PurposeEvery year > 450,000 individuals are diagnosed with cancer and approximately 350,000 die of it in India. The Ministry of Health and Family Welfare has released an Operational Framework for the Management of Common Cancers that highlights population-based cancer screening programs in primary health care facilities by health care providers (HCPs) and capacity building of HCPs. The purpose of this study is to present a low-cost training model that is highly suitable for resource-deficient settings, such as those found in India, through Extension for Community Health Outcome (ECHO), a knowledge-sharing tool, to enable high-quality training of HCPs.Materials and MethodsAn in-person, 3-day training program was conducted for 27 HCPs in the tribal primary health care center of Gumballi in Karnataka, India, to teach the basics of cancer screening in oral, breast, and cervical cancer. The training of HCPs was done using the ECHO platform while they implemented the cancer screening, thus enabling them to build the much needed knowledge and skill set to conduct cancer screening in their respective communities.ResultsThe knowledge level of the HCPs was tracked before the intervention, immediately after the 3-day training program, and 6 months after the ECHO intervention, which clearly showed progressive acquisition and retention of knowledge. A marked improvement in knowledge level score from an average of 6.3 to 13.7 on a 15-point scale was noticed after the initial in-person training. The average knowledge further increased to a score of 14.4 after 6 months as a result of training using the ECHO platform.ConclusionECHO is an affordable and effective model to train HCPs in cancer screening in a resource-constrained setting.
Background Online courses have broken the boundaries in imparting knowledge. While in western countries e-learning in medical education is well accepted, it is still an upcoming field in low- and middle-income countries like India. Attrition is a major threat to online courses world-wide. The objective of this article is to share the experiences in conducting online cancer screening courses, reasons for attrition and ways to improve retention. Methods Online training program in preventive oncology for medical professionals is being conducted since 2017, which is 14-week long with weekly one-hour sessions and specific curriculum for healthcare professionals. Since the retention of participants was a major challenge in all the courses, a short online survey was conducted to identify the reason behind quitting the course and suggestions to improve retention. The data was analyzed in November 2019. Results Among 614 enrolments, 26% (159/614) refused to attend the course and only 55% (252/455) completed the course successfully. Among the attendees 52% (238/455) were females, 71% (325/455) were from the public sector and 71% (324/455) were non-specialists. The attrition was high among non-specialists 49% (160/324), male participants 57% (124/217) and public sector doctors 52% (170/325). The main reasons for quitting the course were high workload in the health facilities 75% (52/69) and poor internet connectivity 12% (8/69). Conclusion The internet connectivity should be strengthened in all the healthcare centers to facilitate e-learning. A dedicated time-slot should be allotted to the providers for e-learning and updating their knowledge in addition to their routine work.
Introduction Smokeless tobacco (ST) is a significant South Asian public health problem. This paper reports a qualitative study of a sample of South Asian ST users. Methods Interviews, using a piloted topic guide, with 33 consenting, urban dwelling adult ST users explored their ST initiation, continued use and cessation attempts. Framework data analysis was used to analyse country specific data before a thematic cross-country synthesis was completed. Results Participants reported long term ST use and high dependency. All reported strong cessation motivation and multiple failed attempts because of ease of purchasing ST, tobacco dependency and lack of institutional support. Conclusions Interventions to support cessation attempts amongst consumers of South Asian ST products should address the multiple challenges of developing an integrated ST policy, including cessation services. Implications This study provides detailed understanding of the barriers and drivers to ST initiation, use and cessation for users in Bangladesh, India and Pakistan. It is the first study to directly compare these three countries. The insight was then used to adapt an existing behavioural support intervention for ST cessation for testing in these countries.
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