Detection and management of localized prostate cancer in Nigeria: barriers and facilitators according to patients, caregivers and healthcare providers

• Published in: BMC health services research Vol. 24; no. 1; pp. 918 - 11
• Main Authors: Tolani, Musliu Adetola, Agbo, Christian A, Paciorek, Alan, Umar, Shehu S, Ojewola, Rufus W, Mohammed, Faruk, Kaninjing, Ernie, Ahmed, Muhammed, DeBoer, Rebecca
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.08.2024; BioMed Central; BMC
• Subjects: Adult; Aged; Androgens; Cancer therapies; Care and treatment; Caregivers; Caregivers - psychology; Delivery of health care; Diagnosis; Early Detection of Cancer; Evaluation; Focus Groups; Health Knowledge, Attitudes, Practice; Health Personnel - psychology; Health Services Accessibility; Humans; Male; Middle Aged; Mortality; Needs assessment; Nigeria; Oncology; Patients; Prostate cancer; Prostatic neoplasms; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - therapy; Qualitative Research; Radiation therapy; Teaching hospitals; Urology; Nigeria; Africa; Qualitative research; Delivery of health care; Prostatic neoplasms; Nigeria; Health services accessibility; Needs assessment
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-024-11340-1

Prostate cancer mortality rates are high in Nigeria. While prostate cancer is highly curable with early detection and effective multidisciplinary management, the quality of care is suboptimal in this setting. Sustainable delivery of high-quality care for patients with localized prostate cancer is needed to save more lives. To inform future interventions to improve care, this study aimed to identify barriers and facilitators that influence prostate cancer detection and management in Nigeria. Six focus group discussions (FGDs), stratified by stakeholders were conducted with a purposive sample of prostate cancer patients (n = 19), caregivers (n = 15), and healthcare providers (n = 18), in two academic tertiary hospitals in northern and southern Nigeria. A discussion guide organized based on the socio-ecological model was used. FGDs were recorded, transcribed, and analysed using the framework technique. Barriers and facilitators were identified at the individual, interpersonal, and organizational levels. Barriers to detection included limited knowledge and misperceptions among patients, caregivers, and community-based non-specialist healthcare providers, and limitations of centralized opportunistic screening; while facilitators included the potential for religious institutions to encourage positive health-seeking behaviour. Barriers to management included non-uniformity in clinical guideline usage, treatment abandonment amidst concerns about treatment and survival, absence of patient interaction platforms and follow-up support systems, difficulty in navigating service areas, low health insurance coverage and limited financial resource of patients. Facilitators of management included the availability of resource stratified guidelines for prostate cancer management and the availability of patient peers, caregivers, nurses, and medical social workers to provide correct medical information and support patient-centred services. Participants also provided suggestions that could help improve prostate cancer detection and management in Nigeria. This study identified multiple determinants affecting the detection and management of localized prostate cancer. These findings will inform the refinement of implementation strategies to improve the quality of prostate cancer care in Nigeria.