Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions

Sayed, Shahin; Cherniak, William; Lawler, Mark; Tan, Soo-Yong; Sadr, Wafaa El; Wolf, Nicholas; Silkensen, Shannon L.; Brand, Nathan; Looi, Lai‐Meng; Pai, Sanjay A; Wilson, Michael L.; Milner, Danny A.; Flanigan, John; Fleming, K. A.

doi:10.1016/s0140-6736(18)30459-8

Cited by 160 publications

(172 citation statements)

References 67 publications

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“…More and better biomarkers are required to increase the cost‐effectiveness of personalized therapies. Attention should be given to developing biomarker tests that can be used at the point of care (outside the laboratory) …”

Section: Biomarkersmentioning

confidence: 99%

“…High‐quality pathology services are crucial for almost any cancer diagnosis . For instance, immunohistochemistry is required to identify the hormone receptor and HER2 status of breast cancer to guide treatment choice.…”

Section: Concurrent Support To Optimize the Use Of Cancer Medicinesmentioning

confidence: 99%

“…However, pathology services are inadequate in many settings with limited resources . In low‐income countries, such as some parts of Africa, only one pathologist may serve millions of people .…”

Section: Concurrent Support To Optimize the Use Of Cancer Medicinesmentioning

confidence: 99%

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Enhancing global access to cancer medicines

Cortés

Peréz-García

Llombart-Cussac

et al. 2020

CA A Cancer J Clinicians

153

108

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Globally, cancer is the second leading cause of death, with numbers greatly exceeding those for human immunodeficiency virus/acquired immunodeficiency syndrome, tuberculosis, and malaria combined. Limited access to timely diagnosis, to affordable, effective treatment, and to high‐quality care are just some of the factors that lead to disparities in cancer survival between countries and within countries. In this article, the authors consider various factors that prevent access to cancer medicines (particularly access to essential cancer medicines). Even if an essential cancer medicine is included on a national medicines list, cost might preclude its use, it might be prescribed or used inappropriately, weak infrastructure might prevent it being accessed by those who could benefit, or quality might not be guaranteed. Potential strategies to address the access problems are discussed, including universal health coverage for essential cancer medicines, fairer methods for pricing cancer medicines, reducing development costs, optimizing regulation, and improving reliability in the global supply chain. Optimizing schedules for cancer therapy could reduce not only costs, but also adverse events, and improve access. More and better biomarkers are required to target patients who are most likely to benefit from cancer medicines. The optimum use of cancer medicines depends on the effective delivery of several services allied to oncology (including laboratory, imaging, surgery, and radiotherapy). Investment is necessary in all aspects of cancer care, from these supportive services to technologies, and the training of health care workers and other staff.

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Section: Biomarkersmentioning

confidence: 99%

Section: Concurrent Support To Optimize the Use Of Cancer Medicinesmentioning

confidence: 99%

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Enhancing global access to cancer medicines

Cortés

Peréz-García

Llombart-Cussac

et al. 2020

CA A Cancer J Clinicians

153

108

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“…The full‐text review showed that none of the publications approached EHR development, deployment, and use to serve the health information needs of health care providers, policymakers and program managers, and other key stakeholders. Instead, the focus was primarily on vertical disease programs and health information system (HIS) subsystems, such as pharmacy or pathology and laboratory medicine systems . For example, one of the publications described a study on EMR use by mobile medical service trips in remote settings, while another described the development, implementation, and use of iSanté, Haiti's national HIV care, and treatment EMR system .…”

Section: Resultsmentioning

confidence: 99%

Research evidence on strategies enabling integration of electronic health records in the health care systems of low‐ and middle‐income countries: A literature review

Kumar

Mostafa

2019

Health Planning & Management

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Summary Integration of electronic health records (EHRs) in the national health care systems of low‐ and middle‐income countries (LMICs) is vital for achieving the United Nations Sustainable Development Goal of ensuring healthy lives and promoting well‐being for all people of all ages. National EHR systems are increasing, but mostly in developed countries. Besides, there is limited research evidence on successful strategies for ensuring integration of national EHRs in the health care systems of LMICs. To fill this evidence gap, a comprehensive survey of literature was conducted using scientific electronic databases—PubMed, SCOPUS, Web of Science, and Global Health—and consultations with international experts. The review highlights the lack of evidence on strategies for integrating EHR systems, although there was ample evidence on implementation challenges and relevance of EHRs to vertical disease programs such as HIV. The findings describe the narrow focus of EHR implementation, the prominence of vertical disease programs in EHR adoption, testing of theoretical and conceptual models for EHR implementation and success, and strategies for EHR implementation. The review findings are further amplified through examples of EHR implementation in Sierra Leone, Malawi, and India. Unless evidence‐based strategies are identified and applied, integration of national EHRs in the health care systems of LMICs is difficult.

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“…Some of the challenges include the absence of essential infrastructure, laboratory supplies, basic equipment, skilled personnel, supply chain management, and equipment maintenance; reliance on empirical treatment; inadequate quality management systems; and no government standards for laboratory testing. In their Series paper, Shahin Sayed and colleagues 3 provide a roadmap to solutions for improving laboratory medicine, and Susan Horton and colleagues 4 call for all stakeholders to ensure the effective provision of PALM services in resource-limited settings.…”

mentioning

confidence: 99%