THE SCHOOL HEALTH PROGRAMME INCREASED ACCESS TO PEDIATRIC RENAL TRANSPLANTATION IN STATE OF GUJARAT IN INDIA

Abstract

Introduction: Renal transplantation is still out of reach for large number of children in low-middle-income countries like India where transplantation causes extraordinary out of pocket expenditure. The School health programme, funded by the government of state of Gujarat and government of India, caters to the expenditure of acute and chronic kidney disease treatment which includes dialysis, renal transplantation surgery and post-transplant care for Gujarat domicile children 0-18 years. The aim of the study was to analyse the impact of this programme on access to transplantation in children at institute of kidney disease and research centre, a tertiary referral teaching institute in state of Gujarat, India. Methods: Electronic record of the school heath programme was retrieved and data on total number of children benefitted were collected. The total annual expenditure, per-capita expenditure and expenditure on kidney transplantation were analysed. Result: Total 49000 children benefitted from the scheme in last 6 years. US $ 4.68 million was the total expenditure with an average annual expenditure of US $ 780797. 146 children got transplanted in last 5 years under the scheme. Total expenditure was US $ 424282 and average per transplant recipient was US $ 2906. Conclusion: The school health programme is one of its kind unique health benefit scheme by any state government in India benefitting large number of children and families across all socioeconomic strata providing access to quality care for kidney diseases including transplantation. This scheme is an example for other states of India as well as other low middle income countries to emulate to increase access to acute and chronic kidney disease care including renal transplantation in children.