Background Breast cancer patients in sub-Saharan Africa experience long time intervals between their first presentation to a health care facility and the start of cancer treatment. The role of the health system in the increasing treatment time intervals has not been widely investigated. This review aimed to identify existing information on health system factors that influence diagnostic and treatment intervals in women with breast cancer in sub-Saharan Africa to contribute to the reorientation of health policies in the region. Methods PubMed, ScienceDirect, African Journals Online, Mendeley, ResearchGate and Google Scholar were searched to identify relevant studies published between 2010 and July 2020. We performed a qualitative synthesis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Related health system factors were extracted and classified according to the World Health Organization’s six health system building blocks. The quality of qualitative and quantitative studies was assessed by using the Critical Appraisal Skills Program Quality-Assessment Tool and the National Institute of Health Quality Assessment Tool, respectively. In addition, we used the Confidence in the Evidence from Reviews of Qualitative Research tool to assess the evidence for each qualitative finding. Results From 14,184 identified studies, this systematic review included 28 articles. We identified a total of 36 barriers and 8 facilitators that may influence diagnostic and treatment intervals in women with breast cancer. The principal health system factors identified were mainly related to human resources and service delivery, particularly difficulty accessing health care, diagnostic errors, poor management, and treatment cost. Conclusion The present review shows that diagnostic and treatment intervals among women with breast cancer in sub-Saharan Africa are influenced by many related health system factors. Policy makers in sub-Saharan Africa need to tackle the financial accessibility to breast cancer treatment by adequate universal health coverage policies and reinforce the clinical competencies for health workers to ensure timely diagnosis and appropriate care for women with breast cancer in this region.

This cross-sectional study examines why people in French-speaking regions of Belgium who initially resisted getting the COVID-19 vaccine eventually chose to get vaccinated.

BackgroundBreast cancer patients in sub-Saharan Africa experience long delays between their first presentation to a health care facility and the start of cancer treatment. The role of the health system in the increasing delays in treatment has not been widely investigated. This review aimed to identify existing information on health system factors that influence treatment delays in women with breast cancer in sub-Saharan Africa to contribute to the reorientation of health policies in the region.MethodsPubMed, ScienceDirect, African Journals Online, Mendeley, ResearchGate and Google Scholar were searched to identify relevant studies published between 2010 and July 2020. We performed a qualitative synthesis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Related health system factors were extracted and classified according to the World Health Organization’s six health system building blocks. The quality of qualitative and quantitative studies was assessed by using the Critical Appraisal Skills Program quality-assessment tool and the National Institute of Health Quality Assessment Tool, respectively. In addition, we used the Confidence in the Evidence from Reviews of Qualitative Research tool to assess the evidence for each qualitative finding.ResultsFrom 14,184 identified studies, this systematic review included 28 articles. We identified a total of 36 barriers and 8 facilitators that may influence treatment delay in women with breast cancer. The principal health system factors identified were mainly related to human resources and service delivery, particularly difficulty accessing health care, diagnostic errors, poor management, and treatment cost.ConclusionThe present review shows that treatment delay among women with breast cancer in sub-Saharan Africa is influenced by many related health system factors. Policy makers in sub-Saharan Africa need to tackle the financial accessibility to breast cancer treatment by adequate universal health coverage policies and reinforce the clinical competencies for health workers to ensure timely diagnosis and appropriate care for women with breast cancer in this region.

Introduction : Diabetes is a constantly evolving chronic disease, with a prevalence of 8.5% in 2014 compared to 4.7% in 1980 corresponding to 422 million the number of adults living with diabetes in 2014, compared to 108 million in 1980. Its early management is necessary to avoid these disastrous complications. Thus, Primary Health Care Establishments are the first gateway for this care. It is essential to describe the profile of this management at local level for diabetes control measures adapted to the local population.Objective : This study aims to describe the epidemiological and therapeutic profile of diabetes at the Primary Health Care Establishments level in the prefecture of Sidi Bernoussi during the year 2018.Methodology: We carried out a descriptive observation study based on data from the 4 quarterly epidemiological surveillance reports for diabetics in the year 2018. Including all diabetics screened and cared for at public health of the prefecture of SIDI BERNOUSSI during the year 2018.Results : The proportion of prevalent cases at Sidi Bernoussi's primary health care establishments level represented 2% of the desert population and is dominated by the age group of [40-59 years] (39.9% of cases). The new cases recruited during the year 2018 are dominated by the female sex of the same age group with a sex ratio of 1.95 for 1 man. Diabetes complications are dominated by hypertension (70% of complicated cases), Oral Antidiabetics are used 54% in the management of diabetics against 1% for hygiene and diet measures alone.Conclusion : We recommend to integrate data from the private sector at the level of the prefectural health directorate of Sidi Bernoussi to have a better real view of the epidemiological situation in the prefecture. In addition, the implementation of the National Multisectoral Strategy for the Prevention and Control of Non-Communicable Diseases 2019 - 2029 and the Multisectoral Strategy for the Prevention and Control of Non-Communicable Diseases 2016-2025 at the local level must be accentuated on early diagnosis allowing care based more on lifestyle. Finally, this present study would be improved by a prospective and analytical study in the prefecture.

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