Public-Private Partnership in Hemodialysis in Nigeria: A Comparative Analysis of Renal Centers across Three Northwestern States

Background: Public-private partnership (PPP) in hemodialysis delivery in Nigeria is a new concept. We set out to compare the performance of Specialist Hospital Sokoto's (SHS) renal center operating with this model with four other neighboring government-operated dialysis centers. Materials and Methods: We reviewed the 6-year records (May 2011 to April 2017) of Dialysis Center of SHS, operated under a PPP and compared some performance indicators with four government-operated dialysis centers over the same period. Comparisons were made using Chi-square and corresponding P values were reported accordingly. P < 0.05 was considered significant. Results: A total of 1167 patients' data were studied. Of these, 252 (21.6%) patients with end-stage renal disease were dialyzed at SHS. The SHS dialysis center experienced 5 months of interruption in dialysis service. Only 38 (15.1%) patients sustained dialysis beyond 90 days and 105 (41.7%) patients had more than three sessions of hemodialysis. Only one patient was referred for kidney transplant from the dialysis center during the review period. SHS performed better than Federal Medical Center and Sir Yahaya Hospitals in terms of service availability, duration on hemodialysis, and greater number of hemodialysis sessions (chi(2) = 29.06, df = 3, P < 0.001). Conclusion: PPP has improved the availability of dialysis service, mean duration on dialysis, and mean number of dialysis sessions but did not improve the kidney transplant referral rate at SHS. There is a need to encourage the current arrangement in the Hospital as well as other centers offering similar partnerships.