ABSTRACT
BACKGROUND: Patients with cancer in low- and middle-income countries experience worse outcomes as a result of the limited capacity of health systems to deliver comprehensive cancer care. The health workforce is a key component of health systems; however, deep gaps exist in the availability and accessibility of cancer care providers. MATERIALS AND METHODS: We carried out a systematic review of the literature evaluating the strategies for capacity building of the cancer workforce. We studied how the policy strategies addressed the availability, accessibility, acceptability, and quality (AAAQ) of the workforce. We used a strategic planning framework (SWOT: strengths, weaknesses, opportunities, threats) to identify actionable areas of capacity building. We contextualized our findings based on the WHO 2030 Global Strategy on Human Resources for Health, evaluating how they can ultimately be framed in a labour market approach and inform strategies to improve the capacity of the workforce (PROSPERO: CRD42020109377). RESULTS: The systematic review of the literature yielded 9617 records, and we selected 45 eligible papers for data extraction. The workforce interventions identified were delivered mostly in the African and American Regions, and in two-thirds of cases, in high-income countries. Many strategies have been shown to increase the number of competent oncology providers. Optimization of the existing workforce through role delegation and digital health interventions was reported as a short- to mid-term solution to optimize cancer care, through quality-oriented, efficiency-improving, and acceptability-enforcing workforce strategies. The increased workload alone was potentially detrimental. The literature on retaining the workforce and reducing brain drain or attrition in underserved areas was commonly limited. CONCLUSIONS: Workforce capacity building is not only a quantitative problem but can also be addressed through quality-oriented, organizational, and managerial solutions of human resources. The delivery of comprehensive, acceptable, and impact-oriented cancer care requires an available, accessible, and competent workforce for comprehensive cancer care. Efficiency-improving strategies may be instrumental for capacity building in resource-constrained settings.
Subject(s)
Capacity Building , Health Workforce , Neoplasms , Humans , Neoplasms/therapy , Health Policy , Comprehensive Health Care/organization & administration , Medical Oncology/organization & administration , Delivery of Health CareABSTRACT
A new biflavonoid-C-glycoside named occidentoside, also the known (-)salipurposide and beta-sitosterol, have been isolated from the nut shells of Anacardium occidentale L. (Anacardiaceae). The structure of occidentoside has been established as tetrahydroninokiflavone-C-glucoside (III) from spectral and chemical evidence. This is the first biflavonoid to occur with one flavanone and one chalcone unit and also the first C-glycoside in the biflavonoid series. Identification of (-)salipurposide is also reported since it has been isolated for the first time from cashew nut shells.
ABSTRACT
The biflavanone mixture from semecarpus anacardium L. was reisolated and dehydrogenated with I (2)/KOAc in AcOH to yield the corresponding, relatively more stable, biflavone mixture which was methylated using diazomethane. Two biflavone methyl ethers SA1 and SA2 were obtained which confirmed the structures proposed for the parent biflavanones A1 and A2 respectively.