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

Andrew Donkor (), Tim Luckett, Sanchia Aranda and Jane Phillips
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Andrew Donkor: University of Technology Sydney
Tim Luckett: University of Technology Sydney
Sanchia Aranda: University of Technology Sydney
Jane Phillips: University of Technology Sydney

International Journal of Public Health, 2018, vol. 63, issue 9, No 8, 1047-1057

Abstract: 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.

Keywords: Neoplasms; Surgery; Radiotherapy; Chemotherapy; Palliative care; Low- and middle-income countries (search for similar items in EconPapers)
Date: 2018
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Citations: View citations in EconPapers (3)

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DOI: 10.1007/s00038-018-1142-2

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