ESRD patients are less than 50 percent of the annual cost of maintenance haemodialysis and cannot sustain optimal long term haemodialysis. A Government driven ESRD Care program is therefore inevitable in the country if we are to improve access to haemodialysis.

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