Sociocultural incentives for cancer care implementation
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EDITORIAL
Sociocultural incentives for cancer care implementation Jörg Haier1,4 · Jonathan Sleeman2,3 · Jürgen Schäfers4
© The Author(s) 2020
Introduction
Sociocultural incentives
The implementation and modification of cancer care systems in low- and middle-income countries (LMICs) to achieve Universal Health Coverage (UHC) for the entire population is usually accompanied not only by intensive and rapid changes in the delivery processes and system structure, but also by severe impact on human resources and sociocultural aspects of cancer care delivery. At the same time this is caused by and results in complex changes in clinical routines, in collaborative patterns among healthcare providers, professions and disciplines, as well as in the behavior of healthcare workers, patients or other stakeholders, and in the organization of cancer care [1]. Since allocation of qualitatively and quantitatively sufficient human resources to the entire population is a major challenge for cancer care in LIMCs, understanding of sociocultural incentives and their strategic use becomes of high importance [2]. These sociocultural incentives include various types of driving motivations that are not directly related to remuneration of healthcare service, such as free housing, access to professional education, social perception and appreciation, among others. Their importance is especially true for the care of patients with metastatic disease, given their vulnerability and particular clinical needs. Here we consider the impact of sociocultural incentives in this context.
Sociocultural incentives aim to guide motivations without directly interfering with financial benefits. Although their effects are indisputable and very well known in other contexts, for example known as generation-Y behavior, they are rarely reflected or scientifically analyzed in healthcare systems, and even less for cancer care. However, individuals are very sensitive to this form of incentivization. Human resource management is a very important area where sociocultural incentives can have intensive motivational effects in cancer care systems. In LMICs, sociocultural incentives in human resource management are even more important, since in these countries quantitative and qualitative availability (sufficient number of healthcare workers with appropriate qualifications), regional distribution of the workforce (shortages in remote and rural areas) and cross-country migration of qualified staff represent major challenges. This is particularly true for the management of advanced cancer stages, due to the complexity of the treatment options and the clinical specialties that are required. In addition, acceptance of cancer care professionals and modern treatment strategies by the targeted population often depends on sociocultural factors. For example, during palliative cancer care the integration of healthcare workers into social structures, their spiritual acceptance and access to education and knowledge are not related to financial benefits, but have to be considered a
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