Models for scaling up high quality affordable healthcare delivery: The case for Kidney care in India

Abstract

Kidney disease is the laggard entrant into the Non communicable disease epidemic unfolding in India. Chronic kidney disease in its advanced stage has complex treatment options: Kidney Transplantation or Dialysis. Since the former is dependent on availability of human organs for which considerable shortage exists, Hemodialysis is the dominant modality offered. Hemodialysis is technology intensive, dependent on skilled labour and expensive therapy. Globally, in developed and emerging economies, it is either fully funded or partially funded by public financing. In Indian context, there is a huge unmet need with a large gap between growing demand from the steady rise in disease prevalence and meagre service provision: only about 15 % of patients with Kidney disease receive dialysis. Low awareness and acceptance by patients, cost of care, lack of third party payers, limited public provision and minimal hospital based provision in urban areas only are overbearing challenges in kidney care.

But the escalating demand and changing dynamics of stake holders in health care in India is creating a compulsive need for a paradigm shift in delivery care models. Wider accessibility, rapid scaling up of skilled manpower, cost effective technology, best practices are essential to improve patient safety and outcome. The recent shift of focus in health care policy on this space is bound to accelerate the momentum to find timely and effective solutions for kidney care in India.