scholarly journals Structural Barriers to Diagnosis and Treatment of Cancer in Low- and Middle-Income Countries: The Urgent Need for Scaling Up

2016 ◽  
Vol 34 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Eduardo Cazap ◽  
Ian Magrath ◽  
T. Peter Kingham ◽  
Ahmed Elzawawy

Noncommunicable diseases are now recognized by the United Nations and WHO as a major public health crisis. Cancer is a main part of this problem, and health care systems are facing a great challenge to improve cancer care, control costs, and increase systems efficiency. The disparity in access to care and outcomes between high-income countries and low- and middle-income countries is staggering. The reasons for this disparity include cost, access to care, manpower and training deficits, and a lack of awareness in the lay and medical communities. Diagnosis and treatment play an important role in this complex environment. In different regions and countries of the world, a variety of health care systems are in place, but most of them are fragmented or poorly coordinated. The need to scale up cancer care in the low- and middle-income countries is urgent, and this article reviews many of the structural mechanisms of the problem, describes the current situation, and proposes ways for improvement. The organization of cancer services is also included in the analysis.

2020 ◽  
Vol 98 (11) ◽  
pp. 781-791 ◽  
Author(s):  
Etienne V Langlois ◽  
Andrew McKenzie ◽  
Helen Schneider ◽  
Jeffrey W Mecaskey

Author(s):  
Marni Sommer ◽  
Garrison Daly ◽  
Caroline Kabiru ◽  
Pema Lhaki ◽  
Neville Okwaro ◽  
...  

AbstractThe very young adolescent population (ages 10–14) is currently under-served by health care systems, particularly in low- and middle-income countries. Although there is a substantial and growing effort to reach adolescents with the health services and commodities they need, such efforts often overlook the period of early adolescence given this population’s lower vulnerability to risk-taking behaviors. However, early adolescence is a period of significant change, with the onset of puberty introducing physiological, emotional, and social changes in girls’ and boys’ lives. This period also represents a time of intensifying gendered norms, and the transition of youth from childhood focused health care (e.g. deworming programs, nutrition interventions) to additional mid- and older adolescent related care [e.g. human papilloma virus (HPV) vaccine, and contraceptive provision). Strengthening young adolescents’ engagement with health care workers around preventative and promotive health behaviors could have profound impacts on their health and wellbeing, which in turn could have cascading effects across the course of their lives. Critically, young adolescents would gain trust in health care systems, and be more likely to return when significant health issues arise later in adolescence or adulthood. Such an effort requires sensitizing health care workers and building their capacity to respond to young adolescents’ unique needs, by defining a package of actions that they are mandated to provide, training them, providing them with desk reference tools, and putting in place systems to provide supportive supervision and collaborative learning on the one hand, and encouraging caregivers to connect their pubescent-aged boys and girls with the health care system, on the other hand. This paper presents an argument for increased focus in particular on building attitudes and capacities of health care workers on engaging with early adolescents, applying Principle 3 of the Society of Adolescent Medicine’s position paper entitled “Health Care Reform and Adolescents.”


2009 ◽  
Vol 4 (2) ◽  
pp. 179-193 ◽  
Author(s):  
DI MCINTYRE ◽  
MICHAEL THIEDE ◽  
STEPHEN BIRCH

Abstract:Although access to health care is frequently identified as a goal for health care policy, the precise meaning of access to health care often remains unclear. We present a conceptual framework that defines access to health care as theempowermentof an individual to use health care and as a multidimensional concept based on the interaction (or degree of fit) between health care systems and individuals, households, and communities. Three dimensions of access are identified: availability, affordability, and acceptability, through which access can be evaluated directly instead of focusing on utilisation of care as a proxy for access. We present the case for the comprehensive evaluation of health care systems as well as the dimensions of access, and the factors underlying each dimension. Such systemic analyses can inform policy-makers about the ‘fit’ between needs for health care and receipt of care, and provide the basis for developing policies that promote improvements in the empowerment to use care.


2020 ◽  
pp. 906-912 ◽  
Author(s):  
Roselle De Guzman ◽  
Monica Malik

Coronavirus or COVID-19 is caused by severe acute respiratory syndrome coronavirus 2. The COVID-19 pandemic has resulted in social and economic disruption throughout the entire world. Each country is being challenged. Although much of the world’s focus has been on the rapid spread in Italy, Spain, and the United States, the potential impact on the world’s poor, a majority of whom are living in Asia, could be devastating. Asia has the world’s most densely populated cities, and its developing countries are facing challenges in their socioeconomic and health care systems. COVID-19 is quickly overwhelming the fragile and overstretched health systems of low- and low- to middle-income countries. With its aging population having chronic diseases and the growing burden of cancer, Asia is facing the dual challenge of controlling the spread of COVID-19 and at the same time providing and maintaining cancer care.


2020 ◽  
Vol 5 (4) ◽  
pp. 267-287
Author(s):  
Heba Nassar ◽  
Hala Sakr ◽  
Asmaa Ezzat ◽  
Pakinam Fikry

Purpose This paper aims to evaluate the technical efficiency of the health-care systems in 21 selected middle-income countries during the period (2000–2017) and determine the source of inefficiency whether it is transient (short run) or persistent (long run). Design/methodology/approach The study uses the stochastic frontier analysis technique through employing the generalized true random effects model which overcomes the drawbacks of the previously introduced stochastic frontier models and allows for the separation between unobserved heterogeneity, persistent inefficiency and transient inefficiency. Findings Persistent efficiency is lower than the transient efficiency; hence, there are more efficiency gains that can be made by the selected countries by adopting long-term policies that aim at reforming the structure of the health-care system in the less efficient countries such as South Africa and Russia. The most efficient countries are Vietnam, Mexico and China which adopted a social health insurance that covers almost the whole population with the aim of increasing access to health-care services. Also, decentralization in health-care has assisted in adopting health-care policies that are suitable for both the rural and urban areas based on their specific conditions and health-care needs. A key success in the implementation of the adopted long-term policies by those countries is the continuous monitoring and evaluation of their outcomes and comparing them with the predefined targets and conducting any necessary modifications to ensure their movement in the right path to achieve their goals. Originality/value Although several studies have evaluated the technical efficiency both across and within countries using non-parametric (data envelopment analysis) and parametric (stochastic frontier analysis) approaches, to the best of the authors’ knowledge, this is the first attempt to evaluate the technical efficiency of selected middle-income countries during the period (2000–2017) using the generalized true random effects stochastic frontier analysis model.


2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Arafat Tfayli ◽  
Sally Temraz ◽  
Rachel Abou Mrad ◽  
Ali Shamseddine

Breast cancer is a major health care problem that affects more than one million women yearly. While it is traditionally thought of as a disease of the industrialized world, around 45% of breast cancer cases and 55% of breast cancer deaths occur in low and middle income countries. Managing breast cancer in low income countries poses a different set of challenges including access to screening, stage at presentation, adequacy of management and availability of therapeutic interventions. In this paper, we will review the challenges faced in the management of breast cancer in low and middle income countries.


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