scholarly journals Barriers to Implementing Clinical Pharmacogenetics Testing in Sub-Saharan Africa. A Critical Review

Pharmaceutics ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 809
Author(s):  
Emiliene B. Tata ◽  
Melvin A. Ambele ◽  
Michael S. Pepper
Keyword(s):  
Health Care ◽  
Large Scale ◽  
Ethical Issues ◽  
Care Delivery ◽  
Clinical Care ◽  
Cost Effective ◽  
Communicable Diseases ◽  
Sub Saharan Africa ◽  
Successful Implementation ◽  
Sub Saharan

Clinical research in high-income countries is increasingly demonstrating the cost- effectiveness of clinical pharmacogenetic (PGx) testing in reducing the incidence of adverse drug reactions and improving overall patient care. Medications are prescribed based on an individual’s genotype (pharmacogenes), which underlies a specific phenotypic drug response. The advent of cost-effective high-throughput genotyping techniques coupled with the existence of Clinical Pharmacogenetics Implementation Consortium (CPIC) dosing guidelines for pharmacogenetic “actionable variants” have increased the clinical applicability of PGx testing. The implementation of clinical PGx testing in sub-Saharan African (SSA) countries can significantly improve health care delivery, considering the high incidence of communicable diseases, the increasing incidence of non-communicable diseases, and the high degree of genetic diversity in these populations. However, the implementation of PGx testing has been sluggish in SSA, prompting this review, the aim of which is to document the existing barriers. These include under-resourced clinical care logistics, a paucity of pharmacogenetics clinical trials, scientific and technical barriers to genotyping pharmacogene variants, and socio-cultural as well as ethical issues regarding health-care stakeholders, among other barriers. Investing in large-scale SSA PGx research and governance, establishing biobanks/bio-databases coupled with clinical electronic health systems, and encouraging the uptake of PGx knowledge by health-care stakeholders, will ensure the successful implementation of pharmacogenetically guided treatment in SSA.

scholarly journals Rural Healthcare Delivery in Sub-Saharan Africa

2020 ◽  
Vol 15 (3) ◽  
pp. 1-21 ◽  
Author(s):  
Nasir Faruk ◽  
N.T. Surajudeen-Bakinde ◽  
Abubakar Abdulkarim ◽  
Abdulkarim Ayopo Oloyede ◽  
Lukman Olawoyin ◽  
...  
Keyword(s):  
Health Care ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Health Care Delivery System ◽  
Health Care Facilities ◽  
Sub Saharan Africa ◽  
World Health ◽  
Successful Implementation ◽  
Care Facilities ◽  
Sub Saharan

Access to quality healthcare is a major problem in Sub-Saharan Africa with a doctor-to-patient ratio as high as 1:50,000, which is far above the recommended ratio by the World Health Organization (WHO) which is 1:600. This has been aggravated by the lack of access to critical infrastructures such as the health care facilities, roads, electricity, and many other factors. Even if these infrastructures are provided, the number of medical practitioners to cater for the growing population of these countries is not sufficient. In this article, how information and communication technology (ICT) can be used to drive a sustainable health care delivery system through the introduction and promotion of Virtual Clinics and various health information systems such as mobile health and electronic health record systems into the healthcare industry in Sub-Saharan Africa is presented. Furthermore, the article suggests ways of attaining successful implementation of telemedicine applications /services and remote health care facilities in Africa.

scholarly journals Scaling-up health insurance through community- based health insurance schemes in rural sub- Saharan African communities

2013 ◽  
Vol 3 (1) ◽  
pp. 14 ◽  
Author(s):  
Ufuoma John Ejughemre
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Rural Communities ◽  
Care Delivery ◽  
Sub Saharan Africa ◽  
Community Based ◽  
Seek Health Care ◽  
Community Based Health Insurance ◽  
The Poor ◽  
Sub Saharan

Context: The knotty and monumental problem of health inequality and the high burden of diseases in sub-Saharan Africa bothers on the poor state of health of many of its citizens particularly in rural communities. These issues are further exacerbated by the harrowing conditions of health care delivery and the poor financing of health services in many of these communities. Against these backdrops, health policy makers in the region are not just concerned with improving peoples’ health but with protecting them against the financial costs of illness. What is important is the need to support more robust strategies for healthcare financing in these communities in sub-Saharan Africa. Objective: This review assesses the evidence of the extent to which community-based health insurance (CBHI) is a more viable option for health care financing amongst other health insurance schemes in rural communities in sub-Saharan Africa. Patterns of health insurance in sub-Saharan Africa: Theoretically, the basis for health insurance is that it allows for risk pooling and therefore ensures that resources follow sick individuals to seek health care when needed. As it were, there are different models such as social, private and CBHI schemes which could come to bear in different settings in the region. However, not all insurance schemes will come to bear in rural settings in the region. Community based health insurance: CBHI is now recognized as a community-initiative that is community friendly and has a wide reach in the informal sector especially if well designed. Experience from Rwanda, parts of Nigeria and other settings in the region indicate high acceptability but the challenge is that these schemes are still very new in the region. Recommendations and conclusion: Governments and international development partners in the region should collect- ively develop CBHI as it will help in strengthening health systems and efforts geared towards achieving the millennium development goals. This is because it is inextricably linked to the health care needs of the poor. 

scholarly journals Intervention studies for improving global health and health care: An important arena for epidemiologists

2009 ◽  
Vol 15 (2) ◽  
Author(s):  
Gunnar Kvåle ◽  
H. Sommerfelt ◽  
K. Fylkesnes
Keyword(s):  
Health Care ◽  
Large Scale ◽  
Intervention Studies ◽  
Care Delivery ◽  
Hiv Infections ◽  
Evidence Base ◽  
Health Problems ◽  
Sub Saharan Africa ◽  
Public Health Importance ◽  
Middle Income

Marginalised populations in many low- and middle-income countries experience an increasing burden of disease, in sub-Saharan Africa to a large extent due to faltering health systems and serious HIV epidemics. Also other poverty related diseases (PRDs) are prevalent, especially respiratory and diarrhoeal diseases in children, malnutrition, maternal and perinatal health problems, tuberculosis and malaria. Daily, nearly 30,000 children under the age of 5 die, most from preventable causes, and 8,000 people die from HIV infections. In spite of the availability of powerful preventive and therapeutic tools for combating these PRDs, their implementation, especially in terms of equitable delivery, leaves much to be desired. The research community must address this tragic gap between knowledge and implementation. Epidemiologists have a very important role to play in conducting studies on diseases that account for the largest share of the global disease burden. A shift of focus of epidemiologic research towards intervention studies addressing health problems of major public health importance for disadvantaged population groups is needed. There is a need to generate an evidence-base for interventions that can be implemented on a large scale; this can result in increased funding of health promotion programs as well as enable rational prioritization and integration between different health interventions. This will require close and synergetic teamwork between epidemiologists and other professions across disciplines and sectors. In this way epidemiologists can contribute significantly to improve health and optimise health care delivery for marginalized populations.

scholarly journals HEALTH EDUCATION AND COMMUNITY MOBILIZATION IN NIGERIA - ISSUES AND PROSPECTS

2020 ◽  
Author(s):  
Ekpomebe Elozino ◽  
Leonard E. Ananomo ◽  
Andrew Abanum Onome Vivian
Keyword(s):  
Health Care ◽  
Health Education ◽  
Health Care Delivery ◽  
Care Delivery ◽  
National Development ◽  
International Health ◽  
Community Mobilization ◽  
Sub Saharan Africa ◽  
International Health Organizations ◽  
Sub Saharan

The significance of health to national development and poverty eradication over the centuries, in that improving health status and increasing life expectancy adds to long term economic growth. This article examined the condition of health education and community mobilization in Nigeria's health care delivery. Health literacy is imperative to power and sustains government efforts in fostering health for all. Many developing countries, particularly those in Sub-Saharan Africa, in the 1970s witnessed remarkable and improper inequalities in the provision and delivery of health services. This contributed to and explained the exploration of diverse approaches to enhance health care delivery by international health organizations.

Patient Navigation and Cancer Care Delivery

2018 ◽  
Author(s):  
Harold P. Freeman ◽  
Melissa A. Simon
Keyword(s):  
Health Care ◽  
Cancer Care ◽  
Patient Navigation ◽  
Care Delivery ◽  
Clinical Care ◽  
Quality Care ◽  
Successful Implementation ◽  
Care Continuum ◽  
Patient Navigators ◽  
Health Care Delivery Systems

Although the US health care system offers the very best care to many, the poor and uninsured typically face challenges in accessing timely health care, even when faced with a life-threatening disease such as cancer. Spurred by unmet patient needs and the growing complexity of health care delivery systems, patient navigation seeks to diminish social, economic, cultural, and medical system barriers to timely quality care. This case study discusses the emergence of patient navigation as a strategy for improving cancer outcomes, especially among vulnerable populations. It explores challenges and opportunities related to advancing successful implementation of patient navigation across the cancer care continuum. It seeks to harness and apply the power and energy of patient navigators with the goal of guiding individuals across the health care continuum—from the communities where they live all the way through screening, diagnosis, and treatment at clinical care sites.

The Learning Health Care System and Ethics: Challenges and Opportunities

2019 ◽  
pp. 158-172
Author(s):  
Stephanie Morain ◽  
Nancy E. Kass ◽  
Ruth R. Faden
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Ethical Issues ◽  
Care Delivery ◽  
Clinical Care ◽  
Knowledge Generation ◽  
Data Generation ◽  
Ethical Challenges ◽  
Learning Health Care System ◽  
Care System

This chapter introduces the concept of a learning health care system (LHCS) and discusses the ethical issues that arise within the LHCS context. The LHCS has gained attention as an organizational innovation to improve the quality and efficiency of health care. In an LHCS, knowledge generation is built into the ongoing practice of clinical care, and findings based on this knowledge are continuously fed back to improve care delivery. The goals of an LHCS are arguably consistent with the moral obligation of health systems to improve quality, safety, and justice in health. However, the LHCS model also presents potential ethical challenges. This article discusses challenges related to continuous data generation, including maintaining privacy and confidentiality; obligations related to data on cost and quality; transparency to patients and other stakeholders; and data interoperability. It also describes issues related to the continued appropriateness of the research-practice distinction and implications for ethical oversight.

mHealth: Mobile Technologies to Virtually Bring the Patient Into an Oncology Practice

2017 ◽  
pp. 144-154 ◽  
Author(s):  
Nathan A. Pennell ◽  
Adam P. Dicker ◽  
Christine Tran ◽  
Heather S. L. Jim ◽  
David L. Schwartz ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Care Delivery ◽  
Clinical Care ◽  
Quality Care ◽  
Cost Effective ◽  
Mobile Technologies ◽  
Care Providers ◽  
Oncology Practice

Accompanied by the change in the traditional medical landscape, advances in wireless technology have led to the development of telehealth or mobile health (mHealth), which offers an unparalleled opportunity for health care providers to continually deliver high-quality care. This revolutionary shift makes the patient the consumer of health care and empowers patients to be the driving force of management of their own health through mobile devices and wearable technology. This article presents an overview of technology as it pertains to clinical practice considerations. Telemedicine is changing the way clinical care is delivered without regard for proximity to the patient, whereas nonclinical telehealth applications affect distance education for consumers or clinicians, meetings, research, continuing medical education, and health care management. Technology has the potential to reduce administrative burdens and improve both efficiency and quality of care delivery in the clinic. Finally, the potential for telehealth approaches as cost-effective ways to improve adherence to treatment is explored. As telehealth advances, health care providers must understand the fundamental framework for applying telehealth strategies to incorporate into successful clinical practice.

scholarly journals Pharmacogenomically actionable medications in a safety net health care system

2016 ◽  
Vol 4 ◽  
pp. 205031211562433 ◽  
Author(s):  
Janet S Carpenter ◽  
Marc B Rosenman ◽  
Mitchell R Knisely ◽  
Brian S Decker ◽  
Kenneth D Levy ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Large Scale ◽  
Clinical Care ◽  
Safety Net ◽  
Successful Implementation ◽  
Pharmacogenetic Testing ◽  
Number Of Patients ◽  
Wide Scale ◽  
Care System

Objective: Prior to implementing a trial to evaluate the economic costs and clinical outcomes of pharmacogenetic testing in a large safety net health care system, we determined the number of patients taking targeted medications and their clinical care encounter sites. Methods: Using 1-year electronic medical record data, we evaluated the number of patients who had started one or more of 30 known pharmacogenomically actionable medications and the number of care encounter sites the patients had visited. Results: Results showed 7039 unique patients who started one or more of the target medications within a 12-month period with visits to 73 care sites within the system. Conclusion: Findings suggest that the type of large-scale, multi-drug, multi-gene approach to pharmacogenetic testing we are planning is widely relevant, and successful implementation will require wide-scale education of prescribers and other personnel involved in medication dispensing and handling.

scholarly journals Hearing health-care delivery in sub-Saharan Africa – a role for tele-audiology

2009 ◽  
Vol 16 (2) ◽  
pp. 53-56 ◽  
Author(s):  
De Wet Swanepoel ◽  
Bolajoko O Olusanya ◽  
Maurice Mars
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Health Care Services ◽  
Care Delivery ◽  
Developmental Outcomes ◽  
Sub Saharan Africa ◽  
World Health ◽  
Pilot Studies ◽  
Hearing Health ◽  
Sub Saharan

Hearing loss is the most prevalent chronic disability and a major contributor to the global burden of disease. Its effects are far-reaching and can lead to severely restricted developmental outcomes for children and limited vocational prospects for adults. The benefits of intervention are dramatic and can significantly improve developmental outcomes, especially in infants identified early. Hearing health-care services in developing regions such as sub-Saharan Africa are however severely limited, leaving affected individuals without access to secondary and tertiary intervention. Tele-audiology has potential for improved access to specialist hearing health services including identification, diagnosis and intervention. There has been limited experience so far with tele-audiology in industrialized countries. In the sub-Saharan region, the continued growth in Internet connectivity and general technological advances make tele-audiology an important approach to consider in the management of hearing loss. Pilot studies are warranted to investigate the potential obstacles to the widespread implementation of telehealth in the delivery of hearing health care in poorly-resourced communities, in line with World Health Organization initiatives.

scholarly journals A Seminar Paper on the Review of Five well-known Medicinal Plants Used in Ethiopia

2021 ◽  
pp. 51-56
Author(s):  
Gadissa Melkamu Bulcha
Keyword(s):  
Health Care ◽  
Medicinal Plants ◽  
Care Delivery ◽  
Zingiber Officinale ◽  
Sub Saharan Africa ◽  
Moringa Stenopetala ◽  
Plant Medicine ◽  
Sub Saharan ◽  
Livestock Health

The indigenous knowledge of medicinal plants appeared when humans started and learned how to use the traditional knowledge of medicinal plants. The various literature available shows the significant role of medicinal plants in primary health care delivery in Ethiopia (about 70% of humans and 90% of livestock population) depend on traditional plant medicine. This is similar to many developing countries, particularly with those countries in Sub-saharan Africa. Medicinal plants provide a vital contribution to human and livestock health care. This seminar review was an attempt to present five medicinal plants (citrus lemon, caricapapaya, Moringa stenopetala, Allium sativum, Zingiber officinale).

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