Oncology Personnel and Drug Availability in Management of Cancer in Eastern Africa: A Scoping Review

Abstract

The burden of care for cancer patients in East Africa has, over the years, been exacerbated by limitations like the absence of comprehensive cancer care pathways, the lack of a specialised oncology workforce, and under provision of the necessary cancer medicines from national governments. The primary objective of this scoping review is to analyse previously documented research, synthesise the available evidence, and characterise these limitations based on individual demographic factors. Data from the appraised evidence alluded to the absence of a specialised oncology workforce, who were found to be centralised within urban centres, resulting in inequitable access to specialised cancer care among patients residing in underserved regions. The review also noted a significant trend of task shifting to the mid-level healthcare workforce, who lack formal standardised training. Similarly, most cancer care facilities were reported to have limited cancer care drugs and diagnostic commodities, with the available drugs being overpriced to match the huge demand. All these factors have a role to play in causing cancer diagnostic delays, and clinical expertise is moot, resulting in most patients being diagnosed with advanced-stage cancer with limited pharmacotherapeutic agents to see them through their disease cycle trajectory. Although most facilities are embracing task shifting and decentralised service delivery approaches, they often face financial constraints and supply chain breakdowns that incapacitate the sustainability of these novel approaches