Understanding the cultural and logistical context for urologists in low-income countries

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Authors
Campain, N.
Mabedi, C.
Savopoulos, V.
Payne, S. R.
MacDonagh, R.
Journal
BJU international
Type
Review
Publisher
Wiley
Rights
This article is protected by copyright. All rights reserved.
Understanding the provision of effective urological management in low-middle income countries (LMICs) is dependent upon the delivery of appropriate and effective care adapted to the needs, capability and resources of the host country. However, a deeper cognisance of the culture, the religious practices and the logistics of healthcare in that environment determines the ability to effectively 'twin', provide a long-term healthcare partnership. Patient beliefs can have profound effects on the understanding of the aetiology of illness, its relevance to their long-term health and the stigmatisation of their family's social status. Consequently, individuals may have a greater willingness to seek help from practitioners of traditional medicine, due to their availability and lower costs by comparison to those demanded by medicine from high-income countries (HICs). This can influence the treatment of many urological conditions as well as late-presenting states such as malignant ureteric obstruction. Social mores, such as cultural paternalism, can also influence many practices that are assumed by HICs to be part of normal healthcare provision, including the delivery of patient information and provision of an informed consent to treatment. Doctor's status, and dress, has greater importance in many countries in sub-Saharan Africa (sSA) than in the UK and the modes of greeting and addressing colleagues and patients can affect the fluency, and effectiveness, of clinical interactions. A local cultural, and religious, knowledge is, therefore, essential to optimise the assimilation of external help. Logistics are perhaps the most important factor that needs to be grasped to provide a sustainable healthcare environment. Limitations in resource allocation are a major factor in planning effective urological treatment in many countries in s-SA, whether the provision of trained personnel, basic infrastructure, a tenable workspace, equipment or drugs. This paper explores all of these factors, and how their recognition assists urologists in providing a twinning process.
Citation
BJU Int. 2022 Jan 19. doi: 10.1111/bju.15690.
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