دورية أكاديمية
أعرض في EDS

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

التفاصيل البيبلوغرافية
العنوان: Political priority and pathways to scale-up of childhood cancer care in five nations.
المؤلفون: Denburg AE; Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.; Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Canada.; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada., Ramirez A; Harvard School of Public Health, Harvard University, Boston, Massachusetts, United States of America., Pavuluri S; Harvard School of Public Health, Harvard University, Boston, Massachusetts, United States of America., McCann E; Harvard School of Public Health, Harvard University, Boston, Massachusetts, United States of America., Shah S; Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Canada., Alcasabas T; Philippine General Hospital, Manila, Philippines., Antillon F; School of Medicine, Universidad Franciso Marroquin, Guatemala City, Guatemala.; Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala., Arora R; Max Super Specialty Hospital, New Delhi, India., Fuentes-Alabi S; Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador., Renner L; Korle Bu Teaching Hospital, Accra, Ghana., Lam C; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America., Friedrich P; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America., Maser B; Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Canada., Force L; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America., Galindo CR; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America., Atun R; Harvard School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
المصدر: PloS one [PLoS One] 2019 Aug 19; Vol. 14 (8), pp. e0221292. Date of Electronic Publication: 2019 Aug 19 (Print Publication: 2019).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Health Policy* , Health Priorities* , Politics*, Health Services Needs and Demand/*organization & administration , Neoplasms/*therapy, Adolescent ; Child ; Child, Preschool ; Developing Countries ; El Salvador ; Ghana ; Government Programs/organization & administration ; Guatemala ; Healthcare Disparities ; Humans ; India ; Infant ; Infant, Newborn ; Philippines ; Policy Making
مستخلص: 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.
Competing Interests: The authors have declared that no competing interests exist.
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تواريخ الأحداث: Date Created: 20190820 Date Completed: 20200402 Latest Revision: 20240612
رمز التحديث: 20240612
مُعرف محوري في PubMed: PMC6699697
DOI: 10.1371/journal.pone.0221292
PMID: 31425526
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0221292