Low And Mid-income Countries Research Articles

CHALLENGES AND OPPORTUNITIES OF THE 2022 G20 SUMMIT IN STRENGTHENING PREVENTION, PREPAREDNESS, AND RESPONSE (PPR) FINANCING AS A PART OF GLOBAL HEALTH ARCHITECTURE RESTRUCTURATION

Restructuring and strengthening the framework of Global Health Architecture (GHA) is one of the significant agendas raised at the 2022 G20 Summit held in Bali, Indonesia. One of the identified motivations behind this initiative concerns the gap in the prevention, preparedness, and response (PPR) financing policy and its sustainability. This problem generates inequity in the global health system–especially experienced by the low- and mid-income countries (LMICs)–and hinders the effort to comprehensively mitigate the impacts the threats have caused, such as from the current COVID-19 outbreak. Consequently, these countries are struggling due to their inability to acquire healthcare resources such as health infrastructures, vaccine access, and human resources. To understand how the 2022 G20 forum could contribute to restructuring and strengthening the architecture, this paper investigates the upcoming summit's potential challenges and opportunities in restructuring the GHA framework to close the gap in financing PPR and creating an equal global health system. In doing so, this article will apply desk study by collecting information from secondary data sources. One of the potential opportunities is to strengthen global health multilateralism through the G20 members' active engagement in the financial intermediary fund (FIF) platform. However, there is also a significant challenge regarding the current global solidarity and political tension. Therefore, the forum must consider these notions to create a more robust and sustained financial policy to strengthen the architecture.

Fostering a sustainable pediatric cardiac workforce in the developing world during the current COVID-19 pandemic

: The majority of the world’s population with congenital heart disease (CHD) does not have access to corrective surgery, including 70% of those living in sub-Saharan Africa. Communicable diseases still cause significant mortality in low- and mid-income countries (LMICs), but increasingly, the burden of non-communicable diseases (NCD), such as CHD and rheumatic heart disease (RHD), has increased, creating great strain on fragile healthcare systems. The number of pediatric cardiac centers in LMICs is grossly inadequate to provide the necessary care. The unprecedented COVID-19 pandemic due to SARS-CoV-2 has only worsened the global disparities, and unfortunately has set the clock back by a few years. There has been an interruption of foreign missions and collaborations, which has affected the care of children with heart disease, and which will further increase the number on the waitlist. Much of the hard-won progress made in improving neonatal, infant, and maternal mortality may be lost due to the pandemic. Time is running out for the ambitious sustainable development goals set for 2030. At present, only 1% of developing world are vaccinated against COVID-19 with the poorest countries not expected to receive vaccine until 2023. This intervening time provides a crucial opportunity to apply “frugal innovation” by training and equipping local teams and policy makers. We employed a Gap and SWOT analysis to identify the steps needed to work towards improving children’s heart care in the developing world, all while using lessons learned from the COVID-19 pandemic.

Safety and Immunogenicity Analysis of a Newcastle Disease Virus (NDV-HXP-S) Expressing the Spike Protein of SARS-CoV-2 in Sprague Dawley Rats.

Despite global vaccination efforts, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to evolve and spread globally. Relatively high vaccination rates have been achieved in most regions of the United States and several countries worldwide. However, access to vaccines in low- and mid-income countries (LMICs) is still suboptimal. Second generation vaccines that are universally affordable and induce systemic and mucosal immunity are needed. Here we performed an extended safety and immunogenicity analysis of a second-generation SARS-CoV-2 vaccine consisting of a live Newcastle disease virus vector expressing a pre-fusion stabilized version of the spike protein (NDV-HXP-S) administered intranasally (IN), intramuscularly (IM), or IN followed by IM in Sprague Dawley rats. Local reactogenicity, systemic toxicity, and post-mortem histopathology were assessed after the vaccine administration, with no indication of severe local or systemic reactions. Immunogenicity studies showed that the three vaccination regimens tested elicited high antibody titers against the wild type SARS-CoV-2 spike protein and the NDV vector. Moreover, high antibody titers were induced against the spike of B.1.1.7 (alpha), B.1.351 (beta) and B.1.617.2 (delta) variants of concern (VOCs). Importantly, robust levels of serum antibodies with neutralizing activity against the authentic SARS-CoV-2 USA‐WA1/2020 isolate were detected after the boost. Overall, our study expands the pre-clinical safety and immunogenicity characterization of NDV-HXP-S and reinforces previous findings in other animal models about its high immunogenicity. Clinical testing of this vaccination approach is ongoing in different countries including Thailand, Vietnam, Brazil and Mexico.

Using social norms theory for health promotion in low-income countries.

Social norms can greatly influence people's health-related choices and behaviours. In the last few years, scholars and practitioners working in low- and mid-income countries (LMIC) have increasingly been trying to harness the influence of social norms to improve people's health globally. However, the literature informing social norm interventions in LMIC lacks a framework to understand how norms interact with other factors that sustain harmful practices and behaviours. This gap has led to short-sighted interventions that target social norms exclusively without a wider awareness of how other institutional, material, individual and social factors affect the harmful practice. Emphasizing norms to the exclusion of other factors might ultimately discredit norms-based strategies, not because they are flawed but because they alone are not sufficient to shift behaviour. In this paper, we share a framework (already adopted by some practitioners) that locates norm-based strategies within the wider array of factors that must be considered when designing prevention programmes in LMIC.

Theory and practice of social norms interventions: eight common pitfalls

BackgroundRecently, Global Health practitioners, scholars, and donors have expressed increased interest in “changing social norms” as a strategy to promote health and well-being in low and mid-income countries (LMIC). Despite this burgeoning interest, the ability of practitioners to use social norm theory to inform health interventions varies widely.Main bodyHere, we identify eight pitfalls that practitioners must avoid as they plan to integrate a social norms perspective in their interventions, as well as eight learnings. These learnings are: 1) Social norms and attitudes are different; 2) Social norms and attitudes can coincide; 3) Protective norms can offer important resources for achieving effective social improvement in people’s health-related practices; 4) Harmful practices are sustained by a matrix of factors that need to be understood in their interactions; 5) The prevalence of a norm is not necessarily a sign of its strength; 6) Social norms can exert both direct and indirect influence; 7) Publicising the prevalence of a harmful practice can make things worse; 8) People-led social norm change is both the right and the smart thing to do.ConclusionsAs the understanding of how norms evolve in LMIC advances, practitioners will develop greater understanding of what works to help people lead change in harmful norms within their contexts. Awareness of these pitfalls has helped several of them increase the effectiveness of their interventions addressing social norms in the field. We are confident that others will benefit from these reflections as well.

Sedentary behavior and body composition in children of low-and mid-income countries: a review

This study reviewed the relationship between sedentary behavior (SB) and body composition in children and adolescents from low-and-mid income countries (LMIC). A systematic review was developed through manual and electronic searches in eight databases. Were included observational studies conducted in LMIC, with children and adolescents from three to 19 years. As results, 39 original articles were found (37 cross-sectional, 1 case control study and 1 cohort), which in all presented 75 analyzes, most of them based on screen behaviors (n = 71; 94.7%). At all, 15 of 25 analyses showed risk associations between SB and unfavorable body composition. When focusing on the dose of sedentary behavior, risk associations were verified in distinct cut of points: 1h/d (3 of 3 analyses); 2h/d (9 of 16); 3h/d (2 of 5); 4h/d (4 of 5) and 5h/d (3 of 6). Television time was the SB type most frequently associated as risk in all categories. In conclusion, recognition of these associations is important both to support future studies and for its dissemination in preventive messages in the population of interest. Also, further longitudinal studies are necessary for narrowing the casual relationships between the variables.

Four avenues of normative influence: A research agenda for health promotion in low and mid-income countries.

Health promotion interventions in low and midincome countries (LMIC) are increasingly integrating strategies to change local social norms that sustain harmful practices. However, the literature on social norms and health in LMIC is still scarce. A well-known application of social norm theory in LMIC involves abandonment of female genital cutting (FGC) in West Africa. We argue that FGC is a special case because of its unique relationship between the norm and the practice; health promotion interventions would benefit from a wider understanding of how social norms can influence different types of health-related behaviors. We hypothesize that four factors shape the strength of a norm over a practice: (1) whether the practice is dependent or interdependent; (2) whether it is more or less detectable; (3) whether it is under the influence of distal or proximal norms; and (4) whether noncompliance is likely to result in sanctions. We look at each of these four factors in detail, and suggest that different relations between norms and a practice might require different programmatic solutions. Future findings that will confirm or contradict our hypothesis will be critical for effective health promotion interventions that aim to change harmful social norms in LMIC. (PsycINFO Database Record

Using social norms theory for health promotion in low-income countries.

SummarySocial norms can greatly influence people’s health-related choices and behaviours. In the last few years, scholars and practitioners working in low- and mid-income countries (LMIC) have increasingly been trying to harness the influence of social norms to improve people’s health globally. However, the literature informing social norm interventions in LMIC lacks a framework to understand how norms interact with other factors that sustain harmful practices and behaviours. This gap has led to short-sighted interventions that target social norms exclusively without a wider awareness of how other institutional, material, individual and social factors affect the harmful practice. Emphasizing norms to the exclusion of other factors might ultimately discredit norms-based strategies, not because they are flawed but because they alone are not sufficient to shift behaviour. In this paper, we share a framework (already adopted by some practitioners) that locates norm-based strategies within the wider array of factors that must be considered when designing prevention programmes in LMIC.

Theory and Practice of Social Norms Interventions: Eight Common Pitfalls

Background: Scholars and practitioners working in health promotion and gender equality in low and mid-income countries (LMIC) are witnessing heightened interest in changing social norms to achieve greater wellbeing. Despite this burgeoning interest, the ability of practitioners to use social norm theory to inform programming, varies widely. Main Body: Here, we identify eight pitfalls that practitioners must avoid as they plan to integrate a social norms perspective in their interventions and as many learnings. The eight learnings are: 1) Social norms and attitudes are different; 2) Social norms and attitudes can be concordant; 3) Protective norms can offer important resources for achieving effective social improvement in people's gender-related health practices; 4) Harmful practices are sustained by an ecology of factors that need to be understood in their interactions; 5) The prevalence of a norm is not necessarily a sign of its strength; 6) Social norms can exert both direct and indirect influence; 7) Publicising the prevalence of a harmful practice can make things worse; 8) People-led social norm change is both the right and the smart thing to do. Conclusions: As the understanding of how norms evolve in LMIC advances, practitioners will develop greater understanding of what works to help people lead change in harmful norms within their contexts. Awareness of these pitfalls has helped several of them increase the effectiveness of their interventions addressing gender-related social norms in the field. We are confident that others will benefit from these reflections as well.

Oncology practitioners\u2019 perspectives and practice patterns of post-treatment cancer survivorship care in the Asia-Pacific region: results from the STEP study

BackgroundMost efforts to advance cancer survivorship care have occurred in Western countries. There has been limited research towards gaining a comprehensive understanding of survivorship care provision in the Asia-Pacific region. This study aimed to establish the perceptions of responsibility, confidence, and frequency of survivorship care practices of oncology practitioners and examine their perspectives on factors that impede quality survivorship care.MethodsA cross-sectional survey of hospital-based oncology practitioners in 10 Asia-Pacific countries was undertaken between May 2015–October 2016. The participating countries included Australia, Hong Kong, China, Japan, South Korea, Thailand, Singapore, India, Myanmar, and The Philippines. The survey was administered using paper-based or online questionnaires via specialist cancer care settings, educational meetings, and professional organisations.ResultsIn total, 1501 oncology practitioners participated in the study. When comparing the subscales of responsibility perception, frequency and confidence, Australian practitioners had significantly higher ratings than practitioners in Hong Kong, Japan, Thailand, and Singapore (all p < 0.05). Surprisingly, practitioners working in Low- and Mid- Income Countries (LMICs) had higher levels of responsibility perception, confidence and frequencies of delivering survivorship care than those working in High-Income Countries (HICs) (p < 0.001), except for the responsibility perception of care coordination where no difference in scores was observed (p = 0.83). Physicians were more confident in delivering most of the survivorship care interventions compared to nurses and allied-health professionals. Perceived barriers to survivorship care were similar across the HICs and LMICs, with the most highly rated items for all practitioners being lack of time, dedicated educational resources for patients and family members, and evidence-based practice guidelines informing survivorship care.ConclusionsDifferent survivorship practices have been observed between HICs and LMICs, Australia and other countries and between the professional disciplines. Future service planning and research efforts should take these findings into account and overcome barriers identified in this study.

Establishing a tracking system in human resources department to improve the completeness of personnel files at a district hospital in Rwanda

Introduction: For decades, many low and mid income countries (LMIC) have invested significant effort to improve access to and quality of health care, with less attention paid to the non-clinical, administrative hospital management. Accordingly, a practical personnel filing system was designed and implemented to improve file management efficiency.Methods: Setting: The quality improvement project took place in a rural hospital in Rwanda. Design: A pre- and post-intervention study design to assess the effect of the intervention between January 2015 and February 2016. File auditing and time study were conducted. Intervention: A custom-made computer database to manage documents in a personnel file, standardized follow up process and policy were created and implemented. Measures: The pre- and post-intervention completeness of all personnel file and the average time to identify the missing items in a personnel file were measured to evaluate the effect of the project.Results: The completion rate of personnel files increased from 83% pre-intervention to 96% post-intervention. The average time to identify missing items significantly reduced from 6 minutes 30 seconds pre-intervention to 49.6 seconds (p &lt; .001).Conclusions: This project demonstrates that quality improvement principles can help address administrative issues in a resource-challenged setting. By utilizing available resources to implement an intervention that focused on creating an easy and efficient process, the personnel file completion rate has increased considerably and the time needed to identify missing items significantly decreased. The hospital should apply the same strategic problem solving methodology to conduct other quality improvement projects.

WE‐H‐201‐01: The Opportunities and Benefits of Helping LMICs: How Helping Them Can Help You

The desperate need for radiotherapy in low and mid‐income countries (LMICs) has been well documented. Roughly 60 % of the worldwide incidence of cancer occurs in these resource‐limited settings and the international community alongside governmental and non‐profit agencies have begun publishing reports and seeking help from qualified volunteers. However, the focus of several reports has been on how dire the situation is and the magnitude of the problem, leaving most to feel overwhelmed and unsure as to how to help and why to get involved.This session will help to explain the specific ways that Medical Physicists can uniquely assist in this grand effort to help bring radiotherapy to grossly‐underserved areas. Not only can these experts fulfill an important purpose, they also can benefit professionally, academically, emotionally and socially from the endeavor. By assisting others worldwide with their skillset, Medical Physicists can end up helping themselves. Learning Objectives: Understand the need for radiotherapy in LMICs. Understand which agencies are seeking Medical Physicists for help in LMICs. Understand the potential research funding mechanisms are available to establish academic collaborations with LMIC researchers/physicians. Understand the potential social and emotional benefits for both the physicist and the LMIC partners when collaborations are made. Understand the potential for collaboration with other high‐income scientists that can develop as the physicist partners with other large institutions to assist LMICs.Wil Ngwa ‐ A recent United Nations Study reports that in developing countries more people have access to cell phones than toilets. In Africa, only 63% of the population has access to piped water, yet, 93% of Africans have cell phone service. Today, these cell phones, Skype, WhatsApp and other information and communication technologies (ICTs) connect us in unprecedented ways and are increasingly recognized as powerful, indispensable to global health. Thanks to ICTs, there are growing opportunities for Medical Physicists to reach out beyond the bunker and impact the world far beyond, without even having to travel.These growing opportunities in global health for Medical Physicists, powered by ICTs, will be highlighted in this presentation, illustrated by high impact examples/models across the globe that are improving patient safety and healthcare outcomes, saving lives. Learning Objectives: Published definitions of global health and the emerging field of global radiation oncology Learn about the transformative potential of ICTs in global radiation oncology care, research and education with focus on Medical Physics Learn about high impact examples of ICT‐powered global radiation oncology and the increasing opportunities for participation by Medical Physicists.Yakov Pipman ‐ The number and scope of volunteer Medical Physics activities in support of low‐to‐middle income countries has been increasing gradually. This happens through a variety of formal channels and to some extent through less formal but personal initiatives. A good deal of effort is dedicated by many, but many more could be recruited through a structured framework to volunteer.We will look into typical volunteer activities and how they fit with organizations already involved in advancing Medical Physics in LMIC. We will identify the range of these organizational activities and their scope to reveal areas of further need.We will point to a few key features of MPWB (www.mpwb.org) as a volunteering and collaborating structure and how members can get involved and contribute to these efforts at the grass roots level. The goal is that scarce resources can thus be channeled to complement rather than compete with those already in place. Learning Objectives: Understand the strengths and limitations of various organizations that support Medical Physics efforts in LMIC. Learn about ways to volunteer and contribute to Global Health through a grass roots organization focused on Medical Physics in LMIC.Perry Sprawls ‐ With the growing capability and complexity of medical imaging methods in all countries of the world, the expanding role of medical physicists includes optimizing imaging procedures with respect to image quality, radiation dose, and other conflicting factors. With access to appropriate educational resources local medical physicists in all countries can provide direct clinical support and educational for other medical professionals. This is being supported through the process of Collaborative Teaching that combines the capabilities and experience of medical physicists in countries spanning the spectrum of economic, technological, and clinical development. The supporting resources are on the web at: www.sprawls.org/resources. Learning Objectives: Identify the medical physics educational needs to support effective and optimized medical imaging procedures. Use collaborative teaching resources to enhance the role of medical physicists in all countries of the world.

WE‐H‐201‐00: Opportunities for Physicists to Support Low and Mid‐Income Countries

The desperate need for radiotherapy in low and mid‐income countries (LMICs) has been well documented. Roughly 60 % of the worldwide incidence of cancer occurs in these resource‐limited settings and the international community alongside governmental and non‐profit agencies have begun publishing reports and seeking help from qualified volunteers. However, the focus of several reports has been on how dire the situation is and the magnitude of the problem, leaving most to feel overwhelmed and unsure as to how to help and why to get involved.This session will help to explain the specific ways that Medical Physicists can uniquely assist in this grand effort to help bring radiotherapy to grossly‐underserved areas. Not only can these experts fulfill an important purpose, they also can benefit professionally, academically, emotionally and socially from the endeavor. By assisting others worldwide with their skillset, Medical Physicists can end up helping themselves. Learning Objectives: Understand the need for radiotherapy in LMICs. Understand which agencies are seeking Medical Physicists for help in LMICs. Understand the potential research funding mechanisms are available to establish academic collaborations with LMIC researchers/physicians. Understand the potential social and emotional benefits for both the physicist and the LMIC partners when collaborations are made. Understand the potential for collaboration with other high‐income scientists that can develop as the physicist partners with other large institutions to assist LMICs.Wil Ngwa ‐ A recent United Nations Study reports that in developing countries more people have access to cell phones than toilets. In Africa, only 63% of the population has access to piped water, yet, 93% of Africans have cell phone service. Today, these cell phones, Skype, WhatsApp and other information and communication technologies (ICTs) connect us in unprecedented ways and are increasingly recognized as powerful, indispensable to global health. Thanks to ICTs, there are growing opportunities for Medical Physicists to reach out beyond the bunker and impact the world far beyond, without even having to travel.These growing opportunities in global health for Medical Physicists, powered by ICTs, will be highlighted in this presentation, illustrated by high impact examples/models across the globe that are improving patient safety and healthcare outcomes, saving lives. Learning Objectives: Published definitions of global health and the emerging field of global radiation oncology Learn about the transformative potential of ICTs in global radiation oncology care, research and education with focus on Medical Physics Learn about high impact examples of ICT‐powered global radiation oncology and the increasing opportunities for participation by Medical Physicists.Yakov Pipman ‐ The number and scope of volunteer Medical Physics activities in support of low‐to‐middle income countries has been increasing gradually. This happens through a variety of formal channels and to some extent through less formal but personal initiatives. A good deal of effort is dedicated by many, but many more could be recruited through a structured framework to volunteer.We will look into typical volunteer activities and how they fit with organizations already involved in advancing Medical Physics in LMIC. We will identify the range of these organizational activities and their scope to reveal areas of further need.We will point to a few key features of MPWB (www.mpwb.org) as a volunteering and collaborating structure and how members can get involved and contribute to these efforts at the grass roots level. The goal is that scarce resources can thus be channeled to complement rather than compete with those already in place. Learning Objectives: Understand the strengths and limitations of various organizations that support Medical Physics efforts in LMIC. Learn about ways to volunteer and contribute to Global Health through a grass roots organization focused on Medical Physics in LMIC.Perry Sprawls ‐ With the growing capability and complexity of medical imaging methods in all countries of the world, the expanding role of medical physicists includes optimizing imaging procedures with respect to image quality, radiation dose, and other conflicting factors. With access to appropriate educational resources local medical physicists in all countries can provide direct clinical support and educational for other medical professionals. This is being supported through the process of Collaborative Teaching that combines the capabilities and experience of medical physicists in countries spanning the spectrum of economic, technological, and clinical development. The supporting resources are on the web at: www.sprawls.org/resources. Learning Objectives: Identify the medical physics educational needs to support effective and optimized medical imaging procedures. Use collaborative teaching resources to enhance the role of medical physicists in all countries of the world.

WE‐H‐201‐03: Enthusiasm and Generosity of Spirit Necessitate a Volunteering Structure to Make Them More Meaningful

The desperate need for radiotherapy in low and mid‐income countries (LMICs) has been well documented. Roughly 60 % of the worldwide incidence of cancer occurs in these resource‐limited settings and the international community alongside governmental and non‐profit agencies have begun publishing reports and seeking help from qualified volunteers. However, the focus of several reports has been on how dire the situation is and the magnitude of the problem, leaving most to feel overwhelmed and unsure as to how to help and why to get involved.This session will help to explain the specific ways that Medical Physicists can uniquely assist in this grand effort to help bring radiotherapy to grossly‐underserved areas. Not only can these experts fulfill an important purpose, they also can benefit professionally, academically, emotionally and socially from the endeavor. By assisting others worldwide with their skillset, Medical Physicists can end up helping themselves. Learning Objectives: Understand the need for radiotherapy in LMICs. Understand which agencies are seeking Medical Physicists for help in LMICs. Understand the potential research funding mechanisms are available to establish academic collaborations with LMIC researchers/physicians. Understand the potential social and emotional benefits for both the physicist and the LMIC partners when collaborations are made. Understand the potential for collaboration with other high‐income scientists that can develop as the physicist partners with other large institutions to assist LMICs.Wil Ngwa ‐ A recent United Nations Study reports that in developing countries more people have access to cell phones than toilets. In Africa, only 63% of the population has access to piped water, yet, 93% of Africans have cell phone service. Today, these cell phones, Skype, WhatsApp and other information and communication technologies (ICTs) connect us in unprecedented ways and are increasingly recognized as powerful, indispensable to global health. Thanks to ICTs, there are growing opportunities for Medical Physicists to reach out beyond the bunker and impact the world far beyond, without even having to travel.These growing opportunities in global health for Medical Physicists, powered by ICTs, will be highlighted in this presentation, illustrated by high impact examples/models across the globe that are improving patient safety and healthcare outcomes, saving lives. Learning Objectives: Published definitions of global health and the emerging field of global radiation oncology Learn about the transformative potential of ICTs in global radiation oncology care, research and education with focus on Medical Physics Learn about high impact examples of ICT‐powered global radiation oncology and the increasing opportunities for participation by Medical Physicists.Yakov Pipman ‐ The number and scope of volunteer Medical Physics activities in support of low‐to‐middle income countries has been increasing gradually. This happens through a variety of formal channels and to some extent through less formal but personal initiatives. A good deal of effort is dedicated by many, but many more could be recruited through a structured framework to volunteer.We will look into typical volunteer activities and how they fit with organizations already involved in advancing Medical Physics in LMIC. We will identify the range of these organizational activities and their scope to reveal areas of further need.We will point to a few key features of MPWB (www.mpwb.org) as a volunteering and collaborating structure and how members can get involved and contribute to these efforts at the grass roots level. The goal is that scarce resources can thus be channeled to complement rather than compete with those already in place. Learning Objectives: Understand the strengths and limitations of various organizations that support Medical Physics efforts in LMIC. Learn about ways to volunteer and contribute to Global Health through a grass roots organization focused on Medical Physics in LMIC.Perry Sprawls ‐ With the growing capability and complexity of medical imaging methods in all countries of the world, the expanding role of medical physicists includes optimizing imaging procedures with respect to image quality, radiation dose, and other conflicting factors. With access to appropriate educational resources local medical physicists in all countries can provide direct clinical support and educational for other medical professionals. This is being supported through the process of Collaborative Teaching that combines the capabilities and experience of medical physicists in countries spanning the spectrum of economic, technological, and clinical development. The supporting resources are on the web at: www.sprawls.org/resources. Learning Objectives: Identify the medical physics educational needs to support effective and optimized medical imaging procedures. Use collaborative teaching resources to enhance the role of medical physicists in all countries of the world.

WE‐H‐201‐02: Emerging Models and Opportunities in Global Health for Medical Physicists Powered by Information and Communication Technologies

The desperate need for radiotherapy in low and mid‐income countries (LMICs) has been well documented. Roughly 60 % of the worldwide incidence of cancer occurs in these resource‐limited settings and the international community alongside governmental and non‐profit agencies have begun publishing reports and seeking help from qualified volunteers. However, the focus of several reports has been on how dire the situation is and the magnitude of the problem, leaving most to feel overwhelmed and unsure as to how to help and why to get involved.This session will help to explain the specific ways that Medical Physicists can uniquely assist in this grand effort to help bring radiotherapy to grossly‐underserved areas. Not only can these experts fulfill an important purpose, they also can benefit professionally, academically, emotionally and socially from the endeavor. By assisting others worldwide with their skillset, Medical Physicists can end up helping themselves. Learning Objectives: Understand the need for radiotherapy in LMICs. Understand which agencies are seeking Medical Physicists for help in LMICs. Understand the potential research funding mechanisms are available to establish academic collaborations with LMIC researchers/physicians. Understand the potential social and emotional benefits for both the physicist and the LMIC partners when collaborations are made. Understand the potential for collaboration with other high‐income scientists that can develop as the physicist partners with other large institutions to assist LMICs.Wil Ngwa ‐ A recent United Nations Study reports that in developing countries more people have access to cell phones than toilets. In Africa, only 63% of the population has access to piped water, yet, 93% of Africans have cell phone service. Today, these cell phones, Skype, WhatsApp and other information and communication technologies (ICTs) connect us in unprecedented ways and are increasingly recognized as powerful, indispensable to global health. Thanks to ICTs, there are growing opportunities for Medical Physicists to reach out beyond the bunker and impact the world far beyond, without even having to travel.These growing opportunities in global health for Medical Physicists, powered by ICTs, will be highlighted in this presentation, illustrated by high impact examples/models across the globe that are improving patient safety and healthcare outcomes, saving lives. Learning Objectives: Published definitions of global health and the emerging field of global radiation oncology Learn about the transformative potential of ICTs in global radiation oncology care, research and education with focus on Medical Physics Learn about high impact examples of ICT‐powered global radiation oncology and the increasing opportunities for participation by Medical Physicists.Yakov Pipman ‐ The number and scope of volunteer Medical Physics activities in support of low‐to‐middle income countries has been increasing gradually. This happens through a variety of formal channels and to some extent through less formal but personal initiatives. A good deal of effort is dedicated by many, but many more could be recruited through a structured framework to volunteer.We will look into typical volunteer activities and how they fit with organizations already involved in advancing Medical Physics in LMIC. We will identify the range of these organizational activities and their scope to reveal areas of further need.We will point to a few key features of MPWB (www.mpwb.org) as a volunteering and collaborating structure and how members can get involved and contribute to these efforts at the grass roots level. The goal is that scarce resources can thus be channeled to complement rather than compete with those already in place. Learning Objectives: Understand the strengths and limitations of various organizations that support Medical Physics efforts in LMIC. Learn about ways to volunteer and contribute to Global Health through a grass roots organization focused on Medical Physics in LMIC.Perry Sprawls ‐ With the growing capability and complexity of medical imaging methods in all countries of the world, the expanding role of medical physicists includes optimizing imaging procedures with respect to image quality, radiation dose, and other conflicting factors. With access to appropriate educational resources local medical physicists in all countries can provide direct clinical support and educational for other medical professionals. This is being supported through the process of Collaborative Teaching that combines the capabilities and experience of medical physicists in countries spanning the spectrum of economic, technological, and clinical development. The supporting resources are on the web at: www.sprawls.org/resources. Learning Objectives: Identify the medical physics educational needs to support effective and optimized medical imaging procedures. Use collaborative teaching resources to enhance the role of medical physicists in all countries of the world.

WE‐H‐201‐04: Models for Developing Medical Physics Educators and Education Programs in the Developing Countries and the Potential Role of US Universities and Individual Medical Physicists

The desperate need for radiotherapy in low and mid‐income countries (LMICs) has been well documented. Roughly 60 % of the worldwide incidence of cancer occurs in these resource‐limited settings and the international community alongside governmental and non‐profit agencies have begun publishing reports and seeking help from qualified volunteers. However, the focus of several reports has been on how dire the situation is and the magnitude of the problem, leaving most to feel overwhelmed and unsure as to how to help and why to get involved.This session will help to explain the specific ways that Medical Physicists can uniquely assist in this grand effort to help bring radiotherapy to grossly‐underserved areas. Not only can these experts fulfill an important purpose, they also can benefit professionally, academically, emotionally and socially from the endeavor. By assisting others worldwide with their skillset, Medical Physicists can end up helping themselves. Learning Objectives: Understand the need for radiotherapy in LMICs. Understand which agencies are seeking Medical Physicists for help in LMICs. Understand the potential research funding mechanisms are available to establish academic collaborations with LMIC researchers/physicians. Understand the potential social and emotional benefits for both the physicist and the LMIC partners when collaborations are made. Understand the potential for collaboration with other high‐income scientists that can develop as the physicist partners with other large institutions to assist LMICs.Wil Ngwa ‐ A recent United Nations Study reports that in developing countries more people have access to cell phones than toilets. In Africa, only 63% of the population has access to piped water, yet, 93% of Africans have cell phone service. Today, these cell phones, Skype, WhatsApp and other information and communication technologies (ICTs) connect us in unprecedented ways and are increasingly recognized as powerful, indispensable to global health. Thanks to ICTs, there are growing opportunities for Medical Physicists to reach out beyond the bunker and impact the world far beyond, without even having to travel.These growing opportunities in global health for Medical Physicists, powered by ICTs, will be highlighted in this presentation, illustrated by high impact examples/models across the globe that are improving patient safety and healthcare outcomes, saving lives. Learning Objectives: Published definitions of global health and the emerging field of global radiation oncology Learn about the transformative potential of ICTs in global radiation oncology care, research and education with focus on Medical Physics Learn about high impact examples of ICT‐powered global radiation oncology and the increasing opportunities for participation by Medical Physicists.Yakov Pipman ‐ The number and scope of volunteer Medical Physics activities in support of low‐to‐middle income countries has been increasing gradually. This happens through a variety of formal channels and to some extent through less formal but personal initiatives. A good deal of effort is dedicated by many, but many more could be recruited through a structured framework to volunteer.We will look into typical volunteer activities and how they fit with organizations already involved in advancing Medical Physics in LMIC. We will identify the range of these organizational activities and their scope to reveal areas of further need.We will point to a few key features of MPWB (www.mpwb.org) as a volunteering and collaborating structure and how members can get involved and contribute to these efforts at the grass roots level. The goal is that scarce resources can thus be channeled to complement rather than compete with those already in place. Learning Objectives: Understand the strengths and limitations of various organizations that support Medical Physics efforts in LMIC. Learn about ways to volunteer and contribute to Global Health through a grass roots organization focused on Medical Physics in LMIC.Perry Sprawls ‐ With the growing capability and complexity of medical imaging methods in all countries of the world, the expanding role of medical physicists includes optimizing imaging procedures with respect to image quality, radiation dose, and other conflicting factors. With access to appropriate educational resources local medical physicists in all countries can provide direct clinical support and educational for other medical professionals. This is being supported through the process of Collaborative Teaching that combines the capabilities and experience of medical physicists in countries spanning the spectrum of economic, technological, and clinical development. The supporting resources are on the web at: www.sprawls.org/resources. Learning Objectives: Identify the medical physics educational needs to support effective and optimized medical imaging procedures. Use collaborative teaching resources to enhance the role of medical physicists in all countries of the world.