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Nath A, Mathur P, Sudarshan K, Kaur Rajput G, Mascarenhas L, Arora RS, Seth R, Kumar Dixit S, Chinnaswamy G, Banipal RPS, Bhutia TW, Kumar Bodal V, Budukh A, Kumar Chaudhary N, Vijay C, Shikha Das D, Gundeti S, Harris C, Hazarika M, Natha Jondhale S, Gunaseelan K, Khamo V, Konjengbam R, Kumar A, Saroj Kumar DM, Majumdar G, Malik S, Mandal S, Najmi AM, Mohan Kumar C, Kumar Pandey A, Pandya S, Pareek P, Pautu JL, Surya Rao V, Ramesh C, Rawal M, Radhakrishnan N, Radhakrishnan V, Shah A, Singh S, Singh V, Singh P, Sundriyal D, Swaminathan R, Avinash T, Priya Kumari T, Tawsik S, Tiwari L. An assessment of childhood cancer care services in India - gaps, challenges and the way forward. Lancet Reg Health Southeast Asia 2023; 16:100235. [PMID: 37694177 PMCID: PMC10485780 DOI: 10.1016/j.lansea.2023.100235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/03/2023] [Accepted: 05/25/2023] [Indexed: 09/12/2023]
Abstract
Background Childhood cancers are emerging as an essential concern in India where there is lack of a specific programme component or policy to address childhood cancer control. There is limited information on the status and quality of childhood cancer care services in India. This paper describes the childhood cancer care services available at secondary and tertiary-level hospitals in India through a cross sectional study design. Methods The survey was conducted in 137 tertiary-level and 92 secondary-level hospitals in 26 states and 4 Union Territories (UTs), ensuring a uniform representation of public and private care hospitals. The study tool collected data on the organisational infrastructure, type of oncology services, health workforce, equipment, treatment and referral protocols, and treatment guidelines. Descriptive statistics was used to primarily present the health service status and data on childhood cancer care services in proportions and mean. Findings A dedicated pediatric oncology department was available in 41.6% of the public, 48.6% of private, and 64% Non Government Organization (NGO) managed tertiary-level hospitals. In 36 (39%) of the 92 hospitals providing secondary care, childhood cancer care was provided. The availability of bone (41.5%) and positron emission tomography (PET) scans (25.9%) was lower in public tertiary hospitals, whereas histopathology, computerised tomography (CT scan), and magnetic resonance imaging (MRI) were lower in public secondary hospitals than private and NGO managed hospitals for the corresponding level of care. Most tertiary hospitals had the required supportive care facilities except for play therapy and hospice care. Less than 50% of the public tertiary hospitals had stocks of the four categories of cancer-treating drugs and essential infrastructure for radiotherapy and chemotherapy. Most secondary-level hospitals not treating childhood cancer had referral linkages with tertiary hospitals. Interpretation The situational analysis of childhood cancer care services in India showed the concentration of availability of childhood cancer care services at the tertiary level of health care. There were gaps in the availability of specialised pediatric oncology care in all the tertiary hospitals. The availability of childhood cancer care services was higher in private and NGO-managed hospitals than in public hospitals. Integration of childhood cancer as a part of the national cancer control response should be taken up as a matter of priority. The need of the hour is to formulate a childhood cancer policy that will enable timely access to care universally. Funding World Health Organization, India provided funding and technical support.
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Affiliation(s)
- Anita Nath
- ICMR-National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bengaluru, Karnataka, India
| | - Prashant Mathur
- ICMR-National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bengaluru, Karnataka, India
| | - K.L. Sudarshan
- ICMR-National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bengaluru, Karnataka, India
| | - Gurpreet Kaur Rajput
- ICMR-National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bengaluru, Karnataka, India
| | - Leena Mascarenhas
- ICMR-National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bengaluru, Karnataka, India
| | | | - Rachna Seth
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | - Tseten W. Bhutia
- Sir Thutob Namgyal Memorial Referral Hospital, Gangtok, Sikkim, India
| | | | - Atul Budukh
- Centre for Cancer Epidemiology (CCE), Tata Memorial Centre (TMC), Homi Bhabha National Institute (HBNI), Mumbai, India
| | | | - C.R. Vijay
- Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | | | | | - Caleb Harris
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | | | | | - K. Gunaseelan
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | | | - Arun Kumar
- Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | | | | | - Shikha Malik
- All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | | | - Arshad Manzoor Najmi
- Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | | | | | - Shashank Pandya
- The Gujarat Cancer & Research Institute, Ahmedabad, Gujarat, India
| | - Puneet Pareek
- All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | | | - V. Surya Rao
- Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
| | - C. Ramesh
- Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Manoj Rawal
- BPS Government Medical College for Women, Haryana, India
| | | | | | - Anand Shah
- The Gujarat Cancer & Research Institute, Ahmedabad, Gujarat, India
| | - S.B. Singh
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Varinder Singh
- Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
| | | | - Deepak Sundriyal
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | | | - T. Avinash
- Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | | | - Sopai Tawsik
- Tomo Riba Institute of Health and Medical Sciences, Naharlagun, Arunachal Pradesh, India
| | - Lokesh Tiwari
- All India Institute of Medical Sciences, Patna, Bihar, India
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Nath A, Sudarshan KL, Rajput GK, Mathew S, Chandrika KRR, Mathur P. A rapid assessment of the impact of coronavirus disease (COVID- 19) pandemic on health care & service delivery for noncommunicable diseases in India. Diabetes Metab Syndr 2022; 16:102607. [PMID: 36115089 PMCID: PMC9451930 DOI: 10.1016/j.dsx.2022.102607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/17/2022] [Accepted: 08/21/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND AIM The coronavirus disease (COVID-19) pandemic had disrupted the availability, access and utilisation of routine health care services. The present study aimed to assess the impact of COVID-19 pandemic restrictions on India's Non communicable Disease (NCD) health care service delivery. METHODS The study included existing hospitals in disease registry network of the Indian Council of Medical Research-National Centre for Disease Informatics and Research (ICMR-NCDIR), Bengaluru. The study participants comprised site investigators who were clinicians from many specialities, including general medicine, surgery, cancer, neurology, cardiology, and endocrinology. A standardised questionnaire was prepared to collect data on NCD health care services at the respective hospitals over three months from March to May 2020. RESULTS Out of 153 hospitals approached for the study, 106 (70%) agreed to participate. Of these, 16 hospitals fully converted for COVID-19 care were excluded from the study. Thus, data from 90 hospitals were included in the final analysis. There had been a total disruption of NCD-related healthcare services during the three months in 44% of the hospitals. In April 2020, the outpatient attendance for over one-third of the hospitals was reduced by more than 75%. Admissions for planned surgeries for cancer treatment were reduced by more than 75% for about 40% of the hospitals. Preventive activities and population-based screening for diabetes, hypertension and cancer appear to have been adversely affected, with about one-third of the hospitals reporting total disruption in April and May 2020. As many as 60% of the institutions reported adequate availability of doctors. Over 91% of the institutions had preparedness/action plans to ensure the continuity of NCD services. CONCLUSION The study shows that despite adequate human and material resources, NCD outpatient services, elective surgeries and population-based screening were severely affected. Most institutions were prepared to overcome the pandemic-imposed disruption and ensure a continuum of care for NCDs'.
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Affiliation(s)
- Anita Nath
- ICMR-National Centre for Disease Informatics and Research (Indian Council of Medical Research), Bengaluru, India.
| | | | - Gurpreet Kaur Rajput
- ICMR-National Centre for Disease Informatics and Research (Indian Council of Medical Research), Bengaluru, India.
| | - Stany Mathew
- ICMR-National Centre for Disease Informatics and Research (Indian Council of Medical Research), Bengaluru, India.
| | | | - Prashant Mathur
- ICMR-National Centre for Disease Informatics and Research (Indian Council of Medical Research), Bengaluru, India.
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