Access to Kidney Care: Global implications for workforce capacity and use of electronic consultations to facilitate kidney care

• Author / Creator

  Osman, Mohamed

• Chronic kidney disease (CKD) is increasingly recognized as a global public health issue due to rising prevalence, associated adverse health outcomes and substantial economic impact. To address this problem, countries need health system strengthening, and the health workforce is considered the cornerstone of any health care system. An adequately trained and sufficiently staffed workforce is essential to reach universal health coverage. In particular, the nephrology workforce is critical to stem the tide against CKD burden. Nonetheless, there are critical gaps in the evidence on the current global nephrology workforce capacity. The overall objective of this thesis was to research access to kidney care through two separate, yet related, aspects of kidney care delivery namely global nephrology workforce capacity and role of telenephrology.
  Three separate studies were conducted to achieve this objective. First, we conducted a multinational cross-sectional survey administered under the auspices of the International Society of Nephrology (ISN). The questionnaire was administered online, and all data were analyzed and presented by ISN regions and World Bank country classification. Overall, 121 countries responded to survey questions pertaining to nephrology workforce. We identified a global nephrologist density of 8.83 per million population (PMP), and we found significant variation in the global density of nephrologists between low-income and high-income countries (0.31 PMP vs. 28.52 PMP) and between ISN regions (lowest density in Africa and South Asia regions).
  Secondly, we conducted a review of the literature on health information technologies looking for its potential applications to enhance global kidney care and in workforce specifically. The analysis of the literature identified that telenephrology would be an indispensable mechanism to close the identified gaps in kidney workforce, particularly in low and middle-income countries.
  Finally, we leveraged a local initiative on a specific type of health information technology named electronic consultations (eConsult) to assess the barriers and facilitators to its wider adoption and implementation. We used scoping review synthesis method to identify the factors that favor or hinder eConsult adoption.
  This work contributes to the knowledge of current global nephrology workforce capacity and provides potential solutions on how to address identified gaps using telenephrology and eConsult specifically. Although this study was focused on access to kidney care, the findings are potentially useful in other chronic conditions.

• Subjects / Keywords

  • electronic consultations
  • workforce
  • kidney care

• Graduation date

  Fall 2018

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/R3H708G6D

• License

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