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Decentralizing cancer care in sub-Saharan Africa through an integrated regional cancer centre model: The case of Kenya

For 50 years, comprehensive cancer treatment services were provided at one public hospital and a few private facilities in the capital city. In 2019, the services were decentralized to new national and regional centers to increase service accessibility using an integration model. This study aimed to...

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Autores principales: Nyangasi, Mary F., McLigeyo, Angela A., Kariuki, David, Mithe, Siwillis, Orwa, Albert, Mwenda, Valerian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516416/
https://www.ncbi.nlm.nih.gov/pubmed/37738236
http://dx.doi.org/10.1371/journal.pgph.0002402
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author Nyangasi, Mary F.
McLigeyo, Angela A.
Kariuki, David
Mithe, Siwillis
Orwa, Albert
Mwenda, Valerian
author_facet Nyangasi, Mary F.
McLigeyo, Angela A.
Kariuki, David
Mithe, Siwillis
Orwa, Albert
Mwenda, Valerian
author_sort Nyangasi, Mary F.
collection PubMed
description For 50 years, comprehensive cancer treatment services were provided at one public hospital and a few private facilities in the capital city. In 2019, the services were decentralized to new national and regional centers to increase service accessibility using an integration model. This study aimed to analyze the status of the utilization of services at regional cancer centers. We analyzed data from the district health information system, focusing on patient demographics, visit type, cancer stage, and the type of treatment provided. For comparison, a trend analysis of new cancer cases recorded at the main national referral hospital between 2011–2021 was also conducted. We conducted a descriptive analysis of the variables of interest; the median was used to summarize continuous variables and percentages were used for categorical variables. A total of 29,321 patients visited the regional centers in 2021; the median age was 57 years (IQR 44–68) and 57.3% (16,815) were female. Visits to regional centres represented 38.8% (29,321/75,501) of all visits to public cancer centers; new visits accounted for 16.4% (4814/29321), and the rest were follow-up visits. Most patients (71%) had an advanced disease. The proportion of male patients with advanced-stage cancer was significantly higher than that of female patients (74% vs. 69%, P<0.001). Of the 15,275 patients who received treatment at regional centers, 69.1% (10,550) received chemotherapy.The increased patient visits show good service uptake at the regional centers, implying improved access. These findings can inform policies that will guide future expansion and service improvement. We recommend optimizing cancer service delivery at regional centers across the care continuum to improve patient outcomes.
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spelling pubmed-105164162023-09-23 Decentralizing cancer care in sub-Saharan Africa through an integrated regional cancer centre model: The case of Kenya Nyangasi, Mary F. McLigeyo, Angela A. Kariuki, David Mithe, Siwillis Orwa, Albert Mwenda, Valerian PLOS Glob Public Health Research Article For 50 years, comprehensive cancer treatment services were provided at one public hospital and a few private facilities in the capital city. In 2019, the services were decentralized to new national and regional centers to increase service accessibility using an integration model. This study aimed to analyze the status of the utilization of services at regional cancer centers. We analyzed data from the district health information system, focusing on patient demographics, visit type, cancer stage, and the type of treatment provided. For comparison, a trend analysis of new cancer cases recorded at the main national referral hospital between 2011–2021 was also conducted. We conducted a descriptive analysis of the variables of interest; the median was used to summarize continuous variables and percentages were used for categorical variables. A total of 29,321 patients visited the regional centers in 2021; the median age was 57 years (IQR 44–68) and 57.3% (16,815) were female. Visits to regional centres represented 38.8% (29,321/75,501) of all visits to public cancer centers; new visits accounted for 16.4% (4814/29321), and the rest were follow-up visits. Most patients (71%) had an advanced disease. The proportion of male patients with advanced-stage cancer was significantly higher than that of female patients (74% vs. 69%, P<0.001). Of the 15,275 patients who received treatment at regional centers, 69.1% (10,550) received chemotherapy.The increased patient visits show good service uptake at the regional centers, implying improved access. These findings can inform policies that will guide future expansion and service improvement. We recommend optimizing cancer service delivery at regional centers across the care continuum to improve patient outcomes. Public Library of Science 2023-09-22 /pmc/articles/PMC10516416/ /pubmed/37738236 http://dx.doi.org/10.1371/journal.pgph.0002402 Text en © 2023 Nyangasi et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Nyangasi, Mary F.
McLigeyo, Angela A.
Kariuki, David
Mithe, Siwillis
Orwa, Albert
Mwenda, Valerian
Decentralizing cancer care in sub-Saharan Africa through an integrated regional cancer centre model: The case of Kenya
title Decentralizing cancer care in sub-Saharan Africa through an integrated regional cancer centre model: The case of Kenya
title_full Decentralizing cancer care in sub-Saharan Africa through an integrated regional cancer centre model: The case of Kenya
title_fullStr Decentralizing cancer care in sub-Saharan Africa through an integrated regional cancer centre model: The case of Kenya
title_full_unstemmed Decentralizing cancer care in sub-Saharan Africa through an integrated regional cancer centre model: The case of Kenya
title_short Decentralizing cancer care in sub-Saharan Africa through an integrated regional cancer centre model: The case of Kenya
title_sort decentralizing cancer care in sub-saharan africa through an integrated regional cancer centre model: the case of kenya
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516416/
https://www.ncbi.nlm.nih.gov/pubmed/37738236
http://dx.doi.org/10.1371/journal.pgph.0002402
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