Perspectives of providers of cancer care in Tanzania: evidence and implications for policy

Cross, Charlotte; Makene, Fortunata Sangora; Mackintosh, Maureen; Ngilangwa, Richard Gordon; Santos, Cristina; Mujinja, Phares G. M. and Ngoma, Twalib (2023). Perspectives of providers of cancer care in Tanzania: evidence and implications for policy. Economic and Social Research Foundation, Dar es Salaam, Tanzania.


This discussion paper presents findings from interviews conducted in 2019 with 30 healthcare professionals in three regions of Tanzania. Participants included: clinicians and nurses at Ocean Road Cancer Institute, Kitete Regional Referral Hospital, Tumbi Regional Referral Hospital, and Aga Khan Hospital; Regional and District Medical Officers; and Regional and District Pharmacists. The paper considers barriers and facilitators to accessing and providing cancer care in Tanzania.

The research forms part of a larger collaborative project, Innovation for Cancer Care in Africa(ICCA). ICCA brings together researchers from Tanzania, Kenya, India and the United Kingdom to address the opportunities and challenges associated with linking industry and health systems in order to widen access to cancer care in Tanzania and Kenya.
Key findings presented in this paper include the following:
• Availability of medicine and equipment to treat cancer at specialist public sector facilities has increased since 2016.
• The cervical screening programme demonstrates the potential for the extension of low-cost screening and early treatment for cervical cancer across Tanzania, with potentially significant implications for reducing late presentation of patients. However, coverage is still incomplete at present and challenges associated with availability of resources and skilled personnel persist.
• Although cancer patients can access free treatment, many still incur considerable costs due to: costs incurred prior to receiving a diagnosis of cancer; travel and accommodation costs required to access treatment; and costs of purchasing medicine or paying for procedures when they are not available at public sector facilities. Costs can lead to delays in accessing treatment or abandonment of treatment.
• Shortages of skilled staff, particularly nurses and pathologists, affects the ability of health facilities to carry out screening and provide treatment, even when medicines and equipment needed to do so are available.
• It can be difficult for patients to obtain a cancer diagnosis due to limited availability of diagnostic technologies at lower tiers of the health system, the costs of diagnostic procedures and travel to obtain them, and shortages of human resources, reagents and consumables required for pathology where it is available.
•Referrals are a key point at which patients leave the system due to the significant costs often associated with pursuing them.
• The importance of palliative care was recognised by participants, however, appropriate pain relief is often unavailable or difficult to access.

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