Abstract
BackgroundManagement of cancer in the Middle East and North Africa (MENA) region is accompanied by multiple challenges including heterogeneous access to early detection and treatment options and limited implementation of national cancer control plans. Furthermore, protracted armed conflicts across the region have had dramatic effects, including disruption of healthcare systems and the migration of healthcare professionals. Strengthening capacity for cancer research has been identified as a key intervention to correct data poverty, inform policy, manage limited resources and improve health outcomes.ObjectiveThe main objective of this study is to gain insights into the landscape, barriers and enablers of cancer training, research and care in the MENA region.MethodWe utilised purposive sampling to interview 16 key informants from a diverse academic, medical and research background originating from countries affected by conflicts, such as Lebanon, and from active conflict zones including Iraq and Syria.ResultsThe themes that emerged from the interviews focused on the barriers to cancer care, barriers to cancer research and training, strengths and importance of cancer research and training recommendations. The detrimental effect of conflict on cancer provision and research was a cross-cutting sub-theme disrupting cancer care provision and research due to unsafe environments, fragmented facilities, absence of drugs and migration of personnel. When asked about perceived optimal training format for cancer research, most informants recommended a post-graduate, face-to-face training focusing on cancer research methods and concepts.ConclusionThis study offers a unique insight into the barriers affecting cancer research and capacity-strengthening priorities from oncologists and researchers working in conflict-affected areas of the MENA region. These data will form the base for future capacity-strengthening initiatives addressing specific regional challenges.
Highlights
Management of cancer in the Middle East and North Africa (MENA) region is accompanied by multiple challenges including heterogeneous access to early detection and treatment options and limited implementation of national cancer control plans
This study offers a unique insight into the barriers affecting cancer research and capacity-strengthening priorities from oncologists and researchers working in conflict-affected areas of the MENA region
Many studies aimed at understanding the needs for cancer care and research have been conducted within the MENA context and beyond [32, 18]
Summary
Management of cancer in the Middle East and North Africa (MENA) region is accompanied by multiple challenges including heterogeneous access to early detection and treatment options and limited implementation of national cancer control plans. Multiple acute and chronic conflicts have affected the provision of cancer care services to populations in the MENA region and exacerbated existing challenges, including lack of universal health coverage, absent cancer control plans, inadequate human resource capacity and limited access to early detection and treatment options [2,3,4,5,6,7]. It is imperative to mobilise individual, institutional, national and international efforts to strengthen cancer research capacity in conflict-affected MENA countries (Table 1) Against this backdrop, and to explore the factors affecting cancer research activity, we conducted key informant interviews (KIIs) aiming to understand the contextual landscape, barriers and enablers of cancer training, research and care. This work is part of the needs assessment phase of the Research for Health in Conflict in the Middle East and North Africa (R4HC-MENA) project efforts for capacity strengthening of cancer research in conflict settings within the MENA region [19]
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