Table 3 Core elements of the right to health*
Component | Dimensions | Relevance for dialysis |
|---|---|---|
Availability | • Public healthcare facilities • Health care goods and equipment • Trained healthcare professionals | • Existence and location of public health facilities • Dialysis services available in public health facilities (renal unit) • Trained clinicians and nurses in delivering dialysis care |
Accessibility | • No discrimination • Physical • Affordable • Information | • Equitable access for all, including children • Geographic location of dialysis centers • Reduce out-of-pocket expenditure, including ancillary costs e.g. medication, transport • Transparent communication about potential rationing |
Acceptability | • Cultural • Gender • Religious | • Respect needs e.g. separate male and female areas in some countries |
Quality | • Safe • Effective • Patient-centered • Timely • Equitable • Integrated • Efficient | • Infection control, building safety, respect curfews • Enough dialysis provided to keep patients safe especially if reduced frequency provided • e.g. adapt to patient’s work schedule if possible, Jehova’s witnesses • Avoid delays in emergencies (usually patients seeking funds, infrastructural failures) • no discrimination • Horizontal, embed dialysis within NCD programmes • Avoid waste, cost-awareness |