Cancer care delivery innovations, experiences and challenges during the COVID-19 pandemic: The Rwanda experience

Umutesi, Grace; Shyirambere, Cyprien; Bigirimana, Jean Bosco; Urusaro, Sandra; Uwizeye, Francois Regis; Nahimana, Evrard; Tuyishimire, Jean D'Amour; Mugenzi, Pacifique; Mubiligi, Joel; Uwinkindi, François; Kateera, Fredrick

doi:10.7189/jogh.11.03067

Cited by 11 publications

(25 citation statements)

References 1 publication

(1 reference statement)

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“…Cancer treating referral hospitals were expected to have all surveyed medicines for the patients to have access at a convenient cost in line with community-based health insurance. Low availability of anti-cancer medicines in Rwanda can result in delayed or omitted chemotherapy, which is a risk factor for the worse survival and progression of cancer diseases to advanced stages [14]. BCCOE, a single cancer treating hospital that has anti-cancer medicines is located in the Burera district of the northern province, at a high distance from Kigali city, which increases the transport cost.…”

Section: Discussionmentioning

confidence: 99%

“…Most patients are poor, but BCCOE offers free anti-cancer medicines, social support, and free meals. BCCOE receives huge support from the international community principally Non-Government Organization Partners In Health (PIH), which covers the cost of medicines and supplementary services [2,14]. The patients get anti-cancer medicines free of charge; however, high transport costs subjected to most patients can reduce care-seeking behaviors and leave cancer patients untreated.…”

Section: Discussionmentioning

confidence: 99%

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Availability and Affordability of Anticancer Medicines at Cancer Treating Hospitals in Rwanda

Rurangwa

Ndayisenga

Sezirahiga³

et al. 2022

Preprint

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Background: Availability and accessibility of anti-cancer medicines is the pillar of cancer management, and it is one of the main concerns in low-income countries including Rwanda. The objective of this study was to assess the availability and affordability of anticancer medicines at cancer-treating hospitals in Rwanda. Methodology: A descriptive cross-sectional study was conducted at 5 cancer-treating hospitals in Rwanda. Quantitative data were collected from stock cards and software that manage medicines and included the availability of anti-cancer medicines at the time of data collection, their stock status within the last two years, and the selling price. Results: The study found the availability of anti-cancer medicines at 41% in public hospitals at the time of data collection, and 45% within the last two years. We found the availability of anti-cancer medicines at 45% in private hospitals at the time of data collection, and 61% within the last two years. 80% of anti-cancer medicines in private hospitals were unaffordable while 20% were affordable. The public hospital that had most of the anti-cancer medicines in the public sector provided free services to the patients, and no cost was applied to the anti-cancer medicines. Conclusion: The availability of anti-cancer medicines in cancer-treating hospitals is low in Rwanda, and most of them are unaffordable. There is a need to design strategies that can increase the availability and affordability of anti-cancer medicines, for the patients to get recommended cancer treatment options.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Availability and Affordability of Anticancer Medicines at Cancer Treating Hospitals in Rwanda

Rurangwa

Ndayisenga

Sezirahiga³

et al. 2022

Preprint

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“…The service has also expanded access to medical care for patients who are unable to travel due to COVID-19 restrictions. For example, drones are being used to deliver cancer drugs to patients in remote villages who are unable to travel to oncology centers during the pandemic [16].…”

Section: Literature Reviewmentioning

confidence: 99%

Advanced Air Mobility: Opportunities and Challenges Deploying eVTOLs for Air Ambulance Service

Goyal

Cohen

2022

Applied Sciences

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Advanced air mobility (AAM) is a broad concept enabling consumers access to on-demand air mobility, cargo and package delivery, healthcare applications, and emergency services through an integrated and connected multimodal transportation network. While a number of technical and social concerns have been raised about AAM, early use cases for emergency response and aeromedical transport may be key to demonstrating the concept and building public acceptance. Using a five-step multi-method approach consisting of preliminary scoping, modeling performance metrics, developing baseline assumptions, analyzing scenarios, and applying a Monte Carlo sensitivity analysis, this study examines the potential operational and market viability of the air ambulance market using a variety of aircraft and propulsion types. The analysis concludes that electric vertical take-off and land (eVTOL) aircraft could confront a number of operational and economic challenges for aeromedical applications compared to hybrid vertical take-off and land (VTOL) aircraft and rotorcraft. The study finds that technological improvements such as reduced charge times, increased operational range, and battery swapping could make the eVTOL aircraft more reliable and cost-effective for aeromedical transport.

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“…The standard treatment, therefore, essentially comprises whole pelvic external beam radiation and concurrent chemotherapy [ 31 ], with brachytherapy as an integral component. In view of the paucity of brachytherapy facilities available in these settings, and the reallocation of funding during the pandemic, access to brachytherapy has been particularly restricted [ 32 , 33 ].…”

Section: Concerns In View Of the Covid-19 Pandemicmentioning

confidence: 99%

Elimination of cervical cancer as a public health problem—how shorter brachytherapy could make a difference during COVID-19

Gangopadhyay¹

2022

ecancer

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The World Health Organization has called for elimination of cervical cancer as a public health problem and has adopted strategies in this regard. However, the estimates for achieving the goals depend on the ability to provide timely treatment in a certain proportion of cases. The coronavirus disease 2019 pandemic has had a serious impact on healthcare delivery in many low and middle income countries (LMICs) with the highest burden of cervical cancer; funds and infrastructure are being reallocated to deal with the emergency, and cancer care has been seriously affected. In the absence of clear and reliable estimates, the exact extent of disruption remains unclear. It is, therefore, essential that pragmatic approaches are adopted to save lives. There has been considerable debate regarding the use of the 9 Gy × 2 fractions high dose rate brachytherapy schedule for the treatment of locally advanced cervical carcinoma. However, in LMICs with the highest global burden of locally advanced cervical cancer cases, radiation facilities have been using this fractionation schedule in many cases to deal with the overwhelming number of patients, who would have otherwise been denied timely treatment. In view of the current pandemic, and the difficulties in accessing and delivering timely healthcare, mortality owing to delayed treatment cannot be denied in LMICs, which already have underequipped healthcare facilities. Use of the shortest available fractionation schedule to provide timely treatment would serve to save more lives in regions with high incidence and mortality from the disease.

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Cancer care delivery innovations, experiences and challenges during the COVID-19 pandemic: The Rwanda experience

Cited by 11 publications

References 1 publication

Availability and Affordability of Anticancer Medicines at Cancer Treating Hospitals in Rwanda

Availability and Affordability of Anticancer Medicines at Cancer Treating Hospitals in Rwanda

Advanced Air Mobility: Opportunities and Challenges Deploying eVTOLs for Air Ambulance Service

Elimination of cervical cancer as a public health problem—how shorter brachytherapy could make a difference during COVID-19

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