Authors
- Andrew Donkor1,
- Andrew Donkor2,
- Tim Luckett1,
- Sanchia Aranda1,
- Sanchia Aranda3,
- Jane Phillips1
- University of Technology Sydney (UTS)1,
- National Centre For Radiotheraphy2,
- Cancer Council Australia3
2018
Excerpt
Professor Jane Phillips is the Director for IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney. She has extensive experience in delivering evidenced-based palliative care across diverse settings, including rural and regional Australia. She has led and evaluated complex health service reforms and a number of major cancer and palliative care reform initiatives at the local and national levels.
Background: Cancer incidence and mortality are rapidly increasing in low and middle income countries, but access to cancer treatments and palliative care remains limited. The aims of this systematic review were to: (i) appraise improvement strategies adopted by low and middle income countries to increase access to cancer treatments and palliative care; and (ii) identify the facilitators and barriers to implementation.
Methods: A systematic review was conducted and was reported in accordance with PRISMA statement. MEDLINE, CINAHL and the Cochrane Library were systematically searched using a combination of medical subject headings and keywords for low and middle income countries, cancer, treatment modalities, and healthcare delivery. Two reviewers independently coded the improvement strategies against the World health Organisation’s Innovative Care for Chronic Conditions framework. Synthesis took a narrative approach. 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 studies 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; health workforce; information; medical products, vaccines and technologies; financing; and leadership and governance gaps.
Background: Cancer incidence and mortality are rapidly increasing in low and middle income countries, but access to cancer treatments and palliative care remains limited. The aims of this systematic review were to: (i) appraise improvement strategies adopted by low and middle income countries to increase access to cancer treatments and palliative care; and (ii) identify the facilitators and barriers to implementation.
Methods: A systematic review was conducted and was reported in accordance with PRISMA statement. MEDLINE, CINAHL and the Cochrane Library were systematically searched using a combination of medical subject headings and keywords for low and middle income countries, cancer, treatment modalities, and healthcare delivery. Two reviewers independently coded the improvement strategies against the World health Organisation’s Innovative Care for Chronic Conditions framework. Synthesis took a narrative approach. 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 studies 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; health workforce; information; medical products, vaccines and technologies; financing; and leadership and governance gaps.