Evaluation of the Current Strategy for Prevention and Control of Cancer- Gaza Governorates
Wissam Abou Amer
وسام أبو عمرو
Universally, cancer disease is considered as one of the first causes of premature death and disability and it is considered the third cause of death in Palestine. This study aims to evaluate the cancer control and prevention in Gaza Governorates in order to provide information that could contribute to identify the gaps in the strategy existence and development, to explore the implementation of the existing strategy and to shed light on the real situation on the ground that may be helpful to enhance any underperformance and identify future priorities. The study is a triangulated, descriptive and cross sectional one that was conducted in order to evaluate the cancer strategy and prevention in Gaza.. The qualitative data included interviews with key informants as well focus groups with cancer patients. The quantitative data was represented by four checklists that identified the number of the available beds and rooms for patients, available health care human resources, diagnostic equipment and exploring the completeness of cancer patient’s files. The results of the study revealed that there are gaps in the strategy of cancer control in Gaza Governorates starting from planning up to implementation. Those gaps are mainly related to poor financial and administrative coordination, shortages in health care human resources and inadequate staffing, inappropriate infrastructure of oncology buildings and deficiencies in necessary equipment and supplies. Moreover, there are heavy workloads on health personnel, prolonged waiting times for patients joined with poor privacy and comfort ability. In addition, the results showed the absence of clear guidelines and policies that should regulate the workflow and referral systems between health facilities. Regarding the prevention and screening services for cancer, they are limited to some sporadic programs and plans. In addition, Cancer diagnostic services are facing many barriers that lead to the delay in the diagnosis of the disease. There are obvious shortages in some facilities which are necessary for diagnosis as tumor marker test, Gamma Camera, Linear accelerator, MRI and CT scanners, and other factors related to poor awareness of patients, physician and health system role. Regarding the offered services to treat cancer disease, there are several obstacles that decrease the quality and completeness of care such as frequent shortages in essential chemotherapy medications, lack of specialized health human resources in specific types of cancer and the absence of radiotherapy treatment. This is joined by the absence of palliative care and poor provided support to the cancer patients and their families. The information system related to cancer diseases and services is also inadequate. There is an obvious poor support for the cancer registry. In addition, there are serious problems in the patient’s medical records. As an outcome, the cancer patient dissatisfaction is an important result associated with high anxiety, fear, and blaming. All of those factors would necessarily have its negative impacts on the overall quality of the health services provided to cancer patients. This is reflected by the patients’ deep dissatisfaction with the provided health care services that should decrease their anxiety, fear and hopelessness. The study recommended enhancing the available cancer strategy as well as adopting advanced policies for cancer prevention and palliative care. In addition, to improve the infrastructure of both facilities and human resources for cancer control. The study also recommended the importance of improving the communication between health personnel and cancer patients and to improve the existing information system such as cancer registry and to increase the research studies related to cancer management and control.