Luo Amy, Naamaoui Maha, Soliman Amr, Obtel Majdouline, Kaikani Wafaa, Charaka Hafida, Nejjari Chakib, Khalis Mohamed
Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA.
Department of Population, Family and Reproductive Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.
Prim Health Care Res Dev. 2025 Jun 16;26:e47. doi: 10.1017/S1463423625100169.
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.
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.
Data were collected through in-depth interviews with cancer lay health advisors ( = 10) and civil society members ( = 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.
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.
本研究探讨癌症非专业健康服务提供者和民间社会对女性癌症检测与治疗的障碍及促进因素的看法。
2010年，摩洛哥卫生部实施了一项癌症护理与控制国家计划。活动重点是加强癌症护理与控制方面的多部门合作，包括在初级保健中促进早期检测。尽管在降低女性癌症死亡率方面取得了进展，但社会文化挑战阻碍了进一步的成果。阐明基于社区和参与癌症控制的民间社会的观点对于解决癌症差异至关重要。
通过对癌症非专业健康顾问（n = 10）和民间社会成员（n = 10）进行深入访谈，收集关于改善求医行为和治疗的挑战与机遇的主题数据。使用主题分析法并以社会生态模型为指导对数据进行分析。
在个人、家庭、社区/社会和卫生系统层面确定了早期诊断和治疗的障碍及促进因素。早期检测的障碍包括禁忌和耻辱感、对死亡的恐惧以及性别规范和角色。经济和地理障碍、缺乏心理社会支持以及卫生系统/提供者沟通不畅是与治疗相关的主要阻碍因素。结果表明了减少女性晚期就诊情况的干预目标，包括加强教育工作和扩大社区与初级保健的外联联系。
