scholarly journals How can we Prove that Tumor Board is a Mandatory Component of High Quality Cancer Care?

2020 ◽  
Vol 5 (2) ◽  
pp. 58-59
Author(s):  
Ahmed Nadeem Abbasi ◽  
◽  
Sehrish Abrar ◽  
Benazir Mir Khan ◽  
◽  
...  
Keyword(s):  
Tumor Board ◽  
Board Meeting ◽  
High Quality ◽  
Middle Income ◽  
Site Specific ◽  
Middle Income Countries ◽  
Cancer Management ◽  
Quality Cancer Care ◽  
Published Evidence ◽  
A Site

Before embarking upon the first modality of cancer management, it is advisable to thoughrouly discuss the patients case in a site specific multidisciplinary tumor board meeting. These meetings are a necessary requirement for a high quality comprehensive cancer service. Published evidence reveals a positive relationship in the form of treatment outcomes. The outcomes are being measured in terms ofs of survival and local control of malignancies for patients who were discussed and deliberated nary tumour boards [1, 2]. These boards are vitally essential for the services offered in Low and Middle Income countries as we regard them as the lifeline for our cancer patients [3].

scholarly journals Evaluating Barriers and Opportunities in Delivering High-Quality Oncology Care in a Resource-Limited Setting Using a Comprehensive Needs Assessment Tool

2018 ◽  
pp. 1-9
Author(s):  
Chika R. Nwachukwu ◽  
Omobola Mudasiru ◽  
Lynn Million ◽  
Shruti Sheth ◽  
Hope Qamoos ◽  
...  
Keyword(s):  
Palliative Care ◽  
Needs Assessment ◽  
Cancer Care ◽  
Assessment Tool ◽  
Hospital Staff ◽  
Teaching Hospitals ◽  
High Quality ◽  
Middle Income ◽  
Quality Cancer Care ◽  
Oncology Care

Purpose Despite recognition of both the growing cancer burden in low- and middle-income countries and the disproportionately high mortality rates in these settings, delivery of high-quality cancer care remains a challenge. The disparities in cancer care outcomes for many geographic regions result from barriers that are likely complex and understudied. This study describes the development and use of a streamlined needs assessment questionnaire (NAQ) to understand the barriers to providing quality cancer care, identifies areas for improvement, and formulates recommendations for implementation. Methods Using a comprehensive NAQ, in-depth interviews were conducted with 17 hospital staff involved in cancer care at two teaching hospitals in Nigeria. Data were analyzed using content analysis and organized into a framework with preset codes and emergent codes, where applicable. Results Data from the interviews were organized into six broad themes: staff, stuff, system, space, lack of palliative care, and provider bias, with key barriers within themes including: financial, infrastructural, lack of awareness, limited human capacity resources, lack of palliative care, and provider perspective on patient-related barriers to cancer care. Specific solutions based on ability to reasonably implement were subcategorized into short-, medium-, and long-term goals. Conclusion This study provides a framework for a streamlined initial needs assessment and a unique discussion on the barriers to high-quality oncology care that are prevalent in resource-constrained settings. We report the feasibility of collecting and organizing data using a streamlined NAQ and provide a thorough and in-depth understanding of the challenges in this setting. Knowledge gained from the assessments will inform steps to improve oncology cancer in these settings.

scholarly journals Much research, but little learned to date: A scoping review on mental health of health workers in low- and lower-middle income countries and roadmap for future research

2021 ◽  
Author(s):  
Julia Lohmann ◽  
Denny John ◽  
Aso Dzay
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Health Workers ◽  
Tertiary Care ◽  
Psychological Wellbeing ◽  
Future Research ◽  
Measurement Tool ◽  
High Quality ◽  
Middle Income ◽  
Middle Income Countries

Abstract BackgroundSARS-CoV-2 has resulted in unprecedented research efforts on health workers’ work realities and their potential mental health impacts. To understand the latter, high-quality evidence on the baseline situation is paramount. With the aim of providing a comprehensive overview of existing evidence and to inform future research, we undertook a scoping review of the quantitative literature on mental health and psychological wellbeing of clinical skilled healthcare personnel working in all settings of care in low- and lower-middle income countries (LLMIC).MethodsWe performed a systematic search of the literature up to the end of 2019, in English or French language, in MEDLINE, EMBASE, PsychINFO, Global Health, and CAIRN. We included both studies estimating levels of mental health and studies investigating associations with other factors. We extracted data on study characteristics and methodology, and assessed the methodological quality of the included studies along nine criteria.ResultsWe found 143 relevant studies, 135 including data on mental health levels and 126 including data on associations with other factors. The studies covered 26 of the world’s 78 LLMICs, with most studies conducted in India, Nigeria, Pakistan, or Egypt, in urban secondary- and tertiary-care settings. 67% of studies assessed burnout, 25% general psychological wellbeing, and 20% other mental health outcomes. Only 19% of studies were of high quality due to shortcomings particularly in regards to sample representativeness, context-specific measurement tool validity, and reporting of methodological detail. We found much heterogeneity in investigated associated factors. Studies focused almost exclusively on potential determinants of mental health, while none linked mental health to objectively measured performance outcomes.ConclusionWe conclude that despite its impressive size, we can learn comparatively little from the current body of literature. Based on our findings, we outline areas for expansion, methodological improvement, and standardization of reporting in future research on mental health of health workers.Systematic review registrationPROSPERO no. CRD42019140036

scholarly journals Looking ahead in the COVID-19 pandemic: emerging lessons learned for sexual and reproductive health services in low- and middle-income countries

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Aduragbemi Banke-Thomas ◽  
Sanni Yaya
Keyword(s):  
Reproductive Health ◽  
Service Provision ◽  
Sexual And Reproductive Health ◽  
Lessons Learned ◽  
Safe Abortion ◽  
Middle Income ◽  
Health Service Provision ◽  
Middle Income Countries ◽  
Published Evidence ◽  
Low And Middle Income

AbstractThe COVID-19 pandemic has caused widespread disruption to essential health service provision globally, including in low- and middle-income countries (LMICs). Recognising the criticality of sexual and reproductive health (SRH) services, we review the actual reported impact of the COVID-19 pandemic on SRH service provision and evidence of adaptations that have been implemented to date. Across LMICs, the available data suggests that there was a reduction in access to SRH services, including family planning (FP) counselling and contraception access, and safe abortion during the early phase of the pandemic, especially when movement restrictions were in place. However, services were quickly restored, or alternatives to service provision (adaptations) were explored in many LMICs. Cases of gender-based violence (GBV) increased, with one in two women reporting that they have or know a woman who has experienced violence since the beginning of the pandemic. As per available evidence, many adaptations that have been implemented to date have been digitised, focused on getting SRH services closer to women. Through the pandemic, several LMIC governments have provided guidelines to support SRH service delivery. In addition, non-governmental organisations working in SRH programming have played significant roles in ensuring SRH services have been sustained by implementing several interventions at different levels of scale and to varying success. Most adaptations have focused on FP, with limited attention placed on GBV. Many adaptations have been implemented based on guidance and best practices and, in many cases, leveraged evidence-based interventions. However, some adaptations appear to have simply been the sensible thing to do. Where evaluations have been carried out, many have highlighted increased outputs and efficiency following the implementation of various adaptations. However, there is limited published evidence on their effectiveness, cost, value for money, acceptability, feasibility, and sustainability. In addition, the pandemic has been viewed as a homogenous event without recognising its troughs and waves or disentangling effects of response measures such as lockdowns from the pandemic itself. As the pandemic continues, neglected SRH services like those targeting GBV need to be urgently scaled up, and those being implemented with any adaptations should be rigorously tested.

The Role of Artificial Intelligence (AI) in Cancer Treatment in Low-Middle Income Countries: The Watson for Oncology (WfO) Experience (Preprint)

2021 ◽  
Author(s):  
Angela Rui ◽  
Srinivas Emani ◽  
Hermano Alexandre Lima Rocha ◽  
Rubina F. Rizvi ◽  
Sergio Ferreira Juaçaba ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Cancer Treatment ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Cultural Barriers ◽  
Successful Implementation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cancer Management ◽  
Low Middle Income Countries

UNSTRUCTURED As technology continues to improve, healthcare systems have the opportunity to utilize a variety of innovative tools for decision making that extend beyond traditional clinical decision support systems (CDSSs). The feasibility and efficacy integrating artificial intelligence (AI) systems into medical practice has shown variable success, especially in resource-poor areas. In this paper, we cover the existing challenges surrounding cancer treatment in low-middle income countries (LMICs). By focusing on the implementation of an AI-based CDSS for oncology, we aim to demonstrate how AI can be both beneficial and challenging for cancer management globally. Additionally, we summarize current physician perspectives from China, India, Brazil, Thailand, and Mexico in regard to their experiences and recommendations for improving the system. By doing so, we hope to highlight the need for additional research on user experience and unique cultural barriers for the successful implementation of AI in LMICs.

scholarly journals Core outcome set in paediatric sepsis in low- and middle-income countries: a study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e034960
Author(s):  
Gavin Wooldridge ◽  
Srinivas Murthy ◽  
Niranjan Kissoon
Keyword(s):  
Study Protocol ◽  
Core Outcome Set ◽  
Core Outcome ◽  
High Quality ◽  
Middle Income ◽  
Ongoing Research ◽  
Middle Income Countries ◽  
Outcome Set ◽  
Low Middle Income Countries ◽  
Low And Middle Income

IntroductionSepsis is the leading cause of death in children worldwide and has recently been declared a major global health issue. New interventions and a concerted effort to enhance our understanding of sepsis are required to address the huge burden of disease, especially in low- and middle-income countries (LMIC) where it is highest. An opportunity therefore exists to ensure that ongoing research in this area is relevant to all stakeholders and is of consistently high quality. One method to address these issues is through the development of a core outcome set (COS).Methods and analysisThis study protocol outlines the phases in the development of a core outcome set for paediatric sepsis in LMIC. The first step involves performing a systematic review of all outcomes reported in the research of paediatric sepsis in low middle-income countries. A three-stage international Delphi process will then invite a broad range of participants to score each generated outcome for inclusion into the COS. This will include an initial two-step online survey and finally, a face-to-face consensus meeting where each outcome will be reviewed, voted on and ratified for inclusion into the COS.Ethics and disseminationNo core outcome sets exist for clinical trials in paediatric sepsis. This COS will serve to not only highlight the heavy burden of paediatric sepsis in this setting and aid collaboration and participation between all stakeholders, but to promote ongoing essential high quality and relevant research into the topic. A COS in paediatric sepsis in LMIC will advocate for a common language and facilitate interpretation of findings from a variety of settings. A waiver for ethics approval has been granted by University of British Columbia Children’s and Women’s Research Ethics Board.

scholarly journals Environmental transmission of diarrheal pathogens in low and middle income countries

2016 ◽  
Vol 18 (8) ◽  
pp. 944-955 ◽  
Author(s):  
Timothy R. Julian
Keyword(s):  
Disease Transmission ◽  
Diarrheal Disease ◽  
Diarrheal Diseases ◽  
Environmental Interventions ◽  
Middle Income ◽  
Site Specific ◽  
Environmental Transmission ◽  
Middle Income Countries ◽  
Specific Factors ◽  
Low And Middle Income

Globally more than half a million children die every year from diarrheal diseases. ThisPerspectivesuggests that reductions in diarrheal disease transmission in LMICs can be achieved by accounting for site-specific factors when designing environmental interventions. This is discussed in the context of the characteristics of the most important diarrheal diseases as well as environmental reservoirs.

scholarly journals Realist Synthesis of the International Theory and Evidence on Strategies to Improve Childhood Vaccination in Low- and Middle-Income Countries: Developing Strategies for the Nigerian Healthcare System

2019 ◽  
Author(s):  
Oluwadamilola Solabi Omoniyi ◽  
Iestyn Williams
Keyword(s):  
Healthcare System ◽  
Vaccination Coverage ◽  
Realist Synthesis ◽  
Childhood Vaccination ◽  
Routine Immunisation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Published Evidence ◽  
Social Mobilisation ◽  
Low And Middle Income

Background: Childhood vaccination coverage rates in low- and middle-income countries (LMICs) vary significantly, with some countries achieving higher rates than others. Several attempts have been made in Nigeria to achieve universal vaccination coverage but with limited success. This study aimed to analyse strategies used to improve childhood vaccine access and uptake in LMICs in order to inform strategy development for the Nigerian healthcare system. Methods: A realist synthesis approach was adopted in order to elucidate the contexts and mechanisms wherewith these strategies achieved their aim (or not). Nine databases were searched for relevant articles and 27 articles were included in the study. Programme theories were generated from the included articles, and data extraction was carried out paying particular attention to context, mechanism and outcomes configurations. Results: Interventions used in LMICs to improve vaccination coverage were categorised as follows: communication/ educational, reminder-type, incentives, social mobilisation, provider-directed strategies, health service integration and multi-pronged strategies. The strategies that appeared most likely to be effective in the health contexts of contemporary Nigeria include communication and educational interventions; employing informal change agents, and; monitoring and evaluation to strengthen communication. The programme theories for the use of reminders, social mobilisation, staff training and supportive supervision were observed in practice, and these strategies were generally successful within some contexts. By contrast, the use of monetary incentives in Nigeria is not supported by the evidence, although further research and evaluation is required. The integration of other interventions with routine immunisation (RI) to improve uptake was more effective when the perceived value of the other program was high. Adoption of multipronged interventions for hard to reach communities was beneficial. However, caution should be exercised because of varying levels of published evidence in respect of each intervention type and a relative lack of the rich description required to conduct a full realist analysis. Conclusion: This paper adds to the evidence base on the adaption of strategies to improve vaccine access and uptake to the context of LMICs.

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