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Barriers faced by rural communities in cancer care: What can be done?

Barriers faced by rural communities in cancer care: What can be done?

Barriers faced by rural communities in cancer care: What can be done?
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By CNBCTV18.com Contributor Aug 12, 2020 9:42 AM IST (Updated)

One of the first steps for better cancer care is to bring more awareness about cancer and help them overcome the stigma around it.

Written by: Ajay Balai and Niraj Bora

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A report by the National Institute of Cancer Prevention and Research (NICPR) indicates that over 2.25 million in India live with cancer. Every year, more than 11 lakh new cancer cases get registered in India. Nearly 70 percent of the population in India reside in rural areas where there is a severe shortage of cancer care facilities. While the number of cancer cases continues to increase in rural areas, nearly 95 percent of the cancer care centres are in urban cities and towns, making it further difficult for rural communities to access cancer care.
To implement solutions, we first need to identify the barriers that exist in access to cancer care in rural areas.
Awareness and stigma attached to cancer
The problem starts with the lack of awareness of cancer-related symptoms and the stigma attached to treatment around it. A majority of cancer-related deaths happen due to late diagnosis. There have been cases where the patient is completely unaware of his/her condition until it’s too late. A number of patients who have been detected with cancer in the early stages have made it through the treatment. In rural areas, awareness around the symptoms and diagnosis are limited since not many medical professionals are specialised in Oncology. In addition to this, with new types of cancer being detected, it’s difficult for medical professionals in rural areas to be updated with new forms of technologically advanced treatments coming up in the segment.
One of the first steps for better cancer care is to bring more awareness about cancer and help them overcome the stigma around it. A grassroots level campaign to educate rural communities about the importance of early detection, treatment options and financial support will make a significant difference. In addition to this, it’s important to change the conversation around cancer and the stigma attached to it. Counselling sessions and awareness camps can add great value. Similar to the Polio campaign, the government has to execute a large scale campaign to build awareness about cancer and overcoming the disease.
Lack of access
An ICICI Securities report points out the need for comprehensive cancer care centres. India has only 200-250 such centres or just 1 for every six million people. Availability of limited healthcare professionals in cancer care (especially rural areas) locally is another problem faced by rural communities in the treatment process. For diagnosis, medicines and ongoing treatments, many patients have to travel a few hundred kms. This becomes a major deterrent. Commuting to bigger cities, taking care of accommodation facilities and managing finances are some of the logistical challenges rural communities tend to face. Treatments like radiation require regular visits for several weeks. Travelling back and forth, or staying in a new urban city takes a toll on the physical and mental health of the patient.
One of the ways to address the lack of access to cancer care is by creating treatment facilities in rural locations. Smaller hospitals in rural areas can be connected to larger urban hospitals who can provide training to medical professionals in rural areas and set up basic cancer care facilities. A partnership model between large hospitals and smaller hospitals in rural areas can help in building cancer care infrastructure. Many cancer care startups are already working towards this and it can play a key role in creating better access to cancer care.
 Affordability and Quality
Cancer can take a toll on the patient’s physical and mental health. In addition to this, patients and their families also undergo financial stress due to the cost of treatment. As per reports, almost 90 percent of the rural population does not have health insurance. Recently, the government has extended coverage for cancer care under the Ayushmann Bharat Scheme. The cost of treatment is not something which has a real solution, except for capping the price of generic drugs.
Secondly, the quality of cancer care is yet another concern. India has less than 4000 Oncologists for a population of 1.3 Billion. There is an acute shortage of Oncologists to cater to rural and urban centres. This creates a gap in treatment. Initiatives like Ayushman Bharat have capped pricing of various treatments as per their norms. This also creates quality barriers due to the upper cap in chargeable prices. Quality healthcare can be a bit expensive at times. If the government can improve the quality within the price cap or if they can increase the price cap more frequently, it would go a long way to improve cancer treatment in India.
One of the ways to deal with the shortage of cancer care centres and oncologists is by creating another class of mid-level expert professionals exclusively for cancer. Many young healthcare professionals can be trained in basic cancer care diagnosis to help identify symptoms at early stages, connect the patient to oncologists and handhold the patient towards the right care. This will ease the pressure on Oncologists and it streamlines the overall treatment quality and cost rationalisation across cancer care treatment.
In addition to this, technology can play a key role in creating better access to cancer care. With internet penetration in rural areas, it’s now easier than ever before to have a virtual consultation with doctors. Companies offering second opinions in vernacular languages have made rural communities a bit closer to the solution stage, and they help the patients to understand and guide through the treatment journey.
—Ajay Balai and Niraj Bora — are Co-Founders,  Universal Cancer Conquest. The views expressed are personal
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