Are Tanzanians with kidney disease dying because treatment is too expensive?

Is the high cost of treatment for kidney disease leading to more deaths in Tanzania?

Syed Chambala, the chairman of the Tanzanian Kidney Patients Union, has called on the Tanzanian government to set up a special fund to support kidney patients and those with related diseases, noting that the the high cost of treatment has limited access for a majority of patients.

Speaking at an event organized by TMJ hospital in Dar es Salaam to mark World Kidney Day, Mr Chambala added that access to treatment is difficult due to the high costs involved, and this has greatly increased the likelihood of death from complications related to kidney problems.

This point echoed by kidney patient Sauka Nguluo Kullaya, a retired Army major.

“Currently, kidney patient spend around 1 million shillings (US$440) every week for dialysis services”, Major Kullaya noted, adding, “Most of the people requiring this services are poor and cannot afford such high treatment cost.”

Therefore the question is, has the high cost of treatment for kidney diseases in Tanzania led to majority of patients dying from complications?

PesaCheck has investigated the claim by Tanzania Kidney Patients Union chairman Syed Chambala that majority of Tanzanians with kidney disease are dying because treatment is too expensive to be MOSTLY TRUE for the following reasons:

Kidney treatment is quite costly due to the need for specialized treatment through repeated dialysis sessions.

This is made worse by delayed diagnosis and treatment, increasing the cost of treatment and risk of complications. Tanzania has limited facilities offering treatment for kidney diseases, adding to the disease burden, and often the only option available is to seek treatment abroad.

Tanzania lacks a national registry of kidney disease patients, making estimates of how many people need treatment in the country difficult.

According to the World Health Organization, there were 4,704 deaths linked to kidney disease in 2014, or 1.32% of total deaths in the country, or 19.53 per 100,000 of population. Kidney disease ranks 16th in terms of total number of deaths, above tuberculosis, hypertension and lung disease, but below malaria, HIV/AIDS and cancer.

However, many of these deaths can be prevented, as research conducted at Muhimbili National Hospital (MNH) shows. The research identifies cost of dialysis as a major challenge in accessing treatment for kidney patients.

MNH performs on average 442 haemodialysis sessions 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 haemodialysis is USD 176. Consequently, an average patient requiring three dialyses per week (156 dialyses per year) will cause annual costs of USD 27,440.

The high cost of dialysis treatment in Tanzania means that many patients have a difficult time paying for treatment and follow up treatments. While medical insurance could help to offset some of these costs, the high cost of insurance itself means that few are able to take it up.

Another study carried out at the University of Dodoma (UDOM) haemodialysis unit shows that about 44% of case study kidney patients could not afford the cost of treatment or could not pay for follow ups. 66% of the patients interviewed in the study reported that they were paying for treatment out of pocket.

The UDOM study also found that 12% of patients died during treatment, due to cardiovascular complications and sepsis.

Furthermore, infrastructural limitations mean that treatment remains both costly and hard to find. are because the cost of dialysis is enormous for a least developed country like Tanzania where resources and technology are rather limited.

From an economic point of view, the high cost of treatment means that majority of Tanzanians cannot afford the treatment, greatly increasing the likelihood that they will die from the disease.

Secondly, lack of enough diagnostic equipment and treatment facilities in some parts of the country means that the disease will go undetected at an early stage thus increasing complication risk leading to high cost of treatment for patients who have to bear the cost from their pockets.

Therefore, the argument claim that a majority of kidney patients in Tanzanian die due expensive treatment is PARTLY TRUE. It is correct that about half of kidney patients cannot afford treatment. But it is not accurate to state that this portion of the population die due to the high cost of treatment.

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This report was written by PesaCheck Fellow Kiki Otieno, a data journalist based in Tanzania, and edited by PesaCheck managing editor Eric Mugendi. The infographics are by John Githinji, a Kenyan Graphic Designer interested in Art, Animation, Information Technology and photography.

PesaCheck, co-founded by Catherine Gicheru and Justin Arenstein, is East Africa’s first fact-checking initiative. It seeks to help the public separate fact from fiction in public pronouncements about the numbers that shape our world, with a special emphasis on pronouncements about public finances that shape government’s delivery of so-called ‘Sustainable Development Goals’ or SDG public services, such as healthcare, rural development, and access to water and sanitation. PesaCheck also tests the accuracy of media reportage. 
To find out more about the project, visit
pesacheck.org.

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PesaCheck is a joint initiative of Code for Africa, through its local Code for Tanzania chapter, and the Data Zetu initiative to give Tanzanian citizens actionable data, in partnership with a coalition of local media organisations, with additional support from the International Center for Journalists(ICFJ).

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