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Healthcare 2017, 5(3), 38; https://doi.org/10.3390/healthcare5030038

Challenges in Expanding Access to Dialysis in South Africa—Expensive Modalities, Cost Constraints and Human Rights

1
Wits Donald Gordon Medical Centre, 27 Eton Road, Parktown, 2193 Johannesburg, South Africa
2
Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa
*
Author to whom correspondence should be addressed.
Received: 28 June 2017 / Revised: 21 July 2017 / Accepted: 24 July 2017 / Published: 31 July 2017
(This article belongs to the Special Issue The Socio-Economic Impact of End Stage Kidney Disease)
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Abstract

South Africa is a country with two distinct health sectors, which are both characterised by inequalities. Within this context, patients with end stage renal disease face unique and sometimes impenetrable barriers to accessing dialysis. There are a number of reasons for this situation. These include: the South African government’s endorsement of discordant, unequal policies, which disadvantage the most vulnerable; a lack of robust national guidelines; and divisive rationing practices, which are ad hoc and place the burden of responsibility for rationing dialysis on the clinician. In this paper, we trace the socio-economic mechanisms of how we have come to be in this situation, and overlay this with a detailed examination of South African legislation. Finally, we make comprehensive practical recommendations for rectifying the situation, which include engagement with key stakeholders, public–private partnerships, and more equitable funding mechanisms. View Full-Text
Keywords: dialysis; rationing; ethics; macroeconomics; human rights; resource constraints; South Africa dialysis; rationing; ethics; macroeconomics; human rights; resource constraints; South Africa
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    Description: Availability of dialysis facilities per yer and per province in South Africa
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Etheredge, H.; Fabian, J. Challenges in Expanding Access to Dialysis in South Africa—Expensive Modalities, Cost Constraints and Human Rights. Healthcare 2017, 5, 38.

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