File
J. Potterton1, A. Sidhanee2, P. Madzimbe3, P. Makupe4, E. Anieto5, P. Delano6, J. Geel7, N.R. Ranasinghe8, J. Challinor9
1University of the Witwatersrand, Physiotherapy, Johannesburg, South Africa, 2University College London Hospital, Physiotherapy, London, United Kingdom, 3United Bulawayo hospital, Physiotherapy, Bulawayo, Zimbabwe, 4Kamuzu Central Hospital, Physiotherapy, Lilongwe, Malawi, 5University of Cape Town, Health and Rehabilitation Sciences, Cape Town, South Africa, 6Pompeu Fabra University, Barcelona, Spain, 7University of the Witwatersrand, Paediatric Haematology and Oncology, Johannesburg, South Africa, 8Refinitiv UK, London, United Kingdom, 9University of California, Nursing, San Francisco, United States
Background: The burden of non-communicable diseases, especially cancer, is on the increase in Low-Middle Income countries (LMICs).It has been challenging to establish the actual incidence of cancer in Africa given to the paucity of population-based cancer registries. A recent study reported a childhood cancer incidence rate of 8.6 cases per 100,000 children in Africa. Despite the increasing burden of childhood cancer in Africa, it is yet to be considered as a major public health concern mainly because of economic challenges in the region and other compelling public health issues, including Covid-19, which have been prioritized.
Cancers are typically identified at advanced stages in LMICs, at which point choices for treatment that could potentially cure the disease become limited and often times unavailable. Impairments in functional capacity and disability are usually associated with advanced stages of cancer. Although rehabilitation is greatly beneficial to children with cancer, it remains underutilized in many settings, with some reporting referral rates as low as 2% . Such poor rates have been attributed to low awareness of the benefits of rehabilitation services as well as its referral pathways.
By 2050, it is predicted that approximately 50% of all paediatric cancer cases world wide will be from Africa, this demands immediate responses from all stakeholders in Africa.
Cancers are typically identified at advanced stages in LMICs, at which point choices for treatment that could potentially cure the disease become limited and often times unavailable. Impairments in functional capacity and disability are usually associated with advanced stages of cancer. Although rehabilitation is greatly beneficial to children with cancer, it remains underutilized in many settings, with some reporting referral rates as low as 2% . Such poor rates have been attributed to low awareness of the benefits of rehabilitation services as well as its referral pathways.
By 2050, it is predicted that approximately 50% of all paediatric cancer cases world wide will be from Africa, this demands immediate responses from all stakeholders in Africa.
Purpose: The aim of this study was to determine whether paediatric oncology services in Africa included access to physiotherapy.
Methods: Data relating to the availability of physiotherapy services was extracted from the SIOP Global Mapping Programme as well as from national Physiotherapy organisations.
Results: Forty seven out of 54 countries provided information. Eleven countries either failed to respond or provided incomplete data. Thirty six countries reported that physiotherapy services were available. 67% of low income countries reported having physiotherapy services whereas 85% of lower-middle income and 83% of upper-middle income countries reported access to physiotherapy services. The survey did not ascertain whether these services were specific to paediatric oncology nor what the therapist patient ratio was.
Conclusions: The data from the SIOP Global Mapping Programme do show that physiotherapy services are available even in low income countries in Africa. Whether this availability translates to clinical paediatric rehabilitation is not known. Availability of services is better in middle income countries than in low income countries. Like unicorns, paediatric physiotherapists offering services to children with cancer in Africa are rare and elusive. Available services need to be strengthened and gaps in service delivery need to be urgently identified and addressed in order to better meet the long term needs of children living with cancer in all parts of the world.
Implications: The role of physiotherapy and rehabilitation in the management of children living with cancer is well established. Although physiotherapy services appear to be available in most African countries, not enough is known about the services being delivered to children with cancer and how easy it is to access these services. As children with cancer gain access to better medical care and live longer so their rehabilitation needs will increase. Advocacy for equitable access to rehabilitation is needed.
Funding acknowledgements: None
Keywords:
paediatric
oncology
Africa
paediatric
oncology
Africa
Topics:
Paediatrics
Oncology, HIV & palliative care
Service delivery/emerging roles
Paediatrics
Oncology, HIV & palliative care
Service delivery/emerging roles
Did this work require ethics approval? No
Reason: The data presented reflect a subanalysis of data collected for a much broader project
All authors, affiliations and abstracts have been published as submitted.
