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05.07.2018 | Review

Barriers and facilitators to implementation of cancer treatment and palliative care strategies in low- and middle-income countries: systematic review

Zeitschrift:
International Journal of Public Health
Autoren:
Andrew Donkor, Tim Luckett, Sanchia Aranda, Jane Phillips
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00038-018-1142-2) contains supplementary material, which is available to authorized users.

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.

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Zusatzmaterial
Supplementary material 1 (DOCX 41 kb)
38_2018_1142_MOESM1_ESM.docx
Literatur
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