Cancer ecosystem assessment in West Africa: health systems gaps to prevent and control cancers in three countries: Ghana, Nigeria and Senegal

Ayandipo, Omobolaji; Wone, I; Kenu, Ernest; Fasehun, Luther-King; Ayandipo, Oluwayemisi; Gaye, F; Ojo, Adedoyin Babatunde; Ayoola, Yewande; Omogi, Jarim; Lakew, Desta; Thiam, Sylla

doi:10.11604/pamj.2020.35.90.18516

Cited by 19 publications

(35 citation statements)

References 10 publications

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“…In 2008, a National Cancer Control Steering Committee was established in Ghana to advise the government on health system planning, oversee the establishment and operation of a National Cancer Control Programme, and develop the National Strategy for Cancer Control in Ghana. 31 , 32 Although there is a clear strategic direction for cancer control, which includes improved access to radiotherapy and other cancer treatment, the program has received criticism for being underresourced to implement its planned activities. 31 In the setting of limited resources and competing priorities, the data from this study can help guide targeted and equity-focused investment.…”

Section: Discussionmentioning

confidence: 99%

“… 31 , 32 Although there is a clear strategic direction for cancer control, which includes improved access to radiotherapy and other cancer treatment, the program has received criticism for being underresourced to implement its planned activities. 31 In the setting of limited resources and competing priorities, the data from this study can help guide targeted and equity-focused investment. Our analysis of the radiotherapy shortfall in Ghana found that a total of 23 EBRT machines and 4 HDR brachytherapy afterloaders were needed to meet the current demand for radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

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Geographic Accessibility and Availability of Radiotherapy in Ghana

et al. 2022

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ImportanceRadiotherapy is critical for comprehensive cancer care, but there are large gaps in access. Within Ghana, data on radiotherapy availability and on the relationship between distance and access are unknown.ObjectivesTo estimate the gaps in radiotherapy machine availability in Ghana and to describe the association between distance and access to care.Design, Setting, and ParticipantsThis is a cross-sectional, population-based study of radiotherapy delivery in Ghana in 2020 and model-based analysis of radiotherapy demand and the radiotherapy utilization rate (RUR) using the Global Task Force on Radiotherapy for Cancer Control investment framework.ExposuresReceipt of radiotherapy and the number of radiotherapy courses delivered.Main Outcomes and MeasuresGeocoded location of patients receiving external beam radiotherapy (EBRT); median Euclidean distance from the district centroids to the nearest radiotherapy centers; proportion of population living within geographic buffer zones of 100, 150, and 200 km; additional capacity required for optimal utilization; and geographic accessibility after strategic location of a radiotherapy facility in an underserviced region.ResultsA total of 2883 patients underwent EBRT courses in 2020, with an actual RUR of 11%. Based on an optimal RUR of 48%, 11 524 patients had an indication for radiotherapy, indicating that only 23% of patients received treatment. An investment of 23 additional EBRT machines would be required to meet demand. The median Euclidean distance from the district centroids to the nearest radiotherapy facility was 110.6 km (range, 0.62-513.2 km). The proportion of the total population living within a radius of 100, 150 and 200 km of a radiotherapy facility was 47%, 61% and 70%, respectively. A new radiotherapy facility in the northern regional capital would reduce the median of Euclidean distance by 10% to 99.4 km (range, 0.62-267.7 km) and increase proportion of the total population living within a radius of 100, 150 and 200 km to 53%, 69% and 84%, respectively. The greatest benefit was seen in regions in the northern half of Ghana.Conclusions and RelevanceIn this cross-sectional study of geographic accessibility and availability of radiotherapy, Ghana had major national deficits of radiotherapy capacity, with significant geographic disparities among regions. Well-planned infrastructure scale-up that accounts for the population distribution could improve radiotherapy accessibility.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Geographic Accessibility and Availability of Radiotherapy in Ghana

et al. 2022

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“…The data capturing from primary and secondary health facilities which is presently limited to communicable diseases should be extended to include noncommunicable diseases including cancers. [80] Minimally invasive biopsy of lung masses remains the route to diagnosis of lung cancer. These small biopsy or cytology specimens should be routinely subjected to immunohistochemical and molecular testing to identify targetable driver mutations.…”

Section: What Needs To Change?mentioning

confidence: 99%

Management of lung cancer in Africa: Underdiagnosis and poor access to treatment – A close look at Nigeria and West African Sub-region

Okonta

Echieh

Abubakar

et al. 2021

JPATS

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Lung cancer is of public health importance and imposes a great deal of socioeconomic and disease burden on the West African subregion and Nigeria in particular. It is one of the most common cancers worldwide and accounts for 11.4% of all new cancers. In this review, we did not find any well-coordinated lung cancer registry in either Nigeria or any other West African country. For us to attain any meaningful level of the interventional plan to address any identifiable deficiencies in the treatment of lung cancer in the West African subregion, it is imperative that a specific regional lung cancer registry with a regular audit of the reporting, is set up. There is an urgent need for further studies on the local risk factors predisposing to lung cancer, especially in the younger age group. Finally, intense pressure must be mounted on the governments within West Africa to implement the 15% GDP allocation to the health budget as agreed in the WHO/Abuja Declaration and to speed up efforts towards universal health insurance.

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“…Because of the increasing incidence of cancer and other noncommunicable diseases, 103 , 104 governments, faith-based organizations, and nonprofit organizations in WA, with the consult of budgeting experts, should commit more funds to allow for the sufficient support of oncology research, cancer registries, treatment facilities, and health care coverage. The long-term improved cancer health of the WA populace can also be assured by various governments contributing funds to the improvement of health amenities and the establishment of initiatives that advocate for healthy food consumption, improved living conditions, reduced health care costs, and widespread formal education.…”

Section: Future Perspectivesmentioning

confidence: 99%

“…More emphasis should be placed on national and international collaborations. 104 In 2016, we created the International Consortium for Advancing Research on TNBC (ICART), a prime example of a global collaborative effort to better understand TNBC and its disparities by leveraging experts across 12 different research groups in nine countries and four continents. 8 Apart from hosting international symposiums and obtaining viable TNBC tumor samples, the ICART has also championed novel studies such as the NeoAdjuvant ChemoTherapy Response in Nigerian patients with TNBC: Biologic and Social Determinants (NACTRENT-BIS) study currently being conducted in Nigeria, with the long-term aim of elucidating the biologic, dietary, social, and reproductive determinants of chemotherapy response.…”

Section: Future Perspectivesmentioning

confidence: 99%