The Program for Enhanced Training in Cancer: An Initial Experience of Supporting Capacity Building for Oncology Training in Sub-Saharan Africa

PURPOSE Sub-Saharan Africa is simultaneously facing a rising incidence of cancer and a dearth of medical professionals as a result of insufficient training numbers and emigration, creating a growing shortage of cancer care. To combat this, Massachusetts General Hospital and Beth Israel Deaconess Medical Center partnered with institutions in South Africa, Tanzania, and Rwanda to develop a fellowship exchange program to supplement the training of African oncologists practicing in their home countries. METHODS In its initial 2 years (2018 and 2019), the Program for Enhanced Training in Cancer (POETIC) hosted a pilot cohort of 14 fellows for 3-week observerships in their areas of interest. Researchers distributed questionnaires for program evaluation to participants before arrival and upon departure, and 8 participated in semistructured interviews. RESULTS Five themes emerged from the qualitative data: expectations of POETIC, differences in oncology between the United States and sub-Saharan Africa, positive elements of the program, areas for improvement, and potential impact. Fellows identified several elements of Western health care that will inform their practice: patient-centered care, research development, and collaboration among medical, radiation, and surgical oncologists. The time in Boston modeled a research infrastructure that participants expressed interest in emulating at their home hospitals. In addition, the fellowship inspired some participants to address prevention and survivorship efforts in their home countries. From the quantitative data, feedback was primarily around logistical areas for improvement. CONCLUSION POETIC was found to be feasible and valuable. The results from the first years justify the program’s continuation in hopes of strengthening global health partnerships to support oncology training in Africa. One weakness is the small number of fellows, which will limit the impact of the study and the relevance of its conclusions. Future work will involve long-term follow up with participants and the development of an alumni network.

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Physician Experiences and Perceived Barriers to Providing Quality Infertility Care in the Greater Accra Region of Ghana

Qualitative Health Research ◽

10.1177/10497323211060816 ◽

2021 ◽

pp. 104973232110608

Author(s):

Carie Muntifering Cox ◽

Ernest Tei Maya ◽

Hamdi Mohamed Ali ◽

Leslie Clayton

Keyword(s):

Sub Saharan Africa ◽

Patient Centered ◽

Individualized Care ◽

Centered Care ◽

School Faculty ◽

Sub Saharan ◽

Common Barriers ◽

Greater Accra Region ◽

Single Facility

High-quality, patient-centered care is essential to achieving equity and dignity for individuals with infertility, yet few studies have explored quality of infertility care in sub-Saharan Africa. We interviewed 13 non-specialist physicians and 2 medical school faculty to explore experiences in and perceptions of providing infertility care in Greater Accra, Ghana. We used a patient-centered infertility care model to inform our analysis and results. Individualized care and taking time to counsel and emotionally support patients were perceived as the most important things a physician can do to provide quality infertility care. Financial costs and lack of infertility services within a single facility were the most common barriers reported to providing quality infertility care. To the best of our knowledge, our study is the first to explore quality of infertility care provided by physicians in public sector facilities in Ghana, shedding light on existing barriers and identifying strategies for improvement.

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Evaluation of an ICD logging system to supplement an EMR in a Sub-Saharan country

Journal of Hospital Administration ◽

10.5430/jha.v7n2p8 ◽

2018 ◽

Vol 7 (2) ◽

pp. 8

Author(s):

Araba A. Wubah ◽

Jean A. Yankson ◽

Cameron Sumpter ◽

Fred Rawlins ◽

Dean Sutphin ◽

...

Keyword(s):

United States ◽

Developing Country ◽

Medical Center ◽

The United States ◽

Sub Saharan Africa ◽

World Health ◽

Medical Documentation ◽

The World ◽

Sub Saharan ◽

College Of Osteopathic Medicine

Adoption of electronic medical records (EMRs) has been spotty and sluggish in the world, including the United States, despite the multiple benefits of medical technology and informatics. Though there are difficulties in establishing and maintaining an EMR system in a developing country, it is not impossible. The International Classification of Diseases (ICD) Logger, called CREDO (Clinical Rotation Evaluation and Documentation Organizer), developed by Edward Via College of Osteopathic Medicine (VCOM), provides a straightforward, economical EMR system to use in a developing country, such as Ghana. However, with a recently established EMR system developed locally and being used at the target new hospital, Healthwise Medical Center, the aim of the study was to use the common medical documentation language of the World Health Organization (WHO) ICD-10 codes to add value to the local EMR. This demonstration enabled the comparison of medical encounters in Ghana to those in the United States, specifically in Appalachia where VCOM students typically do their clinical rotations. We also evaluated the issues and tested the CREDO ICD Logger as a simple, stand-alone EMR system. Therefore, by collecting ICD data twice weekly from Ghana, a data point in Sub-Saharan Africa, it became possible to compare a public health snapshot of developing countries and sites in the United States.

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Supporting COVID-19 Vaccine Rollout before Charter Class Arrives: The University of California, Irvine Experience

Pharmacy ◽

10.3390/pharmacy9040164 ◽

2021 ◽

Vol 9 (4) ◽

pp. 164

Author(s):

Alexandre Chan ◽

Melanie D. Joe ◽

Jan D. Hirsch

Keyword(s):

Interprofessional Education ◽

Large Scale ◽

Medical Center ◽

The United States ◽

University Of California ◽

Pharmaceutical Sciences ◽

Patient Centered ◽

Raising Awareness ◽

Centered Care ◽

The University

Despite numerous challenges in relation to being a recently established school, the University of California, Irvine (UCI) School of Pharmacy and Pharmaceutical Sciences (SPPS), similar to many schools of pharmacy in the United States, was highly committed to supporting the rollout of COVID-19 vaccines. UCI SPPS and our affiliated UCI Medical Center (UCIMC) Pharmacy Department partnered to spearhead the pharmacy element of a large-scale COVID-19 vaccination clinic on campus for both employees and the community. Three key initiatives were established in order to overcome the obstacles we faced in the large-scale roll out of COVID-19 vaccines: (1) forging new collaborations within the pharmacy team, (2) leveraging interprofessional education and practice, and (3) raising awareness of the pharmacists’ role. Our response to the COVID-19 vaccines at UCI was a tangible, visible model that demonstrated that, while we continue to embrace our role in team-based, patient-centered care, it is also important for us to step up and lead the profession. Additionally, this vaccine rollout experience is a teachable moment for our communities and our health professional partners as we continue to march forward as one voice to serve the American public.

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Enhancing patient-health care provider (HCP) communication in oncology care in the United States.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.99 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 99-99

Author(s):

Suzanne Lane ◽

Shelagh Szabo ◽

Ron Halbert ◽

Hans-Peter Goertz ◽

Catherine Lai ◽

...

Keyword(s):

Quality Care ◽

Qualitative Interviews ◽

The United States ◽

Patient Centered Care ◽

Communication Tool ◽

Patient Centered ◽

Communication Tools ◽

Patient Goals ◽

Centered Care ◽

The Impact

99 Background: Patient engagement is essential for high-quality care. This study aimed to develop novel communication tools to be used between patients and HCPs to address current gaps in cancer care. Methods: Qualitative interviews were conducted with 16 US patients with various cancers and stage, 6 oncology nurses, and 4 oncologists. Goals were to understand: patients’ changing concerns at diagnosis and during treatment; HCPs views on eliciting patient preferences; and perspectives from both on improving care. A thematic analysis was conducted to identify gaps in care. 8 patients rated their experience and importance of quality care items on a scale of 1 (not experienced/not important) to 5 (experienced/very important). Two draft tools were developed to address identified gaps. Results: None of the 16 patients reported using a communication tool before or during treatment. Gaps in quality care were identified, including communication, patient-centered care, education, and comprehensive care. Communication and patient-centered care items important to patients, but not always experienced, included clearly explained treatment options, time to discuss topics of concern, patient-led decision making, an open-minded care team, and the ability to change one’s mind (mean experience ≤ 4). The first tool assesses patient’s life and treatment goals and establishes early expectations through an open-ended questionnaire. This tool aims to enrich communication between patients and HCPs, enabling more patient-centered care. The second tool addresses the importance of ongoing education using a checklist. Treatment outcomes and the impact of treatment on QOL were identified as the two most important education items for patients when making treatment decisions (mean importance = 5). This tool aims to enhance educational discussions and enable patients to specify where more information is desired. Conclusions: Patients reported a need for communication tools at the beginning of treatment, specifically related to patient goals and educational needs. With patient and HCP input, two novel communication tools were developed to improve quality care. Future studies will validate and implement the tools in clinical practice.

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Patient Engagement in Research Design and Implementation: Moving From Infancy to Adolescence

Innovation in Aging ◽

10.1093/geroni/igaa057.2855 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 788-788

Author(s):

Carol Geary ◽

Martina Roes ◽

Katherine Abbott

Keyword(s):

Research Design ◽

Patient Engagement ◽

Stakeholder Engagement ◽

The United States ◽

Patient Centered ◽

Program Outcomes ◽

Rural Patient ◽

Centered Care ◽

Patient Engagement In Research ◽

The Impact

Abstract Patient (also referred to as User or Older Adult) engaged research is a unique approach to research design, implementation, and dissemination. The practice of engaged research, in its broader sense, involves service recipients, caregivers, clinicians, and other stakeholders in prioritization of research questions, approach, and practice translation to ensure strong stewardship of funds, valid and reliable methods, and practical application. Patient engaged research also aligns with tenets of person-centered care in the inclusive nature and the expectation that the practice will improve the processes and the outcomes of research. Likewise, GSA’s focus on diversity of thought through interdisciplinary work strongly aligns with inclusion of patient and stakeholder voices in the performance of interdisciplinary research. Although patient and stakeholder engagement in research is a new approach for many, globally, funders increasingly require evidence of “meaningful” engagement in project proposals. In the United States, the Patient-Centered Outcomes Research Institute (PCORI) is well-known for funding engaged research and the National Institute on Aging (NIA) has demonstrated use of “collaborative” methods central to patient engagement within the IMPACT Collaboratory. Patient engagement literature, while growing, does not yet provide adequate guidance for replication of current or development of new approaches to patient engagement in research. Therefore, the purpose of this symposium is to frame patient engagement through a historic lens (Roes) and discuss the ethics of engagement (O’Sullivan). In addition, we will share program outcomes from three patient engagement programs: the Leading Age LTSS Center, Rural Patient & Stakeholder Engagement, and Sages in Every Setting. Patient/Person Engagement in Research Interest Group Sponsored Symposium.

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Patient-Centered Care and People-Centered Health Systems in Sub-Saharan Africa: Why So Little of Something So Badly Needed?

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v6i3.591 ◽

2016 ◽

Vol 6 (3) ◽

pp. 162-173

Author(s):

Jeroen De Man ◽

Roy William Mayega ◽

Nandini Sarkar ◽

Evelyn Waweru ◽

Mart Leys ◽

...

Keyword(s):

Expert Knowledge ◽

Health Workers ◽

Analytical Framework ◽

Patient Centered Care ◽

Fine Tuning ◽

Sub Saharan Africa ◽

Actual Behavior ◽

Patient Centered ◽

Centered Care ◽

Sub Saharan

Patient–centered care (PCC) is increasingly recognized as a key dimension of quality healthcare, but unfortunately remains poorly implemented in practice. This paper explores the current state of PCC in sub-Saharan Africa and potential barriers to its implementation, with a focus on public first line health services. We develop an analytical framework based on expert knowledge, field experience, and a conceptual literature review. Factors contributing to the (lack of) implementation of PCC are structured in three distinct but interacting layers. The first layer encompasses factors that influence and shape the performance of providers. The training of health workers is key in that respect. Training models remain dominated by a biomedical perspective, with little attention for psychosocial dimensions of the illness experience. The second layer of determinants relates to the structural and organizational features of the health system. The emphasis in many African health care systems on specific programmatic outputs, and the subsequent pressure this creates on health workers, jeopardize the delivery of PCC. The third layer is related to the broader socioeconomic environment in which health workers operate. Noteworthy is the gap between the “official” norms in the public sector and the actual behavior of providers. We then propose possible avenues for change for each of these three layers. We conclude by arguing the need for further fine-tuning of the framework outlined in this paper, investing in the contextual validation of measurement tools for PCC, and testing solutions in a participatory action research framework.

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Conflicts in Biafra, Katanga and Cabinda as a result of the geopolitical legacy of colonialism

OOO Zhurnal Voprosy Istorii ◽

10.31166/voprosyistorii202010statyi60 ◽

2020 ◽

Vol 2020 (10-3) ◽

pp. 238-246

Author(s):

Olga Dzhenchakova

Keyword(s):

Democratic Republic ◽

Economic Factor ◽

Colonial Period ◽

Sub Saharan Africa ◽

Negative Consequences ◽

Post Colonial ◽

Republic Of The Congo ◽

Sub Saharan ◽

The Republic ◽

The Impact

The article considers the impact of the colonial past of some countries in sub-Saharan Africa and its effect on their development during the post-colonial period. The negative consequences of the geopolitical legacy of colonialism are shown on the example of three countries: Nigeria, the Democratic Republic of the Congo and the Republic of Angola, expressed in the emergence of conflicts in these countries based on ethno-cultural, religious and socio-economic contradictions. At the same time, the focus is made on the economic factor and the consequences of the consumer policy of the former metropolises pursuing their mercantile interests were mixed.

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