‘I Don’t Even Know How I’m Going to Survive Anymore’: Unmet Needs of Hemodialysis Patients in Pampanga, Philippines

Chronic Kidney Disease (CKD) is a major global health challenge, with growing dependence on in-center hemodialysis. While most studies focus on clinical outcomes, less is known about patients’ lived experiences in low- and middle-income countries, where socioeconomic and systemic barriers intensify these struggles. This study examined the unmet needs of hemodialysis patients in Pampanga, Philippines, incorporating perspectives from patients, caregivers, and healthcare providers. Semi-structured interviews were conducted across three sites—San Fernando City, Angeles City, and Guagua—with 45 participants (20 patients, 15 caregivers, and 10 providers). Data were thematically analyzed using interpretative phenomenological analysis, supported by MAXQDA. Findings revealed multiple unmet needs, including limited awareness of financial assistance, inadequate understanding of CKD, and high out-of-pocket costs, underscoring the need for stronger education and expanded subsidies. Participants also reported transportation barriers, mobility difficulties, and poor access to mental health services. A desire for more empathetic caregiving and peer support also emerged. Addressing these gaps through financial, educational, and psychosocial interventions is critical to improving the quality and equity of renal care in resource-limited settings.