Challenges and facilitators in pathways to cancer diagnosis in Southern Africa: a qualitative study
Objectives To explore healthcare workers’ (HCWs) experiences, barriers and facilitators in managing patients with symptoms of possible breast, cervical or colorectal cancer.Design A qualitative in-depth interview study with HCWs managing patients with breast, cervical and colorectal cancer symptoms....
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BMJ Publishing Group
2025-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/6/e099296.full |
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| author | Fiona M Walter Jennifer Moodley Tasleem Ras Melinda Moyo Natalie Tegama Sarah Day Kirsten Deanne Arendse Suzanne E Scott Sunga Mzeche Bothwell Takaingofa Guzha Valerie Anne Sills |
| author_facet | Fiona M Walter Jennifer Moodley Tasleem Ras Melinda Moyo Natalie Tegama Sarah Day Kirsten Deanne Arendse Suzanne E Scott Sunga Mzeche Bothwell Takaingofa Guzha Valerie Anne Sills |
| author_sort | Fiona M Walter |
| collection | DOAJ |
| description | Objectives To explore healthcare workers’ (HCWs) experiences, barriers and facilitators in managing patients with symptoms of possible breast, cervical or colorectal cancer.Design A qualitative in-depth interview study with HCWs managing patients with breast, cervical and colorectal cancer symptoms. We also conducted workshops with a group of HCWs to check the credibility of the interview findings.Setting The study was conducted with staff working in primary, secondary and tertiary public health facilities in the Eastern and Western Cape in South Africa (SA), and Harare and Bulawayo and their referral provinces in Zimbabwe.Participants HCWs with experience in managing patients with symptoms of possible breast, cervical or colorectal cancer were recruited for the study. Participants were purposively sampled based on region, healthcare level and job role. A total of 56 participants (26 in SA and 30 in Zimbabwe) participated in the in-depth interviews. 26 (12 in SA and 14 in Zimbabwe) participated in four clinical advisory group workshops across both countries.Results Drawing on the Model of Pathways to Treatment, HCWs’ perceptions of patient-level factors influencing the diagnostic interval included financial limitations, patients’ absence and delays in attendance. Healthcare provider and system factors included: challenges with referral and feedback systems; training needs; low awareness of protocols and guidelines; inappropriate and suboptimal clinical assessments; and broader socioeconomic factors and resource limitations.Conclusion Improving the timely diagnosis of breast, cervical and colorectal cancer in Southern Africa necessitates targeted strategies that address both patient-related, provider and health-system delays. |
| format | Article |
| id | doaj-art-e6157afe0d0747678fe8e8e39612e4ed |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-e6157afe0d0747678fe8e8e39612e4ed2025-08-20T03:24:02ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2025-099296Challenges and facilitators in pathways to cancer diagnosis in Southern Africa: a qualitative studyFiona M Walter0Jennifer Moodley1Tasleem Ras2Melinda Moyo3Natalie Tegama4Sarah Day5Kirsten Deanne Arendse6Suzanne E Scott7Sunga Mzeche8Bothwell Takaingofa Guzha9Valerie Anne Sills10Wolfson Institute of Population Health, Queen Mary University of London, London, UKCancer Research Initiative, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South AfricaDepartment of Family, Community and Emergency Care, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South AfricaDepartment of Obstetrics and Gynaecology, Faculty of Medicine & Health Sciences, University of Zimbabwe, Harare, ZimbabweOxford Population Health, University of Oxford, Oxford, UKCancer Research Initiative, University of Cape Town Faculty of Health Sciences, Cape Town, Western Cape, South AfricaWolfson Institute of Population Health, Queen Mary University of London, London, UKWolfson Institute of Population Health, Queen Mary University of London, London, UKDepartment of Obstetrics and Gynaecology, Faculty of Medicine & Health Sciences, University of Zimbabwe, Harare, ZimbabweDepartment of Obstetrics and Gynaecology, Faculty of Medicine & Health Sciences, University of Zimbabwe, Harare, ZimbabweWolfson Institute of Population Health, Queen Mary University of London, London, UKObjectives To explore healthcare workers’ (HCWs) experiences, barriers and facilitators in managing patients with symptoms of possible breast, cervical or colorectal cancer.Design A qualitative in-depth interview study with HCWs managing patients with breast, cervical and colorectal cancer symptoms. We also conducted workshops with a group of HCWs to check the credibility of the interview findings.Setting The study was conducted with staff working in primary, secondary and tertiary public health facilities in the Eastern and Western Cape in South Africa (SA), and Harare and Bulawayo and their referral provinces in Zimbabwe.Participants HCWs with experience in managing patients with symptoms of possible breast, cervical or colorectal cancer were recruited for the study. Participants were purposively sampled based on region, healthcare level and job role. A total of 56 participants (26 in SA and 30 in Zimbabwe) participated in the in-depth interviews. 26 (12 in SA and 14 in Zimbabwe) participated in four clinical advisory group workshops across both countries.Results Drawing on the Model of Pathways to Treatment, HCWs’ perceptions of patient-level factors influencing the diagnostic interval included financial limitations, patients’ absence and delays in attendance. Healthcare provider and system factors included: challenges with referral and feedback systems; training needs; low awareness of protocols and guidelines; inappropriate and suboptimal clinical assessments; and broader socioeconomic factors and resource limitations.Conclusion Improving the timely diagnosis of breast, cervical and colorectal cancer in Southern Africa necessitates targeted strategies that address both patient-related, provider and health-system delays.https://bmjopen.bmj.com/content/15/6/e099296.full |
| spellingShingle | Fiona M Walter Jennifer Moodley Tasleem Ras Melinda Moyo Natalie Tegama Sarah Day Kirsten Deanne Arendse Suzanne E Scott Sunga Mzeche Bothwell Takaingofa Guzha Valerie Anne Sills Challenges and facilitators in pathways to cancer diagnosis in Southern Africa: a qualitative study BMJ Open |
| title | Challenges and facilitators in pathways to cancer diagnosis in Southern Africa: a qualitative study |
| title_full | Challenges and facilitators in pathways to cancer diagnosis in Southern Africa: a qualitative study |
| title_fullStr | Challenges and facilitators in pathways to cancer diagnosis in Southern Africa: a qualitative study |
| title_full_unstemmed | Challenges and facilitators in pathways to cancer diagnosis in Southern Africa: a qualitative study |
| title_short | Challenges and facilitators in pathways to cancer diagnosis in Southern Africa: a qualitative study |
| title_sort | challenges and facilitators in pathways to cancer diagnosis in southern africa a qualitative study |
| url | https://bmjopen.bmj.com/content/15/6/e099296.full |
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