BackgroundThe cost of dialysis in low and middle-Income countries has not been systematically reviewed. The objective of this article is to systematically review peer-reviewed articles on the cost of dialysis across low and middle-income countries.MethodsPubMed and Embase databases were searched for the year 1998 to March 2013, and additional studies were added from Google Scholar search. An article was included if two reviewers agreed that it had reported cost of dialysis from low and middle-Income countries.ResultsThe annual cost per patient for hemodialysis (HD) ranged from Int$ 3,424 to Int$ 42,785, and peritoneal dialysis (PD) ranged from Int$ 7,974 to Int$ 47,971. Direct medical cost especially drugs and consumables for HD and dialysis solutions and tubing for PD were the main cost drivers.ConclusionThe number of studies on the economics of dialysis in low and middle-income countries is limited. Few papers indicate that dialysis is an expensive form of treatment for the population of these countries and that the poorer countries have an over-proportional burden to finance dialysis services. Further research is needed to determine the cost of dialysis based on a standard methodology grounded on existing economic guidelines and to address the question whether dialysis should be an element of the essential package of health in resource-poor countries. Used data should be as complete as possible. In case of missing data, proxies can be used. In case of developing countries, expert interviews are often used for estimating missing information.
BackgroundAlthough End Stage Renal Disease (ESRD) is a disease of increasing epidemiological relevance very little is known about the cost of providing the respective dialysis services in Tanzania. This paper estimates the costs of dialysis for ESRD patients at Muhimbili National Hospital (MNH) in Tanzania in the year 2014.MethodsCost calculations are based on the provider perspective and include only the direct cost of dialysis treatment. Cost of drugs and consumables were obtained from the price list issued by the Medical Stores Department (MSD) in Tanzania. Additional data were collected through face-to-face interview with experts at the dialysis unit.ResultsMNH performs on average 442 hemodialysis per month (34 patients, with three sessions per week) with a personnel placement of 20 nurses, four nephrologists, eight registrars, one nutritionist, two biomedical engineers, four health attendants and nine dialysis machines. The respective average unit cost per hemodialysis is 176 US$. Consequently, an average patient requiring three dialyses per week (i.e. 156 dialyses per year) will cause annual costs of 27,440 US$.ConclusionThe cost of dialysis is enormous for a least developed country like Tanzania where resources and technology are rather limited. Thus, from the economic point of view, it seems rational to allocate health care budgets towards diseases that are curable, have a higher cost-effectiveness and cater for the majority of the population. However, before a final decision on allocation of budgets towards dialysis is made all effort must be invested to improve technical efficiency by cutting the enormous unit cost.
Objectives: In recent years Tanzania introduced digital technologies in health industry where several initiatives such as Government of Tanzania, Hospital Management Information System (GoT-HoMIS) along other digital devices are taken to ensure quality services delivery. The purpose of this study was to assess Health Care Providers (HCPs) knowledge and attitude towards the use of Digital Health Technology (DHT) in provision of maternal health services at Tumbi Regional Referral Hospital (TRRH). Methods: Descriptive cross-sectional design involving 50 purposively selected HCPs from obstetrics and gynecology department was used. A self-administered questionnaire and direct field observation was used to collect data from respondents. Data were analyzed using SPSS V.20 and presented by using tables, percentages and frequencies. Results: We found that, DHT are highly used by HCPs 49(98%). Also, DHT devices are available and functioning properly thus used in providing maternal health services by enhancing effective patient management. 43(86%) of HCPs were aware on DHT practice and about 46(92%) understood the use of DHT in provision of maternal health services despite of varying knowledge level. On the side of attitude, we found that, 43(86%) of the HCP had a positive attitude on the use of DHT. Conclusion: Knowledge, attitudes and rate of use of DHT by HCP was found to be good, despite notable challenges such as dependent on the internet signals for their proper functioning. More initiatives should be undertaken by the Ministry of Health, Community and other stakeholders to promote DHT practices in the health facilities.
Background The shortage of medicines and medical supplies seems to be a major issue that is facing public health facilities in Tanzania. Formerly, the Government initiatives such as engagement with the Prime Vendor System (PVS) demonstrated great assistance in getting rid of this challenge. Despite the operation of PVS, a recent shortage of medicines and medical supplies has been noticed. Objectives This study aim to assess the effectiveness of PVS on the availability of medicine and medical supplies in selected public health facilities in Arusha District Council. Methods The study used a case study design with mixed research approach. We involved 77 respondents which included 25 health-facility-in charges, 50 patients, 1 District Pharmacist Officer and 1 Prime Vendor. Questionnaires, interviews, and observation methods were used to collect data. Data collected covered a period of 2021–2022. Thematic analysis was used to analyze qualitative data whereas descriptive analysis was used to analyze quantitative data with the help of Excel and the Statistical Package for Social Sciences (SPSS) version 28.0. Results The analysis indicates that PVS is not completely effective in supplying medicine and medical supplies due to its low capacity to conform to the orders placed by the public health facilities, a lack of supply competition, and a failure to adhere to contractual terms. Furthermore, at the time of data collection, the average availability of medicines and medical supplies at the selected public health facilities was 74.8%, whereby 80% of the selected public health facilities reported having a scarcity of medicines and medical supplies, and 92% of the interviewed patients reported having no full access to medicines. Conclusion Despite the shortcomings associated with the operation of the PVS, the system still seems to be very important for enhancing the availability of medicines and medical supplies once its effectiveness is strengthened. This study recommends a routine monitoring of PVS operations and timely interventions in order to reinforce adherence to the contracted terms and improve PVS effectiveness.
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