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Access to Imaging Technology in Global Health

Abstract

Diagnostic imaging technologies have changed the way physicians both diagnose and treat human illness. While diagnostic imaging technologies are increasingly available throughout the world, there is great inequality in access to these important medical technologies. According to the World Health Organization (WHO), almost two-thirds of the world population, primarily in low- and middle-income countries (LMICs), lack access to basic imaging technology. This alarming statistic poses the important question, “How does one define ‘access’?” This chapter begins by exploring diagnostic imaging technologies essential to LMICs and the process through which the WHO measures availability of imaging technology. Then, the various aspects that make up the modern concept of “access” to healthcare will be discussed. This chapter will shed light on the modern theory of measuring access as it relates to modern definitions with emphasis on challenges that remain to determine the overall gap in adequate access to diagnostic imaging technology. By understanding what has been done and what remains to be done, one can construct a better picture of how to close the gap in access to imaging technology around the word. Initiatives aimed toward addressing inequality in access will be discussed.

Keywords

  • Access
  • Health technology
  • Social determinants of health
  • Equity
  • Justice
  • Social welfare

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Fig. 3.1
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References

  1. First WHO Global forum on medical devices: context, outcomes, and future actions. World Health Organization. 2011. http://whqlibdoc.who.int/hq/2011/WHO_HSS_EHT_DIM_11.11_eng.pdf. Accessed 25 July 2013.

  2. Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. World Health Organization. 2010. http://www.who.int/healthinfo/systems/WHO_MBHSS_2010_full_web.pdf. Accessed 1 Aug 2013.

  3. Menzin J, Sussman M, Kim I, Friedman M, Neumann PJ. Showing Imaging’s value — understanding the public policy landscape facing medical imaging. Radiol Today. 2008;9(17):22.

    Google Scholar 

  4. Baddeley H, Saltzman GF. Radiology in developing countries: a survey of radiological resources in the South Pacific Islands. Australas Radiol. 1987;31(3):228–31.

    CAS  CrossRef  Google Scholar 

  5. Brederhoff J, Racoveanu NT. Radiological services throughout the world. Diagn Imaging. 1982;51:121–33.

    CAS  PubMed  Google Scholar 

  6. Fuchs WA. Radiology in developing countries. Investig Radiol. 1991;26(10):906–9.

    CAS  CrossRef  Google Scholar 

  7. Global strategy for health for all by the year 2000. World Health Organization. 1981. http://whqlibdoc.who.int/publications/9241800038.pdf. Accessed 1 Aug 2013.

  8. Leggat PA. Basic radiological system: a case study in appropriate technology for better health. Aust J Rural Health. 1997;5:87–9.

    CAS  CrossRef  Google Scholar 

  9. Palmer PE. Radiology in the developing world. Br J Radiol. 1984;57(682):853–6.

    CAS  PubMed  Google Scholar 

  10. Essential Diagnostic Imaging. Department of Essential Health Technologies, World Health Organization. http://www.who.int/eht/en/diagnosticimaging.pdf. Accessed 8 Aug 2013. (22).

  11. Ostensen H, Volodin V. Diagnostic imaging in developing countries: considerations for improvement. Team of Diagnostic Imaging and Laboratory Technology, World Health Organization. Eur Radiol. 2000;10(Suppl 3):397–8.

    CrossRef  Google Scholar 

  12. Palmer PE, Hanson GP. Diagnostic imaging in the community: a manual for clinics and small hospitals, 2011. In: Honey-Buckman J, editor. Pan-American Health Organization, World Health Organization. 2011. http://new.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=14116&Itemid=>. Accessed 25 July 2013.

  13. Staeheli LA, Thompson A. Citizenship, community, and struggles for public space. Prof Geogr. 1997;49:28–38.

    CrossRef  Google Scholar 

  14. Kwan MP. Gender and individual access to urban opportunities: a study using space–time measures. Prof Geogr. 1999;51:210–27.

    CrossRef  Google Scholar 

  15. Janelle D, Hodge D. Measuring and Representing Accessibility in the Information Age. Specialist Meeting of Project Varenius’ Geographies of the Information Society Research Conference Report. National Center for Geographic Information and Analysis. 19–22 Nov 1998.

    Google Scholar 

  16. Handy SL, Niemeier DA. Measuring accessibility: an exploration of issues and alternatives. Environ Plan A. 1997;29(7):1175–94.

    CrossRef  Google Scholar 

  17. Hanson S, Schwab M. Accessibility and intraurban travel. Environ Plan A Econ Space. 1987;19(6):735–48.

    CrossRef  Google Scholar 

  18. Bowen WM, Salling MJ, Haynes KE, Cyran EJ. Toward environmental justice: spatial equity in Ohio and Cleveland. Ann Assoc Am Geogr. 1995;85(4):641–63.

    CrossRef  Google Scholar 

  19. McGrail MR, Humphreys JS. Measuring spatial accessibility to primary care in rural areas: improving the effectiveness of the two-step floating catchment area method. Appl Geogr. 2009;29(4):533–41.

    CrossRef  Google Scholar 

  20. Needs assessment for medical devices: WHO medical device technical series. World Health Organization. 2011. http://whqlibdoc.who.int/publications/2011/9789241501385_eng.pdf. Accessed 1 Aug 2013.

  21. Maru DS, Schwarz R, Andrews J, Basu S, Sharma A, Moore C. Turning a blind eye: the mobilization of radiology services in resource-poor regions. Glob Health. 2010;6:18.

    CrossRef  Google Scholar 

  22. Technical discussions: the role of medical devices and equipment in contemporary health care systems and services. 53rd Session, Regional Committee for the Eastern Mediterranean, World Health Organization. 2006. http://gis.emro.who.int/HealthSystemObservatory/PDF/TechnicalandDiscussionPapers/The%20role%20of%20medical%20devices%20and%20equipment%20in.pdf. Accessed 5 Aug 2013.

  23. Sippel S, Muruganandan K, Levine A, Shah S. Review article: use of ultrasound in the developing world. Int J Emerg Med. 2011;4:72.

    CrossRef  Google Scholar 

  24. Mindel S. Role of imager in developing world. Lancet. 1997;349:426–9.

    CrossRef  Google Scholar 

  25. The Global Burden of Disease: 2004 update. World Health Organization. 2008. http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf. Accessed 25 July 2013.

  26. WHO Publications. Diagnostic Imaging, World Health Organization. http://www.who.int/diagnostic_imaging/publications/en/. Accessed 25 July 2013.

  27. Baseline country survey on medical devices, 2010. World Health Organization. 2011. http://whqlibdoc.who.int/hq/2011/WHO_HSS_EHT_DIM_11.01_eng.pdf. Accessed 25 July 2013.

  28. Baseline country survey on medical devices, 2010: questionnaire. World Health Organization. 2011. http://www.who.int/diagnostic_imaging/activities/en/. Accessed 25 July 2013.

  29. World Health Statistics 2013. World Health Organization. 2013. http://apps.who.int/iris/bitstream/10665/81965/1/9789241564588_eng.pdf. Accessed 25 July 2013.

  30. Chan M. Cancer in developing countries: facing the challenge. Address at the IAEA Scientific Forum 2010. Geneva, Switzerland. 21 Sep 2010.

    Google Scholar 

  31. Gaudin N, Harding R. Global cancer rates could increase by 50% to 15 million by 2020. Geneva, Switzerland. 3 Apr 2003.

    Google Scholar 

  32. Kanavos P. The rising burden of cancer in the developing world. Ann Oncol. 2006;17(Suppl 8):viii15–23. Review.

    CrossRef  Google Scholar 

  33. Mellstedt H. Cancer initiatives in developing countries. Ann Oncol. 2006;17(Suppl 8):viii24–31. Review.

    CrossRef  Google Scholar 

  34. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87–108.

    CrossRef  Google Scholar 

  35. Stewart BW, Wild CP, editors. World Cancer Report 2014. Lyon, France: International Agency for Research on Cancer. 2014.

    Google Scholar 

  36. Frenk J. Cancer is on the rise in developing countries: The Shadow Epidemic. Harvard School of Public Health Magazine. Article based on remarks at Dana-Farber/Harvard Cancer Center. 7 Apr 2009.

    Google Scholar 

  37. Medical Equipment. Global Health Observatory Data Repository, World Health Organization. 2013. http://apps.who.int/gho/data/node.main.509?lang=en. Accessed 1 Aug 2013.

  38. Andersen R, Aday LA. Access to medical care in the U.S.: realized and potential. Med Care. 1978;16(7):533–46.

    CAS  CrossRef  Google Scholar 

  39. Andersen RM, McCutcheon A, Aday LA, Chiu GY, Bell R. Exploring dimensions of access to medical care. Health Serv Res. 1983;18(1):49–74.

    CAS  PubMed  PubMed Central  Google Scholar 

  40. Aday LA, Andersen RM. Equity of access to medical care: a conceptual and empirical overview. Med Care. 1981;19(12):4–27. Review.

    CAS  CrossRef  Google Scholar 

  41. Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981 Feb;19(2):127.

    CAS  CrossRef  Google Scholar 

  42. Halfon N, Inkelas M, Wood D. Nonfinancial barriers to care for children and youth. Annu Rev Public Health. 1995;16:447–72. Review

    CAS  CrossRef  Google Scholar 

  43. Weissman IS, Epstein AM. The insurance gap: does it make a difference? Annu Rev Public Health. 1993;14:243–70.

    CAS  CrossRef  Google Scholar 

  44. Khan AA, Bhardwaj SM. Access to health care. A conceptual framework and its relevance to health care planning. Eval Health Prof. 1994;17(1):60–76.

    CAS  CrossRef  Google Scholar 

  45. Local Production and Technology Transfer to Increase Access to Medical Devices: addressing the barriers and challenges in low- and middle-income countries. World Health Organization. 2012. http://www.who.int/medical_devices/1240EHT_final.pdf. Accessed 1 Aug 2013.

  46. Frost LJ, Reich MR. Access: how do good health technologies get to poor people in poor countries? Cambridge: Harvard University Press. 2008. http://www.accessbook.org/downloads/AccessBook.pdf. Accessed 1 Aug 2013.

  47. Andronikou S, McHugh K, Abdurahman N, Khoury B, Mngomezulu V, Brant WE, et al. Paediatric radiology seen from Africa. Part I: providing diagnostic imaging to a young population. Pediatr Radiol. 2011;41(7):811–25.

    CrossRef  Google Scholar 

  48. Outka G. Social justice and equal access to health care. Perspect Biol Med. 1975;18(2):185–202.

    CAS  CrossRef  Google Scholar 

  49. Levesque JF, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013;12:18. Review.

    CrossRef  Google Scholar 

  50. Acharya LB, Cleland J. Maternal and child health services in rural Nepal: does access or quality matter more? Health Policy Plan. 2000;15(2):223–9.

    CAS  CrossRef  Google Scholar 

  51. Dalla Palma L, Grisi G, Cuttin R, Rimondini A. Digital vs conventional radiography: cost and revenue analysis. Eur Radiol. 1999;9(8):1682–92.

    CAS  CrossRef  Google Scholar 

  52. Mollura DJ, Soroosh G, Culp MP, RAD-AID Conference Writing Group. 2016 RAD-AID Conference on International Radiology for Developing Countries: gaps, growth, and United Nations sustainable development goals. J Am Coll Radiol. 2017;14(6):841–7.

    CrossRef  Google Scholar 

  53. Kangovi S, Barg FK, Carter T, Long JA, Shannon R, Grande D. Understanding why patients of low socioeconomic status prefer hospitals over ambulatory care. Health Aff (Millwood). 2013;32(7):1196–203.

    CrossRef  Google Scholar 

  54. Braveman P, Gottlieb L. The social determinants of health: It’s time to consider the causes of the causes. Public Health Rep. 2014;129(Suppl 2):19–31.

    CrossRef  Google Scholar 

  55. Obrist B, Iteba N, Lengeler C, Makemba A, Mshana C, Nathan R, et al. Access to health care in contexts of livelihood insecurity: a framework for analysis and action. PLoS Med. 2007;4(10):1584–8. Review.

    CrossRef  Google Scholar 

  56. Reid KW, Vittinghoff E, Kushel MB. Association between the level of housing instability, economic standing and health care access: a meta-regression. J Health Care Poor Underserved. 2008;19(4):1212–28.

    CrossRef  Google Scholar 

  57. WHO Study Group. Training in diagnostic ultrasound: essentials, principles and standards. WHO Technical Report Series 875. Geneva. 1998.

    Google Scholar 

  58. Prasad C. A piece of my mind. A train of hope, and a chance to train. JAMA. 2012;307(19):2039–40.

    CAS  CrossRef  Google Scholar 

  59. Kroon J, Prince E, Denicker GA. Trends in treatment performed in the\ Phelophepa Dental Clinic: 1995–2000. SADJ. 2001;56(10):462–6.

    CAS  PubMed  Google Scholar 

  60. PinkDrive. http://www.pinkdrive.co.za. Accessed on 7/29/2017.

  61. Phelophepa. The Corporate Social Investment (CSI) Unit of Transnet. https://www.transnetfoundation.co.za/phelophepa.html. Accessed on 7/29/2017.

  62. Mollura D, Kendrick M, Dorey M. Straightline Aviation and RAD-AID Sign Agreement to Launch Medical Hybrid Airship Program for Humanitarian Aid. 9, 12, 2016. http://www.prnewswire.com/news-releases/straightline-aviation-and-rad-aid-sign-agreement-to-launch-medical-hybrid-airship-program-for-humanitarian-aid-593151491.html. Accessed on 7/29/2017.

  63. Bashshur RL, Reardon TG, Shannon GW. Telemedicine: a new health care delivery system. Annu Rev Public Health. 2000;21:613–37.

    CAS  CrossRef  Google Scholar 

  64. DC. Cancer Consortium. District of Columbia Cancer Control Plan 2013–2018. 2013. http://www.dccanceranswers.org. Accessed on 7/29/2017.

  65. Ahmed SM, Lemkau JP, Nealeigh N, Mann B. Barriers to healthcare access in a non-elderly urban poor American population. Health Soc Care Community. 2001;9(6):445–53.

    CAS  CrossRef  Google Scholar 

  66. Kerner JF, Dusenbury L, Mandelblatt JS. Poverty and cultural diversity: challenges for health promotion among medical underserved. Annu Rev Public Health. 1993;14:355–77.

    CAS  CrossRef  Google Scholar 

  67. Thomas JW, Penchansky R. Relating satisfaction with access to utilization of services. Med Care. 1984;22(6):553–68.

    CAS  CrossRef  Google Scholar 

  68. Kruk ME, Rockers PC, Mbaruku G, Paczkowski MM, Galea S. Community and health system factors associated with facility delivery in rural Tanzania: a multilevel analysis. Health Policy. 2010;97(2–3):209–16.

    CrossRef  Google Scholar 

  69. O’Donnell O. Access to health care in developing countries: breaking down demand side barriers. Cad Saude Publica. 2007;23(12):2820–34.

    CrossRef  Google Scholar 

  70. Derose KP, Varda DM. Social capital and health care access: a systematic review. Med Care Res Rev. 2009;66(3):272–306.

    CrossRef  Google Scholar 

  71. Xu K, Evans DB, Kadama P, Nabyonga J, Ogwal PO, Nabukhonzo P, Aguilar AM. Understanding the impact of eliminating user fees: utilization and catastrophic health expenditures in Uganda. Soc Sci Med. 2006;62(4):866–76.

    CrossRef  Google Scholar 

  72. Russell S, Gilson L. User fee policies to promote health service access for the poor: a wolf in sheep’s clothing? Int J Health Serv. 1997;27(2):359–79.

    CAS  CrossRef  Google Scholar 

  73. Powell DL, Gilliss CL, Hewitt HH, Flint EP. Application of a partnership model for transformative and sustainable international development. Public Health Nurs. 2010;27(1):54–70.

    CrossRef  Google Scholar 

  74. AmeriCares. Medical outreach: best practices study a literature review. May 2013. http://medicaloutreach.americares.org/wp-content/uploads/Americares-MedOutreachPracticesStudy-Lit-Review-Final.pdf. Accessed on 7/29/2017.

  75. Beck RG. Economic class and access to physician services under public medical care insurance. Int J Health Serv. 1973;3(3):341–55.

    CAS  CrossRef  Google Scholar 

  76. Apparicio P, Abdelmajid M, Riva M, Shearmur R. Comparing alternative approaches to measuring the geographical accessibility of urban health services: distance types and aggregation-error issues. Int J Health Geogr. 2008;7:7.

    CrossRef  Google Scholar 

  77. Fortney JC, Burgess JF Jr, Bosworth HB, Booth BM, Kaboli PJ. A re-conceptualization of access for 21st century healthcare. J Gen Intern Med. 2011;26(Suppl 2):639–47. Review.

    CrossRef  Google Scholar 

  78. Shengelia B, Tandon A, Adams OB, Murray CJ. Access, utilization, quality, and effective coverage: an integrated conceptual framework and measurement strategy. Soc Sci Med. 2005;61(1):97–109.

    CrossRef  Google Scholar 

  79. van Campen C, Sixma HJ, Kerssens JJ, Peters L, Rasker JJ. Assessing patients' priorities and perceptions of the quality of health care: the development of the QUOTE-Rheumatic-Patients instrument. Br J Rheumatol. 1998;37(4):362–8.

    CrossRef  Google Scholar 

  80. Ware JH, Louis TA. Statistical problems in environmental research. Can J Stat. 1983;11(1):51–68.

    CrossRef  Google Scholar 

  81. Campbell SM, Roland MO, Buetow SA. Defining quality of care. Soc Sci Med. 2000;51(11):1611–25.

    CAS  CrossRef  Google Scholar 

  82. Haddad S, Fournier P, Potvin L. Measuring lay people’s perceptions of the quality of primary health care services in developing countries. Validation of a 20-item scale. Int J Qual Health Care. 1998;10(2):93–104.

    CAS  CrossRef  Google Scholar 

  83. Tamburlini G, Cattaneo A. Gates’s grandest challenge. Lancet. 2005 15–21;366(9494):1357–8.

    CrossRef  Google Scholar 

  84. Frost LJ, Reich MR. Creating access to health technologies in poor countries. Health Aff (Millwood). 2009;28(4):962–73.

    CrossRef  Google Scholar 

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Morris, M.A., Saboury, B. (2019). Access to Imaging Technology in Global Health. In: Mollura, D., Culp, M., Lungren, M. (eds) Radiology in Global Health. Springer, Cham. https://doi.org/10.1007/978-3-319-98485-8_3

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