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Initiating a Fetal Cardiac Program from Scratch in Low- and Middle-Income Countries: Structure, Challenges, and Hopes
1Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt. drshimaarhaka@mans.edu.eg.
Insights
Establishing fetal cardiac programs in low- and middle-income countries (LMICs) faces significant hurdles. Addressing financial, awareness, and training challenges through partnerships and modified protocols can create successful fetal cardiology services.
Area of Science:
- Cardiology
- Public Health
- Global Health
Background:
- Fetal cardiac programs are standard in developed nations but pose challenges in low- and middle-income countries (LMICs).
- Initiating fetal cardiac services in LMICs from the ground up encounters substantial obstacles.
- A framework for successful fetal cardiac programs, including essential team members, is crucial.
Purpose of the Study:
- To outline the structural framework for establishing efficient fetal cardiac programs in LMICs.
- To identify and address the multifaceted challenges hindering the initiation of fetal cardiac services in LMICs.
- To propose actionable solutions for overcoming barriers to fetal cardiac program development in resource-limited settings.
Main Methods:
- Detailed description of the primary structural components for a fetal cardiac program.
- Identification of key challenges: financial, awareness, prenatal screening, sociocultural, psychosocial, and social support.
- Exploration of solutions including fundraising, awareness campaigns, telemedicine, international partnerships, modified training, and support services.
Main Results:
- Key challenges identified include financial constraints, lack of awareness, inadequate prenatal screening, and sociocultural/psychosocial factors.
- Proposed solutions involve financial support collection, enhanced awareness for healthcare providers and families, telemedicine implementation, and international collaborations.
- Modified training for fetal cardiologists and sonographers, alongside support groups, are vital for program success.
Conclusions:
- Successful fetal cardiac program initiation in LMICs necessitates comprehensive, multi-aspect structural planning.
- Overcoming challenges requires diverse strategies, including improved training, increased awareness, and collaboration between governmental and non-profit organizations.
- Effective resource building and utilization are critical for establishing sustainable fetal cardiac services in LMICs.
Abstract:
Although fetal cardiac programs are well established in developed countries, establishing an efficient program in low- and middle-income countries (LMICs) is still considered a significant challenge. Substantial obstacles usually face the initiation of fetal cardiac service from scratch in LMICs. The primary structural frame of a successful fetal cardiac program is described in detail, emphasizing the required team members. The potential challenges for starting fetal cardiac services in LMICs include financial, awareness-related, prenatal obstetric screening, sociocultural, psychosocial, and social support factors. These challenges could be solved by addressing these barriers, such as collecting funds for financial support, raising awareness among families and health care providers, telemedicine, building international health partnerships, modifying training protocols for fetal cardiologists and sonographers, and initiating support groups and social services for families with confirmed fetal cardiac disease. Initiating a successful fetal cardiac program requires multi-aspect structural planning. The challenges for program initiation require diverse efforts, from modified training and promoting awareness of care providers and the community to governmental and nonprofit organizations' collaborations for proper building and utilization of program resources.
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