Decision-making in end stage kidney disease in Ghana: exploring the ethical and practical context. (360G-Wellcome-101141_Z_13_Z)

Patient decision-making is the subject of extensive research, including in the area of End Stage Kidney Disease (ESKD). However, it is noticeable that very little research has been carried in low-income countries, perhaps because renal replacement therapies (RRT) (transplant and dialysis) are only widely available in more affluent countries. Nonetheless, RRT technologies do exist in developing countries, and patients with ESKD still face choices. We are seeking support for an initial scop ing visit to inform a doctoral research programme exploring decision-making among patients with EKSD in Ghana. Prior to embarking on data collection, we wish to visit the three operational renal units in Ghana to explore how services are organized and the key stages of the ESKD patient's journey. The scoping visit will sensitize the researchers to the key ethical and practical issues surrounding RRT in Ghana, leading to (a) initial recommendations for local practice improvement and (b) publica tion of a review designed to contribute to the limited body of evidence exploring patient decision-making in a resource poor context (with reference to contemporary debates in global health and social justice).