Improving access to cancer care among rural populations in India: Development of a validated tool for health system capacity assessment

Abstract Background Cancer burden in India is rapidly growing, with oral, breast, and uterine cervix being the three most commonly affected sites. It has a catastrophic epidemiological and financial impact on rural communities, the vast majority of whom are socio‐economically disadvantaged. Strength...

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Main Authors: Meritxell Mallafré‐Larrosa, Arunah Chandran, Kunal Oswal, Ishu Kataria, Arnie Purushotham, Rengaswamy Sankaranarayanan, Rajaraman Swaminathan, Rohit Rebello, Rita Isaac, Moni Kuriakose, Richard Sullivan, Partha Basu, ACCI Consortium
Format: Article
Language:English
Published: Wiley 2024-07-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.7343
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author Meritxell Mallafré‐Larrosa
Arunah Chandran
Kunal Oswal
Ishu Kataria
Arnie Purushotham
Rengaswamy Sankaranarayanan
Rajaraman Swaminathan
Rohit Rebello
Rita Isaac
Moni Kuriakose
Richard Sullivan
Partha Basu
ACCI Consortium
author_facet Meritxell Mallafré‐Larrosa
Arunah Chandran
Kunal Oswal
Ishu Kataria
Arnie Purushotham
Rengaswamy Sankaranarayanan
Rajaraman Swaminathan
Rohit Rebello
Rita Isaac
Moni Kuriakose
Richard Sullivan
Partha Basu
ACCI Consortium
author_sort Meritxell Mallafré‐Larrosa
collection DOAJ
description Abstract Background Cancer burden in India is rapidly growing, with oral, breast, and uterine cervix being the three most commonly affected sites. It has a catastrophic epidemiological and financial impact on rural communities, the vast majority of whom are socio‐economically disadvantaged. Strengthening the health system is necessary to address challenges in the access and provision of cancer services, thus improving outcomes among vulnerable populations. Objective To develop, test, and validate a health system capacity assessment (HSCA) tool that evaluates the capacity and readiness for cancer services provision in rural India. Methods A multi‐method process was pursued to develop a cancer‐specific HSCA tool. Firstly, item generation entailed both a nominal group technique (to identify the health system dimensions to capture) and a rapid review of published and gray literature (to generate items within each of the selected dimensions). Secondly, tool development included the pre‐testing of questionnaires through healthcare facility visits, and item reduction through a series of in‐depth interviews (IDIs) with key local stakeholders. Thirdly, tool validation was performed through expert consensus. Results A three‐step HSCA multi‐method tool was developed comprising: (a) desk review template, investigating policies and protocols at the state level, (b) facility assessment protocol and checklist, catering to the Indian public healthcare system, and (c) IDI topic guide, targeting policymakers, healthcare workforce, and other relevant stakeholders. Conclusions The resulting HSCA tool assesses health system capacity, thus contributing to the planning and implementation of context‐appropriate, sustainable, equity‐focused, and integrated early detection interventions for cancer control, especially toward vulnerable populations in rural India and other low‐resource settings.
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spelling doaj-art-0fb41687bb2e4d3e9067c3dca4d258142024-12-19T12:33:09ZengWileyCancer Medicine2045-76342024-07-011314n/an/a10.1002/cam4.7343Improving access to cancer care among rural populations in India: Development of a validated tool for health system capacity assessmentMeritxell Mallafré‐Larrosa0Arunah Chandran1Kunal Oswal2Ishu Kataria3Arnie Purushotham4Rengaswamy Sankaranarayanan5Rajaraman Swaminathan6Rohit Rebello7Rita Isaac8Moni Kuriakose9Richard Sullivan10Partha Basu11ACCI ConsortiumMailman School of Public Health University of Columbia New York New York USAEarly Detection, Prevention and Infections Branch International Agency for Research on Cancer/World Health Organization (IARC) Lyon FranceKarkinos Healthcare Mumbai IndiaCenter for Global Noncommunicable Diseases RTI International New Delhi IndiaInstitute of Cancer Policy Global Oncology Group Kings College London London UKKarkinos Healthcare Mumbai IndiaCancer Institute (WIA) Chennai IndiaDepartment of Medical Oncology GBH Group of Hospital Udaipur Rajasthan IndiaKarkinos Healthcare Mumbai IndiaKarkinos Healthcare Mumbai IndiaInstitute of Cancer Policy Global Oncology Group Kings College London London UKEarly Detection, Prevention and Infections Branch International Agency for Research on Cancer/World Health Organization (IARC) Lyon FranceAbstract Background Cancer burden in India is rapidly growing, with oral, breast, and uterine cervix being the three most commonly affected sites. It has a catastrophic epidemiological and financial impact on rural communities, the vast majority of whom are socio‐economically disadvantaged. Strengthening the health system is necessary to address challenges in the access and provision of cancer services, thus improving outcomes among vulnerable populations. Objective To develop, test, and validate a health system capacity assessment (HSCA) tool that evaluates the capacity and readiness for cancer services provision in rural India. Methods A multi‐method process was pursued to develop a cancer‐specific HSCA tool. Firstly, item generation entailed both a nominal group technique (to identify the health system dimensions to capture) and a rapid review of published and gray literature (to generate items within each of the selected dimensions). Secondly, tool development included the pre‐testing of questionnaires through healthcare facility visits, and item reduction through a series of in‐depth interviews (IDIs) with key local stakeholders. Thirdly, tool validation was performed through expert consensus. Results A three‐step HSCA multi‐method tool was developed comprising: (a) desk review template, investigating policies and protocols at the state level, (b) facility assessment protocol and checklist, catering to the Indian public healthcare system, and (c) IDI topic guide, targeting policymakers, healthcare workforce, and other relevant stakeholders. Conclusions The resulting HSCA tool assesses health system capacity, thus contributing to the planning and implementation of context‐appropriate, sustainable, equity‐focused, and integrated early detection interventions for cancer control, especially toward vulnerable populations in rural India and other low‐resource settings.https://doi.org/10.1002/cam4.7343cancer screeningdelivery of health careearly detection of cancerhealth services researchIndiaoncology service, hospital
spellingShingle Meritxell Mallafré‐Larrosa
Arunah Chandran
Kunal Oswal
Ishu Kataria
Arnie Purushotham
Rengaswamy Sankaranarayanan
Rajaraman Swaminathan
Rohit Rebello
Rita Isaac
Moni Kuriakose
Richard Sullivan
Partha Basu
ACCI Consortium
Improving access to cancer care among rural populations in India: Development of a validated tool for health system capacity assessment
Cancer Medicine
cancer screening
delivery of health care
early detection of cancer
health services research
India
oncology service, hospital
title Improving access to cancer care among rural populations in India: Development of a validated tool for health system capacity assessment
title_full Improving access to cancer care among rural populations in India: Development of a validated tool for health system capacity assessment
title_fullStr Improving access to cancer care among rural populations in India: Development of a validated tool for health system capacity assessment
title_full_unstemmed Improving access to cancer care among rural populations in India: Development of a validated tool for health system capacity assessment
title_short Improving access to cancer care among rural populations in India: Development of a validated tool for health system capacity assessment
title_sort improving access to cancer care among rural populations in india development of a validated tool for health system capacity assessment
topic cancer screening
delivery of health care
early detection of cancer
health services research
India
oncology service, hospital
url https://doi.org/10.1002/cam4.7343
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