Resolving disparities in access to cancer care in LMIC-positive learning using a 10-year-old model.

Authors

Dinesh Pendharkar

Dinesh Pendharkar

Sarvodaya Cancer Institute, Faridabad, India

Dinesh Pendharkar , Chandramauli Tripathi , Ashok Kumar Nagar

Organizations

Sarvodaya Cancer Institute, Faridabad, India, District Hospital, Ujjain, India, District Hospital, Jhalawar, India

Research Funding

No funding sources reported

Background: Despite significant advances in cancer diagnosis and treatment, there are wide disparities in access to cancer care, more so in low- and middle-income countries. The problem is multifactorial, such as patient-related, health system-related, socio-cultural-related to language and literacy, and socio-cultural-related to beliefs and stigma. These disparities extend across the cancer continuum, from diagnosis to end-of-life care. It is imperative to address these disparities. Here we report 10-year experience from an innovative access delivery model in one go, comprehensively addressing many of these challenges. Methods: Learning from the WHO framework of health system strengthening, a model that affects the major contributors to health system strengthening was developed. These include government-owned health departments, district hospitals, and physicians. Various regulations strengthened each of these components. The regulations were issued to create systems in district hospitals, train an alternative oncology workforce, and make oncology drugs available in the periphery. This measure allowed cancer-care-related services to be feasible in the existing peripheral health system. Results: In 2014, one of the states in India decided to initiate cancer care services in government-run district hospitals. One physician and two nurses from every district hospital were trained to offer cancer-related services locally from diagnosis to end-of-life, including cancer chemotherapy, under the 24 x7 mentorship of a senior oncologist. To date, more than 250 physicians and 500 nurses have been trained in this field. The program has been extended to eight states and 198 districts, covering an area of over a million square kilometers and a population of over 380 million. Data from only one district alone showed that nearly 7000 new patients availed of services (average 700 per year) with more than 17000 sessions of chemotherapy (Table). Conclusions: The majority of the world, including LMICs, is dependent on the services provided by government-run health institutions. The empowerment of government health systems appears to be the single most important factor in improving access to cancer care. This model of cancer cere delivery has consistently proven its robustness, replicability, and scalability. This finding deserves consideration for further research and expansion to other countries.

Cancer care services (year wise) provided by district hospital Ujjain.

YearChemotherapyPalliativeTotal IPDTotal OPDNew Patient
2014253-253388217
2015114416213061807477
2016105716413212026589
2017192413220563770658
2018236127126364244764
2019240344728504255798
2020272669334195336735
2021214856527133889642
20221530132828584245731
20231946125532014796789
Total17492501722613347566400

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2024 ASCO Breakthrough

Session Type

Poster Session

Session Title

Poster Session A

Track

Gastrointestinal Cancer,Central Nervous System Tumors,Developmental Therapeutics,Genitourinary Cancer,Quality of Care,Healthcare Equity and Access to Care,Population Health,Viral-Mediated Malignancies

Sub Track

Other Therapeutic Interventions

Citation

J Clin Oncol 42, 2024 (suppl 23; abstr 156)

DOI

10.1200/JCO.2024.42.23_suppl.156

Abstract #

156

Poster Bd #

J8

Abstract Disclosures

Similar Abstracts

First Author: Mary Mackrell

Abstract

2023 ASCO Annual Meeting

Evidence supporting innovative cancer care delivery model for overcoming health disparity.

First Author: Dinesh Pendharkar