The dynamics of breast cancer screening approaches in urban India: An ethnographic study from Delhi

As low-and middle-income countries (LMIC) progress through a demographic and epidemiological transition, countries like India are experiencing an increase in the incidence of cancer. For women, much of the cancer-related mortality is due to breast and cervical cancer. Mobile screening camps are being implemented as one of the approaches to expand access to opportunistic cancer screening.Using a socio-ecological framework, we intended to understand how female participants access and navigate the camps and the ways in which breast cancer awareness is affected by this screening process. We conducted 48 in-depth interviews with female camp attendees and stakeholder consultations with doctors and mobile camp staff in the National Capital Region to characterize the different levels of influence that determine whether or not a woman will attend a camp and subsequently seek follow-up. Using the extended case-study method, we examined how the barriers and facilitators of cancer screening vary among different identities and the role of facilitators in mobilization.We found that the influence of social networks and the facilitation of camp organizers are some of the greatest predictors of attendance. We identified specific influencers, such as religious leaders and employers, who have various degrees of engagement with the targeted population and can motivate them to attend the screening camps. We propose a screening programme that would leverage these networks as well as existing programmes, such as the Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH ​+ ​A) platform, for targeted screening and establishing continuity. While capacity is built to host large-scale screening, interim solutions can focus on improving the functioning of existing opportunistic screening by engaging a strong network of community facilitators and closing knowledge gaps. Reducing the cancer burden will require that women are not only screened for cancer, but also able to successfully complete cancer treatment

Children’s environmental health in south and southeast Asia: networking for better child health outcomes

Children are particularly vulnerable to environmental hazards because they receive higher doses of pollutants in any given environment and often do not have equitable access to social protection mechanisms such as environmental and health care services. The World Health Organization established a global network of collaborating centres that address children's environmental health (CEH). The network developed a focus on low- and middle-income countries (LMICs) and is broadening its reach by conducting regional workshops for CEH.Objective: This paper reports on the outcomes of a workshop held in conjunction with the 17th International Conference (November 2017) of the Pacific Basin Consortium for Environment and Health, focused on the state of CEH in South and Southeast Asia as presented by seven countries from the region (India, Bangladesh, Nepal, Bhutan, Vietnam, Thailand, Sri Lanka).Workshop outcomes: Country reports presented at the meeting show a high degree of similarity with respect to the issues threatening the health of children. The most common problems are outdoor and household air pollution in addition to exposure to heavy metals, industrial chemicals, and pesticides. Many children still do not have adequate access to clean water and improved sanitation while infectious diseases remain a problem, especially for children living in poverty. Child labour is widely prevalent, generally without adequate training or personal protective equipment. The children now face the dual burden of undernutrition and stunting on the one hand and overnutrition and obesity on the other.Conclusion: It is evident that some countries in these regions are doing better than others in varying areas of CEH. By establishing and participating in regional networks, countries can learn from each other and harmonise their efforts to protect CEH so that all can benefit from closer interactions