Health Systems Barriers to Cancer Care in Sub-Saharan Africa: A scoping review

This scoping review aimed to synthesise evidence on health system barriers and deficiencies that impact access to quality cancer care in sub-Saharan Africa. The author conducted a search of multiple databases for relevant studies published between 2000-2020. They included quantitative and qualitative studies that examined health system challenges related to cancer care delivery in sub-Saharan African countries. Key findings from the 19 included studies highlighted deficiencies across all six building blocks of the health system framework defined by WHO. Specifically, the review found limited health financing for cancer, shortages in health workforce and training, inadequate access to essential cancer medicines and technologies, poor information systems for cancer data collection, challenges with service delivery models and referral systems, and suboptimal governance and leadership regarding cancer care policies in the region. Overall, the scoping review synthesises evidence that sub-Saharan African health systems currently have critical gaps in their capacity, resources and infrastructure to equitably meet the rising burden of cancer. The author advocates that addressing these health system barriers will be essential to improve access, quality and outcomes of cancer care for patients across sub-Saharan Africa.