Andrew Donkor1,2, Tim Luckett3, Sanchia Aranda3,4, Jane Phillips3. 1. Faculty of Health, IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, 2007, Australia. Andrew.Donkor@student.uts.edu.au. 2. National Centre for Radiotherapy, Korle-Bu Teaching Hospital, Accra, Ghana. Andrew.Donkor@student.uts.edu.au. 3. Faculty of Health, IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, 2007, Australia. 4. Cancer Council Australia, Sydney, NSW, Australia.
Abstract
OBJECTIVES: To appraise improvement strategies adopted by low- and middle-income countries to increase access to cancer treatments and palliative care; and identify the facilitators and barriers to implementation. METHODS: A systematic review was conducted and reported in accordance with PRISMA statement. MEDLINE, CINAHL, and the Cochrane Library databases were searched. Bias was assessed using the Standards for Quality Improvement Reporting Excellence, and evidence graded using the Australian National Health and Medical Research Council system. RESULTS: Of 3069 articles identified, 18 studied were included. These studies involved less than a tenth (n = 12, 8.6%) of all low- and middle-income countries. Most were case reports (58%), and the majority focused on palliative care (n = 11, 61%). Facilitators included: stakeholder engagement, financial support, supportive learning environment, and community networks. Barriers included: lack of human resources, financial constraints, and limited infrastructure. CONCLUSIONS: There is limited evidence on sustainable strategies for increasing access to cancer treatments and palliative care in low- and middle-income countries. Future strategies should be externally evaluated and be tailored to address service delivery; workforce; information; medical products, vaccines, and technologies; financing; and leadership and governance.
OBJECTIVES: To appraise improvement strategies adopted by low- and middle-income countries to increase access to cancer treatments and palliative care; and identify the facilitators and barriers to implementation. METHODS: A systematic review was conducted and reported in accordance with PRISMA statement. MEDLINE, CINAHL, and the Cochrane Library databases were searched. Bias was assessed using the Standards for Quality Improvement Reporting Excellence, and evidence graded using the Australian National Health and Medical Research Council system. RESULTS: Of 3069 articles identified, 18 studied were included. These studies involved less than a tenth (n = 12, 8.6%) of all low- and middle-income countries. Most were case reports (58%), and the majority focused on palliative care (n = 11, 61%). Facilitators included: stakeholder engagement, financial support, supportive learning environment, and community networks. Barriers included: lack of human resources, financial constraints, and limited infrastructure. CONCLUSIONS: There is limited evidence on sustainable strategies for increasing access to cancer treatments and palliative care in low- and middle-income countries. Future strategies should be externally evaluated and be tailored to address service delivery; workforce; information; medical products, vaccines, and technologies; financing; and leadership and governance.
Entities:
Keywords:
Chemotherapy; Low- and middle-income countries; Neoplasms; Palliative care; Radiotherapy; Surgery
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