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Guideline implementation for breast healthcare in low- and middle-income countries†‡

Breast healthcare program resource allocation

  1. Joe Harford PhD1,§,*,
  2. Edward Azavedo MD, PhD2,
  3. Mary Fischietto MPA1,
  4. on behalf of the Breast Health Global Initiative Healthcare Systems Panel

Article first published online: 3 OCT 2008

DOI: 10.1002/cncr.23841

Issue

Cancer

Cancer

Supplement: Guidelines for International Breast Health and Cancer Control–Implementation

Volume 113, Issue Supplement 8, pages 2282–2296, 15 October 2008

Additional Information

How to Cite

Harford, J., Azavedo, E., Fischietto, M. and on behalf of the Breast Health Global Initiative Healthcare Systems Panel (2008), Guideline implementation for breast healthcare in low- and middle-income countries. Cancer, 113: 2282–2296. doi: 10.1002/cncr.23841

Author Information

  1. 1

    Office of International Affairs, National Cancer Institute, Bethesda, Maryland

  2. 2

    Department of Radiology, Karolinska University Hospital Stockholm, Sweden

  1. §

    Fax: (301) 496-3954

  2. BHGI Health Care Systems Panel members included Brother Charles Anthony, Co-chair Edward Azavedo, Alberto Barceló, Eduardo Cazap, Tony Hsiu-His Chen, Stephen W. Duffy, Ahmed Elzawawy, MD, Wu Fan, Harold Freeman, Doudja Hammouda, Co-chair Joe Harford, Elmer Huerta, Raimund Jakesz, David Lubinski, Jean M. Lynn, Shahla Masood, Helge Stalsberg, and Vivien Davis Tsu.

*Office of International Affairs, National Cancer Institute, Executive Plaza North, Suite 100. 6130 Executive Boulevard, Bethesda, MD 20892

  1. †

    The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations suggest endorsement by the US government.

  2. ‡

    Complete financial disclosures are presented at the end of this article.

  3. §

    Fax: (301) 496-3954

  4. BHGI Health Care Systems Panel members included Brother Charles Anthony, Co-chair Edward Azavedo, Alberto Barceló, Eduardo Cazap, Tony Hsiu-His Chen, Stephen W. Duffy, Ahmed Elzawawy, MD, Wu Fan, Harold Freeman, Doudja Hammouda, Co-chair Joe Harford, Elmer Huerta, Raimund Jakesz, David Lubinski, Jean M. Lynn, Shahla Masood, Helge Stalsberg, and Vivien Davis Tsu.

Publication History

  1. Issue published online: 3 OCT 2008
  2. Article first published online: 3 OCT 2008
  3. Manuscript Accepted: 24 JUN 2008
  4. Manuscript Received: 10 JUN 2008

Funded by

  • The Breast Health Global Initiative (BHGI) Global Summit
  • AstraZeneca
  • Bristol-Myers Squibb Company
  • Ethicon Endo Surgery, Inc.
  • GE Healthcare
  • F. Hoffmann-La Roche AG
  • Novartis Oncology
  • Pfizer Inc.
  • US Agency for Healthcare Research and Quality. Grant Number: 1 R13 HS017218-01

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Keywords:

  • healthcare systems;
  • breast care program;
  • human resource allocation;
  • patient navigation;
  • capacity building

Abstract

Breast cancer is serious public health problem in countries of all resource levels. Although major advances in the detection and treatment of the disease have occurred in higher income settings, similar progress has been slow or scarce in most low- and middle-income countries (LMCs). The poorer outcomes in LMCs may relate to the limited capability of their healthcare systems (HCS) to provide successful early detection, diagnosis, and treatment of breast cancer. Impediments to better outcomes include insufficient numbers of appropriately trained healthcare workers, limited access to screening/treatment facilities, inadequate supplies of necessary drugs, and timeliness of treatment after diagnosis. Clearly, these HCS deficiencies are broader than the scope of the Breast Health Global Initiative (BHGI) and are not unique to the issue of breast cancer. To address issues in HCS that hinder the delivery of breast health services, the BHGI Healthcare Systems and Public Policy Panel explored the HCS structures and function needed to operate a breast care program (BCP). Like with all BHGI guidelines, those proposed by this panel were expressed in terms of 4 strata of resource levels: basic, limited, enhanced, and maximal. The current report describes the issues and questions related to HCS that are important to consider when designing, implementing, and measuring the performance of a BCP. Health ministers, other policymakers, healthcare personnel, administrators, and anyone else involved in developing a BCP can use and adapt this framework to improve outcomes and ensure the more effective use of resources. Cancer 2008;113(8 suppl):2282–96. © 2008 American Cancer Society.

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