Abstract
IntroductionCancer is an important health problem in Africa with projections that incidence could double by 2030. While sparse, the literature on cancer control in African low- and middle-income countries suggests poor cancer planning, overburdened services and poor outcomes. South Africa has established oncology health care services but also has low cancer awareness, poor cancer surveillance and widespread service challenges.MethodsData for this study was derived from 316 photovoice interviews with cancer patients, families of cancer patients and oncology workers across South Africa. The objectives of the study were to collect first-hand feedback about cancer challenges and to develop recommendations for the improvement of cancer control strategies.Results9 themes of cancer challenges were distinguished via thematic content analysis of the photo-narratives. The identified themes of cancer challenges were physical and treatment challenges, emotional, poor services, transport, finances, information, powerlessness, stigma, and schooling challenges.ConclusionThe findings of this study offer the patient and family perspective of cancer challenges as a valid contribution to our body of cancer knowledge. The 9 themes of cancer challenges profile the emotional, physical and social impact of cancer on patients and families, and offer detailed subjective information about problem occurrence in the trajectory of care. Recommendations following from the 9 themes of cancer challenges include training for improved patient-centred care standards, the need for cancer surveillance, innovative and locally appropriate cancer awareness campaigns, private and government health care partnerships and the development of psychosocial services. The advocating of findings and recommendations to influence cancer control strategies in South Africa, is indicated.
Highlights
Cancer is an important health problem in Africa with projections that incidence could double by 2030
A host of socio economic problems, low cancer awareness, health systems shaped by complex political history [6] and competing health priorities, all contribute to widespread challenges for many cancer patients in their efforts to access cancer diagnostic, treatment and care services [7,8,9]
The advantage of using photovoice as an interview method for this study is that the narrative component could be used as data for the thematic analysis of cancer challenges, and the photovoice material could serve as evidence-based advocacy material
Summary
Cancer is an important health problem in Africa with projections that incidence could double by 2030. The literature on cancer control in African low- and middle-income countries suggests poor cancer planning, overburdened services and poor outcomes. South Africa has established oncology health care services and has low cancer awareness, poor cancer surveillance and widespread service challenges. Methods: Data for this study was derived from 316 photovoice interviews with cancer patients, families of cancer patients and oncology workers across South Africa. A host of socio economic problems, low cancer awareness, health systems shaped by complex political history [6] and competing health priorities, all contribute to widespread challenges for many cancer patients in their efforts to access cancer diagnostic, treatment and care services [7,8,9]. The purpose of the thematic analysis was to identify and describe grassroots cancer-related challenges and thereby contribute to what is known about the experience of coping with cancer in the SA context
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