Psychosocial and palliative care in African national cancer control plans: A qualitative study.

OBJECTIVE: Low and middle income countries of Africa account for a disproportionate amount of the global health burden of cancer. Providing patients access to psychosocial oncology and palliative care through policy structures such as the National Cancer Control Plans (NCCP) is essential to improving the care provided to patients and their families. The first phase of this study sought to determine the extent to which palliative care and psychosocial oncology were integrated in NCCPs in African countries. METHODS: A qualitative thematic analysis of the plans was used using Nvivo, with two-raters coding and continuous team discussions. Data were organized into an infographic map showing the coverage of themes across African countries. RESULTS: Fifty-eight NCCPs and NCD plans were analyzed in the 54 countries in Africa. The findings illustrate a lack of standardization across countries' NCCPs in addressing psychosocial oncology and palliative care themes. Certain areas presented good coverage across several plans, such as barriers to access, education, awareness, and health behaviors, coordination of care, families, caregivers and community involvement, and palliative care. Other themes presented low coverage, such as doctor-patient communication, mental health, bereavement, psychosocial care, survivorship care, and traditional medicine. CONCLUSIONS: One may consider further developing NCCP areas as they pertain to psychosocial oncology and palliative care to ensure their proper place on the policy agenda for a healthier Africa.

Behavioural oncology research in Africa: Lessons from the last two decades and key considerations moving forward.

OBJECTIVE: To analyse the state of behavioural oncology research in Africa and outline key considerations for future research. METHODS: Five bibliographic databases were searched to identify original English-language articles published between January 2000 and August 2020. The Behavioural Epidemiology Framework was applied to studies with data/findings from Africa to delineate their current state. Research gaps/opportunities available for behavioural oncology research in Africa were further highlighted. RESULTS: Two hundred eighty-seven original research with findings from Africa has been published over the last two decades, with the highest contribution arising from Nigeria, Kenya, Ethiopia and South Africa. Cervical and breast cancers were the most widely investigated. Prominently studied behaviours relate to cancer screening, health literacy, lifestyle, and vaccination. Behavioural oncology literature in Africa is generally in Phases I and III and lacks in measurement studies (<2%) and studies that seek to evaluate behaviour change/health promotion interventions (<6%) or translate them into practice (13.2%). CONCLUSION: Embracing new and progressive approaches, including methodological/analytical paradigms and implementation science is imperative to advance the frontiers of behavioural oncology research in Africa. This calls for a responsive research approach that can mobilise multidisciplinary/multilevel coalitions, ensuring a research structure that effectively integrates behavioural research and cancer prevention/control in the region.