Improving childhood cancer care in Latin America and the Caribbean: a PAHO Childhood Cancer Working Group position statement

Denburg, Avram; Cuadrado, Cristóbal; Alexis, Cheryl; Klüssmann, Federico Antillón; Zamora, José Carlos Barrantes; Bodkyn, Curt; Bull, Myriam Campbell; Álvarez, Gustavo Dufort y; Gooding, Latoya; Kutluk, Tezer; Luciani, Silvana; Marcillo, Jessyca Karina Manner; Martins, Sandro José; Metzger, Monika L.; Vera, Anyul Milena; Moreno, Florencia; Noguera, Jabibi; Hernandez, Armando Pena; Delgado, Karina Quintero; Richards-Dawson, Michelle-Ann; Scopinaro, Marcelo; Klincovstein, Jaime Shalkow; Sinquee-Brown, Corrine; Suárez, Amaranto; Torode, Julie; Verdecia, Caridad; Vasquez, Roberto; Gupta, Sumit

doi:10.1016/s1470-2045(17)30325-x

Cited by 18 publications

(22 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Childhood cancer policy communities have internally recognized the need to define the problem and their prioritized responses to it in terms of wider policy currents advancing NCD care, and to paint external portrayals of it in these terms (S3-ES, PRA3-ES, S1-GUA, S3-IND, NGO2-GHA). Implicit in these formulations of the problem, and solutions thereto, is a recognition that health system strengthening arguments provide a critical link to governmental perspectives and priorities [58, 59]. Where national governments have articulated NCD priorities, as they have in the Philippines, India, El Salvador, and Ghana, childhood cancer advocates have endeavored to hitch their issue to these priorities, with varying success (PRA6-ES, NGO1-GHA, S2-PHI, NGO2-IND).…”

Section: Resultsmentioning

confidence: 99%

Political priority and pathways to scale-up of childhood cancer care in five nations

et al. 2019

View full text Add to dashboard Cite

Background Despite increasing global attention to non-communicable diseases (NCDs) and their incorporation into universal health coverage (UHC), the factors that determine whether and how NCDs are prioritized in national health agendas and integrated into health systems remain poorly understood. Childhood cancer is a leading non-communicable cause of death in children aged 0–14 years worldwide. We investigated the political, social, and economic factors that influence health system priority-setting on childhood cancer care in a range of low- and middle-income countries (LMIC). Methods and findings Based on in-depth qualitative case studies, we analyzed the determinants of priority-setting for childhood cancer care in El Salvador, Guatemala, Ghana, India, and the Philippines using a conceptual framework that considers four principal influences on political prioritization: political contexts, actor power, ideas, and issue characteristics. Data for the analysis derived from in-depth interviews ( n = 68) with key informants involved in or impacted by childhood cancer policies and programs in participating countries, supplemented by published academic literature and available policy documents. Political priority for childhood cancer varies widely across the countries studied and is most influenced by political context and actor power dynamics. Ghana has placed relatively little national priority on childhood cancer, largely due to competing priorities and a lack of cohesion among stakeholders. In both El Salvador and Guatemala, actor power has played a central role in generating national priority for childhood cancer, where well-organized and -resourced civil society organizations have disrupted legacies of fragmented governance and financing to create priority for childhood cancer care. In India, the role of a uniquely empowered private actor was instrumental in creating political priority and establishing sustained channels of financing for childhood cancer care. In the Philippines, the childhood cancer community has capitalized on a window of opportunity to expand access and reduce disparities in childhood cancer care through the political prioritization of UHC and NCDs in current health system reforms. Conclusions The importance of key health system actors in determining the relative political priority for childhood cancer in the countries studied points to actor power as a critical enabler of prioritization in other LMIC. Responsiveness to political contexts–in particular, rhetorical and policy priority placed on NCDs and UHC–will be crucial to efforts to place childhood cancer firmly on national health agendas. National governments must be convinced of the potential for foundational health system strengthening through attention to childhood cancer care, and the presence and capability of networked actors primed to amplify public sector investments and catalyze change on the ground.

show abstract

Section: Resultsmentioning

confidence: 99%

Political priority and pathways to scale-up of childhood cancer care in five nations

et al. 2019

View full text Add to dashboard Cite

show abstract

“…24 In contrast, leukemia remained the main cause of childhood cancer deaths in Latin American countries-likely as a consequence of delays in diagnosis and lack of access to advanced treatments, as well as treatment discontinuation. 3,8,25 Moreover, children with cancer from several Latin American countries must often be referred to universal health care systems in places far from their place of residence. 25 Childhood cancer mortality rates in countries from North America and Australasia are comparable or even more favorable to those registered in Western Europe, whereas most Latin American countries still showed rates higher than those of Central-Eastern European countries, the area with the highest rates in Europe.…”

Section: Discussionmentioning

confidence: 99%

“…In the United States, Canada, Japan, and Australia, death rates from neoplasms of the CNS were higher than those from leukemia, reflecting the lack of substantial improvements in the treatment of these malignancies, even in high‐income countries 24 . In contrast, leukemia remained the main cause of childhood cancer deaths in Latin American countries—likely as a consequence of delays in diagnosis and lack of access to advanced treatments, as well as treatment discontinuation 3,8,25 . Moreover, children with cancer from several Latin American countries must often be referred to universal health care systems in places far from their place of residence 25 …”

Section: Discussionmentioning

confidence: 99%

Childhood cancer mortality trends in the Americas and Australasia: An update to 2017

Malvezzi

Santucci

Alicandro

et al. 2021

Cancer

View full text Add to dashboard Cite

BACKGROUND: Marked reductions in childhood cancer mortality occurred over the last decades in high-income countries and, to a lesser degree, in middle-income countries. This study aimed to monitor mortality trends in the Americas and Australasia, focusing on areas showing unsatisfactory trends. METHODS: Age-standardized mortality rates per 100,000 children (aged 0-14 years) from 1990 to 2017 (or the last available calendar year) were computed for all neoplasms and 8 leading childhood cancers in countries from the Americas and Australasia, using data from the World Health Organization database. A joinpoint regression was used to identify changes in slope of mortality trends for all neoplasms, leukemia, and neoplasms of the central nervous system (CNS) for major countries. RESULTS: Over the last decades, childhood cancer mortality continued to decrease by approximately 2% to 3% per year in Australasian countries (ie, Japan, Korea, and Australia), by approximately 1.5% to 2% in North America and Chile, and 1% in Argentina. Other Latin American countries did not show any substantial decrease. Leukemia mortality declined in most countries, whereas less favorable trends were registered for CNS neoplasms, particularly in Latin America. Around 2016, death rates from all neoplasms were 4 to 6 per 100,000 boys and 3 to 4 per 100,000 girls in Latin America, and 2 to 3 per 100,000 boys and approximately 2 per 100,000 girls in North America and Australasia. CONCLUSIONS: Childhood cancer mortality trends declined steadily in North America and Australasia, whereas they were less favorable in most Latin American countries. Priority must be given to closing the gap by providing high-quality care for all children with cancer worldwide. Cancer 2021;0:1-12.

show abstract

“…Lastly, childhood cancer care in Latin America and the Caribbean is also a major objective in our region. The PAHO Childhood Cancer Working Group was created in 2017 to support the development of childhood cancer care through structured knowledge exchange, capacity building, and collaboration [30]. The SickKids-Caribbean Initiative was created in 2013 for the care of children with cancer and blood disorders in partnership with the University of the West-Indies, Ministries of Health and health institutions; the aim is to improve outcomes and quality of life for children with cancer [31].…”

Section: Strategy For Cooperation In Oncology In Martiniquementioning

confidence: 99%

International cooperation in public health in Martinique: geostrategic utility for cancer surveillance in the Caribbean

et al. 2020

View full text Add to dashboard Cite

Background: Cooperation in public health and in oncology in particular, is currently a major issue for the island of Martinique, given its geopolitical position in the Caribbean region. The region of Martinique shares certain public health problems with other countries of the Caribbean, notably in terms of diagnostic and therapeutic management of patients with cancer. We present here a roadmap of cooperation priorities and activities in cancer surveillance and oncology in Martinique. Main body: The fight against cancer is a key public health priority that features high on the regional health policy for Martinique. In the face of these specific epidemiological conditions, Martinique needs to engage in medical cooperation in the field of oncology within the Caribbean, to improve skills and knowledge in this field, and to promote the creation of bilateral relations that will help to improve cancer management in an international healthcare environment. Conclusions: These collaborative exchanges will continue throughout 2020 and will lead to the implementation of mutual research projects across a larger population basin, integrating e-health approaches and epidemiological ecohorts.

show abstract

Improving childhood cancer care in Latin America and the Caribbean: a PAHO Childhood Cancer Working Group position statement

Cited by 18 publications

References 6 publications

Political priority and pathways to scale-up of childhood cancer care in five nations

Political priority and pathways to scale-up of childhood cancer care in five nations

Childhood cancer mortality trends in the Americas and Australasia: An update to 2017

International cooperation in public health in Martinique: geostrategic utility for cancer surveillance in the Caribbean

Contact Info

Product

Resources

About