背景:印度的癌症负担正在迅速增加,口服,乳房,子宫颈是三个最常见的受累部位。它对农村社区造成灾难性的流行病学和财务影响,其中绝大多数在社会经济上处于不利地位。必须加强卫生系统,以应对获取和提供癌症服务方面的挑战,从而改善弱势群体的结果。
目标:为了开发,test,并验证卫生系统能力评估(HSCA)工具,该工具可评估印度农村地区癌症服务提供的能力和准备情况。
方法:采用多种方法来开发癌症特异性HSCA工具。首先,项目生成既需要标称组技术(以识别要捕获的卫生系统维度),也需要对已发布和灰色文献进行快速审查(以在每个选定维度内生成项目)。其次,工具开发包括通过医疗机构访问对问卷进行预先测试,并通过与当地主要利益相关者进行一系列深入访谈(IDI)来减少项目。第三,工具验证通过专家共识进行.
结果:开发了三步HSCA多方法工具,包括:(a)案头审查模板,调查州一级的政策和协议,(b)设施评估方案和核对表,迎合印度公共医疗系统,和(C)IDI主题指南,针对政策制定者,医疗保健劳动力,和其他相关利益相关者。
结论:由此产生的HSCA工具评估卫生系统能力,从而有助于规划和实施适合上下文的,可持续,以公平为中心,和癌症控制的综合早期检测干预措施,特别是对印度农村和其他低资源地区的弱势群体。
BACKGROUND: Cancer burden in India is rapidly growing, with oral, breast, and uterine cervix being the three most commonly affected sites. It has a catastrophic epidemiological and financial impact on rural communities, the vast majority of whom are socio-economically disadvantaged. Strengthening the health system is necessary to address challenges in the access and provision of cancer services, thus improving outcomes among vulnerable populations.
OBJECTIVE: To develop, test, and validate a health system capacity assessment (HSCA) tool that evaluates the capacity and readiness for cancer services provision in rural India.
METHODS: A multi-method process was pursued to develop a cancer-specific HSCA tool. Firstly, item generation entailed both a nominal group technique (to identify the health system dimensions to capture) and a rapid review of published and gray literature (to generate items within each of the selected dimensions). Secondly, tool development included the pre-testing of questionnaires through healthcare facility visits, and item reduction through a series of in-depth interviews (IDIs) with key local stakeholders. Thirdly, tool validation was performed through expert consensus.
RESULTS: A three-step HSCA multi-method tool was developed comprising: (a) desk review template, investigating policies and protocols at the state level, (b) facility assessment protocol and checklist, catering to the Indian public healthcare system, and (c) IDI topic guide, targeting policymakers, healthcare workforce, and other relevant stakeholders.
CONCLUSIONS: The resulting HSCA tool assesses health system capacity, thus contributing to the planning and implementation of context-appropriate, sustainable, equity-focused, and integrated early detection interventions for cancer control, especially toward vulnerable populations in rural India and other low-resource settings.