Views from Multidisciplinary Oncology Clinicians on Strengthening Cancer Care Delivery Systems in Tanzania

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Views from Multidisciplinary Oncology Clinicians on Strengthening Cancer Care Delivery Systems in Tanzania


JournalThe Oncologist
Article typeJournal research article – Clinical research
Publication date – May – 2021
Authors – Sarah K. Nyagabona , Rohan Luhar , Jerry Ndumbalo , Nanzoke Mvungi , Mamsau Ngoma , Stephen Meena , Sadiq Siu , Mwamvita Said , Julius Mwaiselage , Edith Tarimo , Geoffrey Buckle , Msiba Selekwa , Beatrice Mushi , Elia J. Mmbaga , Katherine Van Loon , Rebecca J. DeBoer
KeywordsAfrica, Cancer care, facilities, guideline adherence, implementation science, Low-and middle-income countries, quality improvement
Open access – Yes
SpecialitySurgical oncology
World region Eastern Africa
Country: Tanzania
Language – English
Submitted to the One Surgery Index on June 4, 2021 at 7:29 am
Abstract:

Background
In response to the increasing burden of cancer in Tanzania, the Ministry of Health Community Development, Gender, Elderly and Children launched National Cancer Treatment Guidelines (TNCTG) in February 2020. The guidelines aimed to improve and standardize oncology care in the country. At Ocean Road Cancer Institute (ORCI), we developed a theory-informed implementation strategy to promote guideline-concordant care. As part of the situation analysis for implementation strategy development, we conducted focus group discussions to evaluate clinical systems and contextual factors that influence guideline-based practice prior to launching of TNCTG.

Methods
In June 2019, three focus group discussions were conducted with a total of 21 oncology clinicians at ORCI, stratified by profession. A discussion guide was used to stimulate dialogue about facilitators and barriers to delivery of guideline concordant care. Discussions were audio recorded, transcribed, translated, and analyzed using thematic framework analysis.

Results
Participants identified factors both within the inner context of ORCI clinical systems and outside of ORCI. Themes within the clinical systems included: capacity and infrastructure, information technology, communication, efficiency and quality of services provided. Contextual factors external to ORCI included: inter-institutional coordination, oncology capacity in peripheral hospitals, public awareness and beliefs, and financial barriers. Participants provided pragmatic suggestions for strengthening cancer care delivery in Tanzania.

Conclusion
Our results highlight several barriers and facilitators within and outside of the clinical systems at ORCI that may affect uptake of the TNCTG. Our findings were used to inform a broader guideline implementation strategy, in effort to improve uptake of the TNCTGs at ORCI.

OSI Number – 21119

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