Unmet Supportive Care Needs Among Cancer Patients in Sub-Saharan African Countries: A Mixed Method Systematic Review and Meta-Analysis

Meless Gebrie Bore; Abel Fekadu Dadi; Kedir Yimam Ahmed; Tahir Ahmed Hassen; Getiye Dejenu Kibret; Zemenu Yohannes Kassa; Erkihun Amsalu; Daniel Bekele Ketema; Lin Perry Professor; Addisu Alehegn Alemu; Jemal Ebrahim Shifa; Animut Alebel; Cheru Tesema Leshargie; Habtamu Mellie Bizuayehu

doi:10.1016/j.jpainsymman.2023.11.023

Unmet Supportive Care Needs Among Cancer Patients in Sub-Saharan African Countries: A Mixed Method Systematic Review and Meta-Analysis

J Pain Symptom Manage. 2024 Mar;67(3):e211-e227. doi: 10.1016/j.jpainsymman.2023.11.023. Epub 2023 Dec 2.

Authors

Affiliations

¹ School of Nursing and Midwifery (M.G.B., Z.Y.K.), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia; School of Nursing (M.G.B.), College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia. Electronic address: [email protected].
² Menzies School of Health Research (A.F.D.), Charles Darwin University, Northern Territory, Australia; Addis Continental Institute of Public Health (A.F.D.), Addis Ababa, Ethiopia. Electronic address: [email protected].
³ Rural Health Research Institute (K.Y.A.), Charles Sturt University, Orange, New South Wales, Australia. Electronic address: [email protected].
⁴ Center for Women's Health Research (T.A.H.), College of Health, Medicine and Wellbeing, the University of Newcastle, New South Wales, Australia. Electronic address: [email protected].
⁵ School of Public Health (G.D.K., D.B.K., A.A., C.T.L.), College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia; Save Sight Institute (G.D.K.), The University of Sydney, New South Wales, Australia.
⁶ School of Nursing and Midwifery (M.G.B., Z.Y.K.), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia; Department of Midwifery (Z.Y.K.), College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia.
⁷ Sydney Medical School (E.A.), Faculty of Medicine and Health, University of Sydney, New South Wales, Australia; St. Paul Hospital Millennium Medical College (E.A.), Addis Ababa, Ethiopia.
⁸ School of Public Health (G.D.K., D.B.K., A.A., C.T.L.), College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia; The George Institute for Global Health (D.B.K.), University of New South Wales (UNSW), Sydney, Australia. Electronic address: [email protected].
⁹ Faculty of Health, University of Technology Sydney (L.P.), Ultimo, Australia; Prince of Wales Hospital (L.P.), Randwick, New South Wales, Australia. Electronic address: [email protected].
¹⁰ School of Women's and Children's Health (A.A.A.), University of New South Wales, Sydney, Australia; College of Medicine and Health Science (A.A.A.), Debre Markos University, Debre Markos, Ethiopia. Electronic address: [email protected].
¹¹ School of Public Health, Faculty of Health (J.E.S., A.A., C.T.L.), University of Technology Sydney, Ultimo, New South Wales, Australia. Electronic address: [email protected].
¹² School of Public Health (G.D.K., D.B.K., A.A., C.T.L.), College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia; School of Public Health, Faculty of Health (J.E.S., A.A., C.T.L.), University of Technology Sydney, Ultimo, New South Wales, Australia. Electronic address: [email protected].
¹³ School of Public Health (G.D.K., D.B.K., A.A., C.T.L.), College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia; School of Public Health, Faculty of Health (J.E.S., A.A., C.T.L.), University of Technology Sydney, Ultimo, New South Wales, Australia. Electronic address: [email protected].
¹⁴ First Nations Cancer and Wellbeing (FNCW) Research Program (H.M.B.), School of Public Health, The University of Queensland, Australia. Electronic address: [email protected].

PMID: 38043746
DOI: 10.1016/j.jpainsymman.2023.11.023

Abstract

Introduction: Supportive cancer care is vital to reducing the current disparities in cancer outcomes in Sub-Saharan Africa (SSA), including poor survival and low quality of life, and ultimately achieving equity in cancer care. This is the first review aimed to evaluate the extent of unmet supportive care needs and identify their contributing factors among patients with cancer in SSA.

Methods: Six electronic databases (CINAHL, Embase, Medline [Ovid], PsycINFO, PubMed, and Cochrane Library of Databases] were systematically searched. Studies that addressed one or more domains of unmet supportive cancer care needs were included. Findings were analyzed using narrative analysis and meta-analysis, as appropriate.

Result: Eleven articles out of 2732 were retained in the review. The pooled prevalence of perceived unmet need for cancer care in SSA was 63% (95% CI: 45, 81) for physical, 59% (95% CI: 45, 72) for health information and system, 58% (95% CI: 42, 74) for psychological, 44% (95% CI: 29, 59) for patient care and support, and 43% (95% CI: 23, 63) for sexual. Older age, female sex, rural residence, advanced cancer stage, and low access to health information were related to high rates of multiple unmet needs within supportive care domains.

Conclusion: In SSA, optimal cancer care provision was low, up to two-thirds of patients reported unmet needs for one or more domains. Strengthening efforts to develop comprehensive and integrated systems for supportive care services are keys to improving the clinical outcome, survival, and quality of life of cancer patients in SSA.

Keywords: Cancer; Sub-Saharan African countries; health information and system domain; patient care and support domain; physical domain; psychological domain; sexuality domain; supportive care; unmet needs.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Africa South of the Sahara / epidemiology
Health Services Needs and Demand*
Humans
Needs Assessment
Neoplasms* / therapy
Palliative Care
Quality of Life