The future of Choosing Wisely Africa

Dr Fidel Rubagumya - Queen's University, Canada / University of Rwanda, Kigali, Rwanda

What are the next steps in Choosing Wisely Africa?

The next steps, first of all we have done a lot in terms of Choosing Wisely on the continent. One is that we published a paper in 2020 sharing the ten practices that should be avoided on the continent. This has been accepted hugely on the continent. We also did a publication on understanding what the practitioners think about these practices and it showed us that actually many of our colleagues on the continent really agree with the list.

The next step was to look at how this practice was actually implemented in the clinics. So, as I said, we have heard from the presentation from Dr Sarah we did this in three countries – Rwanda, Tanzania and Ghana – and we are seeing variability in terms of practices in these countries where you find that MDTs are, for example, 100% for breast cancer in Rwanda but it’s still low in other countries. Hypofractionation in radiotherapy is also variable in these countries. So we find that there are practices that are really following the recommendations of Choosing Wisely Africa but others that are also not yet picked up.

So the next step is updating the list and going with the current evidence; it has been three years now and in oncology usually there is a lot that is happening on a daily basis. So we are going to update the list and then, of course, continue to raise awareness of the Choosing Wisely concept on the continent. To say that many physicians, oncologists, on the continent are actually practising what we are asking them to do by focussing on high value best care. That’s what we’re going to be doing next.

Anything you would like to add?

Personally I’m really happy today, the room was well attended and it shows that people are actually interested to understand what Choosing Wisely is and the concept in general. I hope that we keep the momentum and people continue to attend these meetings where we are raising awareness of patient-centred care that looks at improving the value of care that we are giving rather than the volume of care that we are giving.