GROUND-BREAKING SOUTH AFRICAN HEALTH REVIEW HIGHLIGHTS CANCER CARE CRISIS
Download the SAHR 2023: Strengthening cancer services
The Health Systems Trust is proud to announce the release of the
South African Health Review (SAHR) 2023, a pioneering edition dedicated entirely to the pressing challenges, successes, and gaps in cancer care within the South African healthcare system. This landmark publication draws on the expertise of leading specialists and academics across the country, calling for urgent reforms and investment to improve cancer prevention, early diagnosis, treatment, and support in an integrated, patient-centred and innovative way.
This special edition marks a first for the
SAHR, offering in-depth analysis and insights aimed at rethinking current policies and fostering a more integrated, holistic approach to cancer care.
Key areas of focus include:
● Delays in diagnosis and treatment
● Fragmented services and inequitable access to care
● Disparities between policy and practice
● Low awareness and screening rates for cancer
● Innovations in screening and patient management
Key Findings and Recommendations from the South African Health Review 2023:
The South African Health Review highlights the
urgent need for a strategic cancer plan that addresses the distinct requirements of children and other vulnerable populations. The report stresses that targeted interventions are essential to improve childhood cancer outcomes, ensuring that these groups receive the care they need.
The
fragmentation of services presents another barrier to effective cancer care. Staff shortages and poor communication disrupt coordinated care delivery. Strengthening the role of primary healthcare to manage cancer cases can help to alleviate this issue and ensure that patients receive more continuous and holistic care throughout the care pathway.
Access to oncology medicines remains a challenge due to non-transparent approval processes and pricing disparities between the public and private sectors. A multi-stakeholder forum is recommended to create legislative solutions that address these barriers, ensuring that life-saving treatments are accessible to all who need them.
The
Review also emphasises the need for
improved public awareness and early diagnosis of cancer. Many South Africans remain unaware of cancer risks and symptoms as well as continue to experience high levels of stigma and discrimination. The development of locally validated tools for cancer awareness could significantly enhance early detection efforts.
Many women are not participating in
breast cancer screening, often due to socio-economic and cultural factors. Addressing these barriers is vital to increasing screening uptake and promoting early detection, particularly among underserved populations.
The
Review also found that
delays in diagnosing breast cancer are a significant concern. Although the national Breast Cancer Prevention and Control Policy recommends a referral time of 21 to 60 days, the Review reveals that a four-month delay between the first visit and diagnostic biopsy is not uncommon. This points to a considerable knowledge gap regarding the urgency of referrals for suspected malignancies and poorly developed health systems to respond to patients timeously.
In under-resourced areas,
clinical genetics services can significantly improve patient care and help to identify at-risk family members. Expanding these services through collaborative efforts could extend crucial care to more people.
Ototoxicity monitoring for patients undergoing certain cancer treatments is another area of concern. By integrating audiological services into cancer care, healthcare providers can offer a more comprehensive, patient-centred approach.
The
Review stresses the importance of
expanding cancer prevention strategies to regulate risk factors like alcohol consumption, obesity, and ultra-processed foods. These prevention efforts are critical to reducing the overall cancer burden in the country.
Finally,
better data collection is needed for effective cancer management. The current lack of comprehensive cancer-related data hampers the ability to assess the true burden of the disease and limits the development of informed strategies for prevention, treatment, and palliative care. Addressing this gap is key to improving cancer outcomes across South Africa.
Commenting on the
Review, Professor Salome Maswime, Chairperson of the Board of Trustees at Health Systems Trust, expressed her optimism:
"I am confident that this landmark edition will spark meaningful change, elevating cancer services as a national priority, raising awareness, and driving progress towards a stronger healthcare system that better serves all South Africans."
About the South African Health Review
The
South African Health Review is an accredited peer-reviewed publication. Now in its 26th edition, the aims of the Review are to advance the sharing of knowledge, to feature critical commentary on policy implementation, and to offer an empirical understanding towards improving South Africa’s health system. The Review is recognised as one of the most authoritative sources of commentary on the South African health system.
About the Health Systems Trust
The Health Systems Trust (HST) is a leading role-player in the South African public health arena, focusing on health systems strengthening, research, and strategic support in the implementation of priority health programmes. Established in April 1992, on the brink of democracy in South Africa, HST has played a significant role in the evolution of the national health system.
Issued by the Health Systems Trust