Understanding the challenges of delivering radiotherapy in low- and middle-income countries in Africa

作者：Taofeeq Abdallah Ige, Philippa Lewis, C. Shelley, David A Pistenmaa, C. Norman Coleman, Ajay Kumar Aggarwal, Manjit K. Dosanjh, Saad Khoudri, Ismail Zergoug, Higidio Miezi Eduardo, Memory Fadziso Bvochora-Nsingo, Kuhle Fulu, Tlotlo Bathethi Ralefala, Surbhi Grover, Anne Marthe Maison-Mayeh, Samba Richard Ndi, Ehab M. Attalla, Nashaat Ahmed Deiab, Eskadmas Yinesu Belay, George Felix Acquah, Emmanuel Amankwaa-Frempong, Hubert Foy, Ejidio Ngigi, Fadwa Badi, Ihab Elburi, Tovo Harivony, Aphousalle Kone, Siaka Maiga, Ahmedou Tolba, Seeven Mootoosamy, Salwa El-Boutayeb, Ainadine Momade, Wilfred Midzi, Melanie Hester Grobler, Simeon Chinedu Aruah, Kra Joel, Magatte Diagne, Christoph Jan Trauernicht, Fawzia E. M. Elbashir, Nadir Abd Ellatif Ali, Hellen Makwani, Shaid Yusufu, Leila Charrada-Ben Farhat, Besbes Mounir, Awusi Kavuma, Godfrey Azangwe · 发表于：Journal of Cancer Policy · 年份：2022 · DOI：10.1016/j.jcpo.2022.100372 · 被引用次数：33 · 研究领域：Advances in Oncology and Radiotherapy、Global Health and Surgery、Advanced Radiotherapy Techniques

BACKGROUND: Access to high quality radiotherapy (RT) continues to be a major issue across Africa with Africa having just 34% of its optimal capacity. METHODS: We co-developed a survey with clinical, academic and policy stakeholders designed to provide a structured assessment of the barriers and enablers to RT capacity building in Africa. The survey covered nine key themes including funding, procurement, education and training. The survey was sent to RT professionals in 28 countries and the responses underwent qualitative and quantitative assessment. RESULTS: We received completed questionnaires from 26 African countries. Funding was considered a major issue, specifically the lack of a ring fenced funds from the Ministry of Health for radiotherapy and the consistency of revenue streams which relates to a lack of prioritisation for RT. In addition to a significant shortfall in RT workforce disciplines, there is a general lack of formal education and training programmes. 13/26 countries reported having some IAEA support for RT for education and training. Solutions identified to improve access to RT include a) increasing public awareness of its essential role in cancer treatment; b) encouraging governments to simplify procurement and provide adequate funding for equipment; c) increasing training opportunities for all radiotherapy disciplines and d) incentivizing staff retention. CONCLUSION: This survey provides unique information on challenges to delivering and expanding radiothe...