Challenges to women's cancer control in Morocco: a qualitative study of lay advisors and civil society perspectives

Abstract

Aim: This study explores the perspectives of cancer lay health providers and civil society on the barriers and facilitators to cancer detection and treatment among women.

Background: In 2010, the Moroccan Ministry of Health implemented a national plan for cancer care and control. Activities focused on strengthening multisectoral collaboration in cancer care and control, including promoting early detection in primary care. Despite progress in reducing women's cancer mortality, socio-cultural challenges impede further gains. Elucidating the perspectives of the community-based and civil society allied in cancer control is critical to addressing cancer disparities.

Methods: Data were collected through in-depth interviews with cancer lay health advisors (n = 10) and civil society members (n = 10) on topics of challenges and opportunities to improve care-seeking and treatment. Data were analysed using thematic analysis and guided by the socio-ecological model.

Findings: Barriers and facilitators to early diagnosis and treatment were identified at levels of the individual, family, community/societal, and the health system. Barriers to early detection include taboo and stigma, fear of death, and gender norms and roles. Financial and geographic barriers, lack of psychosocial support, and poor health system/provider communication were major deterrents related to treatment. Results suggest intervention targets to reduce late-stage presentation for women, including enhancing educational efforts and augmenting community outreach linkages to primary care.

Keywords: Morocco; cancer; community health; health systems; lay health providers.

Figure 1.

Socio-ecological model of the barriers and facilitators to women’s cancer care in Morocco.