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- Title
Health system strengthening: Integration of breast cancer care for improved outcomes.
- Authors
Horton, Susan; Camacho Rodriguez, Rolando; Anderson, Benjamin O.; Aung, Soe; Awuah, Baffour; Delgado Pebé, Lucia; Duggan, Catherine; Dvaladze, Allison; Kumar, Somesh; Murillo, Raúl; Mra, Rai; Rositch, Anne F.; Songiso, Mutumba; Sullivan, Richard; Tsunoda, Audrey T.; Teo, Soo‐Hwang; Gelband, Hellen; Teo, Soo-Hwang
- Abstract
The adoption of the goal of universal health coverage and the growing burden of cancer in low- and middle-income countries makes it important to consider how to provide cancer care. Specific interventions can strengthen health systems while providing cancer care within a resource-stratified perspective (similar to the World Health Organization-tiered approach). Four specific topics are discussed: essential medicines/essential diagnostics lists; national cancer plans; provision of affordable essential public services (either at no cost to users or through national health insurance); and finally, how a nascent breast cancer program can build on existing programs. A case study of Zambia (a country with a core level of resources for cancer care, using the Breast Health Global Initiative typology) shows how a breast cancer program was built on a cervical cancer program, which in turn had evolved from the HIV/AIDS program. A case study of Brazil (which has enhanced resources for cancer care) describes how access to breast cancer care evolved as universal health coverage expanded. A case study of Uruguay shows how breast cancer outcomes improved as the country shifted from a largely private system to a single-payer national health insurance system in the transition to becoming a country with maximal resources for cancer care. The final case study describes an exciting initiative, the City Cancer Challenge, and how that may lead to improved cancer services.
- Subjects
ZAMBIA; URUGUAY; WORLD Health Organization; BREAST cancer; SYSTEM integration; NATIONAL health insurance; SINGLE-payer health care; MIDDLE-income countries
- Publication
Cancer (0008543X), 2020, Vol 126, Issue 10, p2353
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.32871