Financing Cancer Care in Low-Resource Settings

PURPOSE The aim of this study was to understand how telementoring and training through the ECHO model can build the cancer workforce and bring best practice cancer care to low-resource settings. METHODS The ECHO Institute launched a 5-year project to expand the use of the ECHO model to improve the capacity of local providers to bring cancer prevention, diagnostic, treatment, and survivorship knowledge to rural and underserved populations. The ECHO model leverages technology, telementoring, and case-based learning to connect rural populations to specialty cancer care, improve access to evidence-based therapies and practices, and provide state-of-the-art training and mentorship to build the cancer workforce, particularly in underserved regions. Through the ECHO model, local providers are paired with experts and doctors at National Cancer Institute–designated Comprehensive Cancer Care Centers and academic medical centers for ongoing training, technical assistance, and mentorship. Although originally developed to bring best practice care for hepatitis C to rural communities, the ECHO model is now being used to treat 70 conditions or topics globally. RESULTS Since 2016, the ECHO model has been replicated by 73 partner hubs in 13 countries that are operating 130 cancer programs focused on diverse cancer prevention and treatment topics, including increasing clinical trial enrollment, cancer control and best practices, cervical cancer prevention and treatment, tobacco cessation, and more. To date, 21 peer-reviewed publications have documented the ECHO model’s efficacy in improving the use of best practices in cancer care and expanding access to care in low-resource settings. CONCLUSION Use of the ECHO model to train and mentor local providers is building the cancer workforce and increasing capacity to address critical topics in cancer screening, diagnosis, care, and survivorship. The ECHO Institute is successfully strengthening the cancer health system and accelerating the transmission of best practice cancer care from cancer centers to health care workers in underserved communities.

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Overcoming Challenges of Holistic Cancer Care in Low-Resource Settings

Journal of Global Oncology ◽

10.1200/jgo.18.64700 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 174s-174s

Author(s):

E.S. Akintude ◽

I. Lawal ◽

A. Osinowo ◽

A. Okeremi

Keyword(s):

Cancer Patients ◽

Emotional Support ◽

Cancer Care ◽

Healthcare Professionals ◽

Healthcare Providers ◽

Cost Of Care ◽

Disruptive Effect ◽

Low Resource Settings ◽

Low Resource ◽

Program Policy

Background and context: Live does not remain the same after receiving the news of cancer in a family. Most people face some degree of depression, anxiety, fear or distress when cancer becomes part of their lives. The disruptive effect of cancer on family happiness is worsen by high cost of care, this is particularly relevant in low resource settings where health poverty is prevalent and most healthcare expenses are out of pocket. My family never remained the same from the point we received the diagnosis of colon cancer in my late husband. While I derive satisfaction in the knowledge that we fought the disease with everything we had up until the time of his death, I am however certain that the attendant stress would have been significantly lessened had healthcare providers availed us with all the necessary information required for us to cope with the condition. Consequently, Niola Cancer Care Foundation was conceptualized to bridge the identify gaps. Aim: To support healthcare providers in providing holistic care to cancer patients in low resource settings. Strategy/Tactics: Drawing largely from the experience and knowledge acquired during the care and management of my late husband and subsequent requests from careers of cancer patients for guidance, we conceptualized Cancer Assistance Network (CAN) with the aim of providing support to cancer patients and the carer to ease their challenges in accessing care in Nigeria. Program/Policy process: Cancer patients and their carers are recruited into the Cancer Assistance Network either through our routine hospital visits or by client-initiated contact. To facilitate individualization of support to suite individual patient's needs and requirements, the client requesting assistance is required to answer specific questions relating to the disease condition, treatment received so far and area of assistance required from Niola Cancer Care Foundation. Based on agreed criteria, the level of support that can be rendered is discussed. The support is categorized into 3 broad headings; financial, informational and emotional support. Outcomes: Finance is the primary reasons why most patients or their carer seek support from Niola Cancer Care Foundation. Unfortunately, most times we are not able to meet their financial requirements leading to initiation disappointment. We are however able to restore hope and confidence as we provide informational and emotional support. What was learned: Healthcare professionals for whatever reasons seems not to be comfortable discussing holistic cancer care with patients particularly those with advanced state requiring palliative care. Consequently, there is a disconnect between patients and healthcare professional's expectation of outcome. We are working with healthcare professionals to better understand factors responsible for poor communication of expected outcome between them and the patients.

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