**4.1 Cost of treatment**

Cost of kidney transplant varies from country to country. For example, the cost is estimated at about \$32,000 in Nigeria [84], \$18,775 in Ghana [85], and \$10,000 in Tanzania [20].

Source of funding for organ and tissue donation and transplant depends on the country: public sources in Ethiopia, Ghana, Mali, Seychelles and Comoros but private in Nigeria, Burkina Faso, Madagascar and 10 other countries See **Table 6**. Most recipients pay OOP either personally or by relatives, employers and to a lesser extent philanthropists [45]. While the National insurance pays two-thirds of the transplant cost in Kenya [47], it is free in Tanzania [51].

Post-transplant maintenance of immunosuppression is a major challenge. This is exigent since therapy must be individualized. Two perspectives associated with immunosuppression in SSA include:


#### *4.1.1 Availability, affordability and patient's adherence to prescription*

Adequate immunosuppression is key to allograft survival. In patients who pay OOP, prohibitive costs of medications may have negative impact on their finances. Furthermore, side effects of medications affect their health-related QOL. In many LRCs, these medicines are imported at high cost and not readily available. These contribute to poor adherence with subsequent allograft rejection and graft loss.

*Organ Donation and Transplantation in Sub-Saharan Africa: Opportunities and Challenges DOI: http://dx.doi.org/10.5772/intechopen.94986*



#### **Table 6.**

*Aspects of transplantation programmes in SSA modified from Loua et al [3].*
