Evolution of Cardiac Arrythmia Management by Catheter Ablation in Tanzania

Yona Gandye, Mervat Aboulmaaty, Amy Bonny, Mathew Sackett, K. Khanbhai, Pedro Pallangyo, H. Mayala, Mohamed Elalfy, Smitha Bhalia, M. Janabi
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Abstract

In Tanzania, despite the expansion of cardiovascular management through the expansion of health system infrastructure to combat cardiovascular diseases, radiofrequency ablation of cardiac arrhythmias remains a major challenge as the current management with catheter ablation is inaccessible to the majority. Several limitations for developing invasive arrhythmia care are identified: lack of manpower, healthcare resources, health systems challenges, high cost of consumables, healthcare financing challenges and limited antiarrhythmic medications. The proposed solutions to address the unmet are: inauguration of a domestic arrhythmia society with dedicated prioritized academic programs, advocacy for training in the cost-effective conventional approach to arrhythmia ablation, reducing irrational claim deduction from insurers and regulation of central medical store policy, calling the Ministry of Health to implement insurance accreditation of radiofrequency ablation in Tanzania, sensitize the government to offer motivation to candidates pursuing electrophysiology career, the government through the Ministry of Health and education to transform the current training infrastructure to meet current academic needs including radiofrequency ablation services, the creation of training partnerships within Africa to improve local electrophysiology expertise. Radiofrequency ablation using a conventional approach, which is cost-effective, can be adopted to ensure service availability in Tanzania and the Sub-Sahara region. A unique responsibility lies within the government and financers to reinforce the efforts to implement these recommendations and achieve the medical tourism policy in Tanzania.
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坦桑尼亚导管消融术治疗心律失常的发展历程
在坦桑尼亚,尽管通过扩大医疗系统基础设施来防治心血管疾病,扩大了心血管管理范围,但心律失常的射频消融仍然是一项重大挑战,因为大多数人无法获得目前的导管消融管理。发展侵入性心律失常治疗的几个限制因素是:缺乏人力、医疗资源、医疗系统挑战、耗材成本高、医疗融资挑战和抗心律失常药物有限。为解决这些问题而提出的解决方案包括成立国内心律失常协会,并制定专门的优先学术计划,倡导对心律失常消融术进行成本效益高的常规方法培训,减少保险公司不合理的索赔扣减,规范中央医药商店政策,呼吁卫生部对坦桑尼亚的射频消融术进行保险认证、提高政府的认识,为追求电生理学事业的候选人提供动力;政府通过卫生部和教育部改造现有的培训基础设施,以满足当前的学术需求,包括射频消融服务;在非洲建立培训合作伙伴关系,以提高当地的电生理学专业知识。可以采用具有成本效益的传统方法进行射频消融,以确保在坦桑尼亚和撒哈拉以南地区提供服务。政府和出资方肩负着独特的责任,必须加大力度落实这些建议,实现坦桑尼亚的医疗旅游政策。
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审稿时长
6 weeks
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