scholarly journals Surveying and mapping breast cancer services in Ghana: a cross-sectional pilot study in the Eastern Region

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e051122
Author(s):  
Moustafa Moustafa ◽  
Meghan Eileen Mali ◽  
Fidel Lopez-Verdugo ◽  
Ousman Sanyang ◽  
Jonathan Nellermoe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Scale Up ◽  
Surgical Care ◽  
Survey Study ◽  
Eastern Region ◽  
Cross Sectional ◽  
Surgical Services ◽  
Cancer Services ◽  
Screening Services ◽  
Private Government

ObjectivesDefine the services available for the care of breast cancer at hospitals in the Eastern Region of Ghana, identify areas of the region with limited access to care through geospatial mapping, and test a novel survey instrument in anticipation of a nationwide scale up of the study.DesignA cross-sectional, facility-based survey study.SettingThis study was conducted at 33 of the 34 hospitals in the Eastern Region of Ghana from March 2020 to May 2020.ParticipantsThe 33 hospitals surveyed represented 97% of all hospitals in the region. This included private, government, quasi-government and faith-based organisation owned hospitals.ResultsSixteen hospitals (82%) surveyed provided basic screening services, 11 (33%) provided pathological diagnosis and 3 (9%) provided those services in addition to basic surgical care.53%, 64% and 78% of the population lived within 10 km, 25 km and 45 km of screening, diagnostic and treatment services respectively. Limited chemotherapy was available at two hospitals (6%), endocrine therapy at one hospital (3%) and radiotherapy was not available. Twenty-nine hospitals (88%) employed a general practitioner and 13 (39%) employed a surgeon. Oncology specialists, pathology personnel and a plastic surgeon were only available in one hospital (3%) in the Eastern Region.ConclusionsAlthough 16 hospitals (82%) provided screening, only half the population lived within reasonable distance of these services. Few hospitals offered diagnosis and surgical services, but 64% and 78% of the population lived within a reasonable distance of these hospitals. Geospatial analysis suggested two priorities to cost-effectively expand breast cancer services: (1) increase the number of health facilities providing screening services and (2) centralise basic imaging, pathological and surgical services at targeted hospitals.

scholarly journals Decentralization and Regionalization of Surgical Care as a Critical Scale-up Strategy in Low- and Middle-Income Countries Comment on "Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries"

2020 ◽  
Author(s):  
Jaymie A. Henry
Keyword(s):  
Scale Up ◽  
Surgical Care ◽  
Lessons Learned ◽  
Optimal Distribution ◽  
Middle Income ◽  
Middle Income Countries ◽  
Surgical Services ◽  
Obstetric Services ◽  
Surgical Conditions ◽  
Low And Middle Income

As global attention to improve the quality, safety and access to surgical care in low- and middle-income countries (LMICs) increases, the need for evidence-based strategies to reliably scale-up the quality and quantity of surgical services becomes ever more pertinent. Iversen et al discuss the optimal distribution of surgical services, whether through decentralization or regionalization, and propose a strategy that utilizes the dimensions of acuity, complexity and prevalence of surgical conditions to inform national priorities. Proposed expansion of this strategy to encompass levels of scale-up prioritization is discussed in this commentary. The decentralization of emergency obstetric services in LMICs shows promising results and should be further explored. The dearth of evidence of regionalization in LMICs, on the other hand, limits extrapolation of lessons learned. Nevertheless, principles from the successful regionalization of certain services such as trauma care in high-income countries (HICs) can be adapted to LMIC settings and can provide the backbone for innovation in service delivery and safety.

scholarly journals Diabetes self-care practices and resilience in the Brazilian COVID-19 pandemic: results of a web survey: DIABETESvid

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Bárbara Aparecida Binhardi ◽  
Carla Regina de Souza Teixeira ◽  
Bianca de Almeida-Pititto ◽  
Francisco Barbosa-Junior ◽  
Laercio Joel Franco ◽  
...  
Keyword(s):  
Physical Activity ◽  
Great Part ◽  
Self Care ◽  
Healthcare Services ◽  
Survey Study ◽  
Web Survey ◽  
Eastern Region ◽  
Cross Sectional ◽  
Social Distancing ◽  
Care Practices

Abstract Background The world guidance on the measures of social distancing for prevention of COVID-19 has changed the daily habits of great part of the population, and this could influence the care and resilience with diabetes during situations of adversity. This study aimed at assessing the characteristics of diabetic individuals and self-care practices and resilience with diabetes in the context of the COVID-19 pandemic in Brazil. Methods This is a cross-sectional web survey study carried out among adults with diabetes, in which a structured 43-item questionnaire was conducted on the REDCap plataform, including the Diabetes Self-Care Activities Questionnaire and Connor-Davidson Resilience Scale, to measure socio-demographic and clinical characteristics. The web survey was disseminated through the main social media and data were collected from September 1st to October 19th, 2020. Data analysis was performed according to type of diabetes mellitus (DM) and at a significance level of 5% (p < 0.05). Results Of the 1633 participants, 67.5% were women, 43.2% aged between 35 and 59 years old, 68.0% lived in the south-eastern region of Brazil, 57.1% had a high education level, 49% reported to have DM1 and 140 participants reported to have had COVID-19. Diabetes care mostly involved the use of medications (93%), whereas the least used ones were physical activity (24.6%) and examination of the shoes (35.7%). About 40% of the participants reported to be followed up by telemedicine, 61.5% monitored the glycaemic levels, 61.2% followed a healthy diet and 43.4% left home only to go to the supermarket and drugstore. The mean resilience was 25.4 (SD = 7.7). Conclusions In Brazil, individuals with diabetes followed social distancing and maintained their medication treatment for DM. However, practice of physical activity and foot examination was little followed by the participants, who also had a low level of resilience. These findings showed the importance of patient follow-up in the healthcare services, meaning that telemedicine should be improved and support provided for adaptation in view of the therapeutic setbacks.

scholarly journals Deaths from surgical conditions in Malawi - a randomised cross-sectional Nationwide household survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Carlos Varela ◽  
Sven Young ◽  
Reinou S. Groen ◽  
Leonard Banza ◽  
Nyengo Mkandawire ◽  
...  
Keyword(s):  
Health Care ◽  
Health Facility ◽  
Scale Up ◽  
Surgical Care ◽  
Household Survey ◽  
Abdominal Distension ◽  
African Countries ◽  
Cross Sectional ◽  
Middle Income ◽  
Surgical Conditions

Abstract Background Relatively little is known about deaths from surgical conditions in low- and middle- income African countries. The prevalence of untreated surgical conditions in Malawi has previously been estimated at 35%, with 24% of the total deaths associated with untreated surgical conditions. In this study, we wished to analyse the causes of deaths related to surgical disease in Malawi and where the deaths took place; at or outside a health facility. Methods The study is based on data collected in a randomised multi-stage cross-sectional national household survey, which was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48,233 settlements, using 55 villages from each district as data collection sites. Two to four households were randomly selected from each village. Two members from each household were interviewed. A total of 1479 households (2909 interviewees) across the whole country were visited as part of the survey. Results The survey data showed that in 2016, the total number of reported deaths from all causes was 616 in the 1479 households visited. Data related to cause of death were available for 558 persons (52.7% male). Surgical conditions accounted for 26.9% of these deaths. The conditions mostly associated with the 150 surgical deaths were body masses, injuries, and acute abdominal distension (24.3, 21.5 and 18.0% respectively). 12 women died from child delivery complications. Significantly more deaths from surgical conditions or injuries (55.3%) occurred outside a health facility compared to 43.6% of deaths from other medical conditions, (p = 0.0047). 82.3% of people that died sought formal health care and 12.9% visited a traditional healer additionally prior to their death. 17.7% received no health care at all. Of 150 deaths from potentially treatable surgical conditions, only 21.3% received surgical care. Conclusion In Malawi, a large proportion of deaths from possible surgical conditions occur outside a health facility. Conditions associated with surgical death were body masses, acute abdominal distention and injuries. These findings indicate an urgent need for scale up of surgical services at all health care levels in Malawi.

Psychological Distress and Social Support Availability in Different Family Caregivers of Latinas With Breast Cancer

2019 ◽  
pp. 104365961989682
Author(s):  
Chris Segrin ◽  
Terry Badger ◽  
Alla Sikorskii
Keyword(s):  
Breast Cancer ◽  
Social Support ◽  
Psychological Distress ◽  
Family Caregivers ◽  
Breast Cancer Survivors ◽  
Well Being ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Diverse Range

Introduction: Latinas with breast cancer draw on a diverse range of family members for informal care. Latin cultures typically prescribe high levels of support and care for an ill family member that leave caregivers vulnerable to compromised well-being. Method: In this cross-sectional survey study, 258 family caregivers of Latinas with breast cancer completed reports of psychological distress, availability of social support, and acculturation. Results: Mothers who provide care to a daughter with breast cancer experience higher levels of psychological distress and report lower availability of informational support than most other types of family caregivers. Mothers’ lower levels of acculturation may at least partially explain these reductions in well-being. Discussion: This study highlights the diverse range of family and fictive kin who participate in family caregiving for Latina breast cancer survivors. Spousal caregivers may not represent a unique population, whereas mothers as caregivers are indeed distinct for their higher distress levels.

scholarly journals Real-world experiences with acupuncture among breast cancer survivors: a cross-sectional survey study

2020 ◽  
Vol 28 (12) ◽  
pp. 5833-5838 ◽  
Author(s):  
Jacqueline Zayas ◽  
Kathryn J. Ruddy ◽  
Janet E. Olson ◽  
Fergus J. Couch ◽  
Brent A. Bauer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Real World ◽  
Breast Cancer Survivors ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional

scholarly journals Patient-reported Outcomes of Patients With Breast Cancer During the COVID-19 Outbreak in the Epicenter of China: A Cross-sectional Survey Study

2020 ◽  
Vol 20 (5) ◽  
pp. e651-e662 ◽  
Author(s):  
Li Juanjuan ◽  
Cesar Augusto Santa-Maria ◽  
Feng Hongfang ◽  
Wang Lingcheng ◽  
Zhang Pengcheng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Patient Reported Outcomes ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patient Reported

scholarly journals Community Mobilization and Awareness Creation for Orofacial Cleft Services: A Survey of Nigerian Cleft Service Providers

2014 ◽  
Vol 2014 ◽  
pp. 1-10
Author(s):  
Raphael A. Adebola ◽  
Babatunde O. Bamgbose ◽  
Joshua B. Adeoye
Keyword(s):  
Service Providers ◽  
Surgical Care ◽  
Community Mobilization ◽  
Orofacial Cleft ◽  
Care Provision ◽  
Care Providers ◽  
Awareness Campaign ◽  
Cross Sectional ◽  
Surgical Services ◽  
Self Administered Questionnaire

Background. The opportunity to provide free surgical care for orofacial clefts has opened a new vista and is enhanced by well-informed communities who are aware of the free surgical services available to them. It is the responsibility of cleft care providers to adequately inform these communities via a combination of community mobilization and awareness creation. Methods. This was a nationwide, cross-sectional descriptive study of all orofacial cleft service providers in Nigeria using a structured, self-administered questionnaire. Results. A total of 4648 clefts have been repaired, 50.8% by the ten government-owned and 49.2% by the five nongovernment-owned organizations included in the study. The nongovernment-owned institutions seemed to be more aggressive about community mobilization and awareness creation than government-owned ones, and this was reflected in their patient turnout. Most of the organizations studied would prefer a separate, independent body to handle their awareness campaign. Conclusion. Community mobilization requires skill and dedication and may require formal training or dedicated budgets by government-owned and nongovernment-owned institutions alike. Organizations involved in cleft care provision must take community mobilization and awareness seriously if the largely unmet needs of orofacial cleft patients in Nigeria are to be tackled.

scholarly journals Macroeconomic costs of the unmet burden of surgical disease in Sierra Leone: a retrospective economic analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e017824 ◽  
Author(s):  
Caris E Grimes ◽  
Matthew Quaife ◽  
Thaim B Kamara ◽  
Christopher B D Lavy ◽  
Andy J M Leather ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Scale Up ◽  
Unmet Need ◽  
National Income ◽  
Surgical Care ◽  
Economic Losses ◽  
Cross Sectional ◽  
Surgical Disease ◽  
Low Middle Income Countries ◽  
Life Years

ObjectivesThe Lancet Commission on Global Surgery estimated that low/middle-income countries will lose an estimated cumulative loss of US$12.3 trillion from gross domestic product (GDP) due to the unmet burden of surgical disease. However, no country-specific data currently exist. We aimed to estimate the costs to the Sierra Leone economy from death and disability which may have been averted by surgical care.DesignWe used estimates of total, met and unmet need from two main sources—a cluster randomised, cross-sectional, countrywide survey and a retrospective, nationwide study on surgery in Sierra Leone. We calculated estimated disability-adjusted life years from morbidity and mortality for the estimated unmet burden and modelled the likely economic impact using three different methods—gross national income per capita, lifetime earnings foregone and value of a statistical life.ResultsIn 2012, estimated, discounted lifetime losses to the Sierra Leone economy from the unmet burden of surgical disease was between US$1.1 and US$3.8 billion, depending on the economic method used. These lifetime losses equate to between 23% and 100% of the annual GDP for Sierra Leone. 80% of economic losses were due to mortality. The incremental losses averted by scale up of surgical provision to the Lancet Commission target of 80% were calculated to be between US$360 million and US$2.9 billion.ConclusionThere is a large economic loss from the unmet need for surgical care in Sierra Leone. There is an immediate need for massive investment to counteract ongoing economic losses.

Sign in / Sign up

Export Citation Format

Share Document