The challenge of chronic kidney disease and healthcare access in Sri Lanka: A systematic literature review

Abstract

Chronic diseases can be identified as a sector that presents a significant challenge to global health policies in the 21st century. A rise in Chronic Kidney Disease (CKD) was reported in Sri Lanka in the early 1990s, which could not be attributed to traditional causes. Notably, 10 out of Sri Lanka’s 25 districts are affected by CKD, with the North Central Province being the most severely affected, followed by the North Western, Eastern, and Uva provinces. Given this background, the rising number of kidney patients has placed an excessive burden on the Sri Lankan healthcare system. Accordingly, the aim of this study is to identify the current challenges of chronic kidney disease and the current status of healthcare access in Sri Lanka. To explore the existing challenges faced by the patients, a systematic literature review was conducted by retrieving eight research articles that were deemed most appropriate using Google Scholar. A thematic analysis was performed to identify the key challenges in the literature. As the result of this literature review, the main challenges of chronic kidney disease in Sri Lanka can be identified as decline in the economic and living standards of patients, the shortage of resources and workforce, the distance and cost of transportation for patients, poor knowledge and ignorance, lack of proper screening and management programs, reduced quality of care, psychosocial impacts, weaknesses in doctor-patient interactions, and challenges in care. Limitation of access to healthcare is described as the main reason behind these challenges. Although many studies have been conducted to identify the factors contributing to CKDu, the main issue remains the limited research and reviews on the broader challenges caused by CKD and their impact on patients and their families. More studies should be conducted to study the challenges and provide recommendations to the health officials to mitigate the pressure on the health care system.