Using multiple perspectives analysis to propose state cancer control policy in Abia State, Nigeria.

Abstract

e14132 Background: Beyond the National Cancer Control Plan, most States in Nigeria do not have State cancer control policies. Using the multiple perspectives analysis framework, this research sought to explore the perspectives of patients diagnosed with cancer, healthcare providers and health policymakers regarding cancer policy in Abia State. Methods: A concurrent mixed methods action research design was used. Sample included individuals aged ≥18 years who were diagnosed with cancer (patients), provided cancer treatment (providers) or made health policy (policymakers) in the State. Data were collected using surveys and key informant interviews. Data analysis involved descriptive statistics, chi-square test and a deductive thematic analysis. Results: Participants were 29 patients, 50 providers and 33 policymakers (n = 122), with an average age of 45 (±11) years. Challenges identified by ≥60% of participants were: low public awareness (75.9%); limited availability of treatment options (62.6%); lack of treatment pathways (92.8%); lack of local cancer data (95.2%); and, absence of support groups for patients (88.0%). Each group of participants (n = 3) rated cancer 9 out of 10 as a public health priority. Some qualitative themes were: low cancer awareness, delays in cancer treatment and financial burden on patients. “One thing I’d like to include in the policy is to make cancer a reportable disease in the State.” -Policymaker. Most participants (80%, 90/112) recommended that health insurance should fund ≥16% of cancer control activities, although policymakers were more likely to make quarterly insurance contributions than patients (7 out of 10 vs. 5 out of 10). Conclusions: Cancer control was an important issue for people in the State. Inadequate prevention services with a background of > 3-month diagnostic delays, characterized cancer control in Abia State. Future cancer control policy should emphasize cancer prevention, the creation of local clinical pathways and a blended financing model. [Table: see text]

Review of cancer control policy in Nigeria and comparison with selected African countries: Implications for future policy making

“…Low political will has been identified as challenge to adapt the present plan need to further explore the role of health insurance organization and how to mobilize financial resources for sustainable cancer control. Meanwhile, evidence showed that Nigerian health care professionals have limited knowledge about 46,47 cancer care , and the need to improve cancerrelated education among health professionals in 48 Nigeria has been recognized. The national cancer control plan also acknowledged the dearth of adequately-skilled clinicians who provide cancer 12 services.…”