Author
Listed:
- Paul H. Park
(Partners in Health, Boston, MA 02199, USA
Department of Medicine, Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA 02115, USA
Harvard Medical School, Boston, MA 02115, USA)
- Cyprien Shyirambere
(Inshuti Mu Buzima/Partners in Health, Rwinkwavu, Rwanda)
- Fred Kateera
(Inshuti Mu Buzima/Partners in Health, Rwinkwavu, Rwanda)
- Neil Gupta
(Partners in Health, Boston, MA 02199, USA
Department of Medicine, Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA 02115, USA
Harvard Medical School, Boston, MA 02115, USA)
- Christian Rusangwa
(Inshuti Mu Buzima/Partners in Health, Rwinkwavu, Rwanda)
- Joia Mukherjee
(Partners in Health, Boston, MA 02199, USA
Department of Medicine, Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA 02115, USA
Harvard Medical School, Boston, MA 02115, USA)
- Alex Coutinho
(Inshuti Mu Buzima/Partners in Health, Rwinkwavu, Rwanda)
- Leslie Lehmann
(Harvard Medical School, Boston, MA 02115, USA
Center for Global Cancer Medicine, Dana-Farber Cancer Institute, Boston, MA 02215, USA)
- Lori Buswell
(Center for Global Cancer Medicine, Dana-Farber Cancer Institute, Boston, MA 02215, USA)
- Lawrence N. Shulman
(Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA)
- Joel M. Mubiligi
(Inshuti Mu Buzima/Partners in Health, Rwinkwavu, Rwanda)
- Francois Uwinkindi
(Rwanda Biomedical Centre, Division of Non-Communicable Diseases, Kigali, Rwanda
Co-senior authors.)
- Lisa R. Hirschhorn
(Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
Co-senior authors.)
Abstract
Background: The majority of countries in sub-Saharan Africa are ill-prepared to address the rising burden of cancer. While some have been able to establish a single cancer referral center, few have been able to scale-up services nationally towards universal health coverage. The literature lacks a step-wise implementation approach for resource-limited countries to move beyond a single-facility implementation strategy and implement a national cancer strategy to expand effective coverage. Methods: We applied an implementation science framework, which describes a four-phase approach: Exploration, Preparation, Implementation, and Sustainment (EPIS). Through this framework, we describe Rwanda’s approach to establish not just a single cancer center, but a national cancer program. Results: By applying EPIS to Rwanda’s implementation approach, we analyzed and identified the implementation strategies and factors, which informed processes of each phase to establish foundational cancer delivery components, including trained staff, diagnostic technology, essential medicines, and medical informatics. These cancer delivery components allowed for the implementation of Rwanda’s first cancer center, while simultaneously serving as the nidus for capacity building of foundational components for future cancer centers. Conclusion: This “progressive scaling” approach ensured that initial investments in the country’s first cancer center was a step toward establishing future cancer centers in the country.
Suggested Citation
Paul H. Park & Cyprien Shyirambere & Fred Kateera & Neil Gupta & Christian Rusangwa & Joia Mukherjee & Alex Coutinho & Leslie Lehmann & Lori Buswell & Lawrence N. Shulman & Joel M. Mubiligi & Francois, 2021.
"Implementing Cancer Care in Rwanda: Capacity Building for Treatment and Scale-Up,"
Sustainability, MDPI, vol. 13(13), pages 1-13, June.
Handle:
RePEc:gam:jsusta:v:13:y:2021:i:13:p:7216-:d:583689
Download full text from publisher
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