Stakeholder's Perspectives on the Barriers and Facilitators of Childhood Cancer Care in India.

IF 1.7 4区医学 Q2 PEDIATRICS

Indian pediatrics Pub Date : 2025-06-02 DOI:10.1007/s13312-025-00098-2

Anita Nath, Prashant Mathur, Kondalli Lakshminarayana Sudarshan, Ramandeep Arora, Rachna Seth, Sanjiv Kumar, Girish Chinnaswamy, Atul Budukh, Varinder Singh, T Priya Kumari, Raja Paramjeet Singh Banipal, Vijay Kumar Bodal, A R Arun Kumar, C R Vijay, T Avinash, C Ramesh, Sadashivudu Gundeti, Shikha Malik, Narendra Kumar Chaudhary, Gautam Majumdar, Deepshikha Das, Nita Radhakrishnan, V Surya Rao, Manoj Rawal, Jeremy L Pautu, Deepak Sundriyal, Munlima Hazarika, Caleb Harris, Sunil Natha Jondhale, Vinotsole Khamo, Arshad Manzoor Najmi, Puneet Pareek, Ratan Konjengbam, Saroj Kumar Das Majumdar, Shashank Pandya, Anand Shah, S B Singh, Venkatraman Radhakrishnan, R Swaminathan, Chandra Mohan Kumar, Pritanjali Singh, Lokesh Tiwari, Syamsundar Mandal, Sopai Tawsik, Awadhesh Kumar Pandey, K Gunaseelan, Tseten W Bhutia

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引用次数: 0

Abstract

Objective: To explore the stakeholders' perspectives on barriers and facilitators influencing childhood cancer care delivery in India.

Methods: A nationwide survey was conducted across 26 states and 4 Union Territories, involving childhood cancer physicians from tertiary and secondary hospitals, state nodal officers (SNOs) for the National Programme for Control of Non-Communicable Diseases (NP-NCD), and representatives from Civil Society Organizations (CSOs) and Non-Governmental Organizations (NGOs). A hub-and-spoke sampling model was employed, with designated tertiary hospitals coordinating data collection from secondary hospitals. An online survey tool assessed perceived challenges and facilitators in childhood cancer care. Data collection occurred from July to September 2021, and descriptive statistics were used for analysis.

Results: Responses were received from 137 tertiary hospitals (100%), 92 secondary hospitals (91%), 16 SNOs (53.3%), and 9 CSO/NGO representatives (23.1%). Key barriers to diagnosis and treatment included shortage of human resources, beds, and equipment, along with advanced-stage presentation and inadequate back-referrals from tertiary to secondary hospitals. Treatment abandonment and denial were highlighted as major concerns. SNOs and CSOs identified financial constraints, limited insurance coverage, and reliance on traditional healers as additional challenges. Facilitators included strengthening referral networks, expanding diagnostic capabilities, ensuring free treatment and medications, and improving infrastructure and workforce capacity.

Conclusion: Resource constraints, late-stage presentation, treatment abandonment, and financial challenges are the significant barriers to childhood cancer care in India. Addressing these through improved referral systems, expanded diagnostic services, financial support mechanisms, and policy-level interventions are needed to enhance childhood cancer care outcomes and quality of life.

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利益相关者对印度儿童癌症护理障碍和促进因素的看法。

目的：探讨利益相关者对影响印度儿童癌症护理服务的障碍和促进因素的看法。方法：在26个邦和4个联邦直辖区进行了一项全国性调查，涉及来自三级和二级医院的儿童癌症医生，国家非传染性疾病控制计划（NP-NCD）的州节点官员（SNOs），以及民间社会组织（cso）和非政府组织（ngo）的代表。采用轮辐抽样模型，指定三级医院协调二级医院的数据收集。一项在线调查工具评估了儿童癌症护理面临的挑战和促进因素。数据收集时间为2021年7 - 9月，采用描述性统计进行分析。结果：共有137家三级医院（100%）、92家二级医院（91%）、16家SNOs（53.3%）和9家CSO/NGO代表（23.1%）回复了问卷。诊断和治疗的主要障碍包括人力资源、床位和设备短缺，以及从三级医院到二级医院的晚期就诊和回诊不足。放弃治疗和拒绝治疗被强调为主要问题。SNOs和cso认为财政限制、有限的保险覆盖范围和对传统治疗师的依赖是额外的挑战。促进措施包括加强转诊网络，扩大诊断能力，确保免费治疗和药物，以及改善基础设施和劳动力能力。结论：资源限制、晚期表现、放弃治疗和经济挑战是印度儿童癌症治疗的重大障碍。需要通过改进转诊系统、扩大诊断服务、财政支持机制和政策层面的干预措施来解决这些问题，以提高儿童癌症护理结果和生活质量。

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来源期刊

Indian pediatrics 医学-小儿科

CiteScore

3.30

自引率

8.70%

发文量

344

审稿时长

3-8 weeks

期刊介绍： The general objective of Indian Pediatrics is "To promote the science and practice of Pediatrics." An important guiding principle has been the simultaneous need to inform, educate and entertain the target audience. The specific key objectives are: -To publish original, relevant, well researched peer reviewed articles on issues related to child health. -To provide continuing education to support informed clinical decisions and research. -To foster responsible and balanced debate on controversial issues that affect child health, including non-clinical areas such as medical education, ethics, law, environment and economics. -To achieve the highest level of ethical medical journalism and to produce a publication that is timely, credible and enjoyable to read.