Challenges in a Newly Established Cancer Centre in Tanzania: Staff’s Perspectives

Abstract

Background: Cancer is a growing public health issue in low and middle income countries (LMIC). From estimated 14 million new cases each year, 8 million are diagnosed in LMIC. Case fatality rate is 75% in comparison with 46% in high income countries. Causes are low literacy levels, lack of awareness and knowledge about cancer among the population as well as limited education of health care providers leading also to late detection and diagnosis. In Tanzania, one of the poorest economies in the world, cancer incidences will double in the year 2030. To address the needs of cancer patients, the tertiary hospital of northern Tanzania established a new chemotherapy center in December 2016. However, there is limited knowledge about perceptions of professional staff toward chemotherapy treatment and cancer care in general in East Africa. This study aims to understand attitudes and perspectives of health care professionals and treatment related spectrum of challenges in the newly established center to assist future efforts in this field. Aim: This study aims to understand and analyze the attitudes and perspectives of the health care staff at the newly established Cancer Care Centre toward chemotherapy and the challenges they face on daily basis at their workplace. This understanding will assist future efforts to further apprehend the possible cancer treatment related spectrum of challenges that occur in low resource settings. Methods: As the research field is widely unknown, qualitative methods using in-depth interviews were chosen for inductive conceptualization of the topic. Analysis of data was performed according to qualitative content analysis. Results: 11 interviews were conducted with 3 males and 8 females with an average working experience was 7 years. 6 main categories were found: training and education of staff, interaction with the patients, availability of financial support, challenges in management, interests in future development and job satisfaction. Subcategories elaborated further within the main categories. Conclusion: Limitations in staffing, in training and education about chemotherapy were a major concern among the interviewees. The importance of sustainable funding and the needed cooperation of the government with international aid were mentioned as a key to avoid shortage of medication and equipment. Beside these concerns, the health care workers expressed their satisfaction with the new possibilities of treating cancer and the rewarding feedback of the patients. Misconceptions and poor knowledge on the patient side were mentioned as a reason for delayed health seeking behavior. Screening and awareness programs were mentioned as possible useful interventions.