The socio-cultural contexts shaping health-seeking behaviours among community members regarding childhood cancer in Tanzania: A qualitative study.

Résumé

BACKGROUND: Timely diagnosis of childhood cancer, early hospital presentation and completion of treatment significantly improve outcomes. Unfortunately, in Tanzania, thousands of children die of cancer each year without ever being diagnosed or treated. To reduce childhood death from cancer, it is important to understand the social-cultural context, values and beliefs that influence healthcare-seeking behaviours among the Tanzanian community.METHODS: This was a cross-sectional qualitative study conducted in Mwanza, Kilimanjaro and Dar-es-Salaam regions between March and June 2021. We purposively selected community members aged ≥18 years from three rural and three urban settings to participate in seven focus group discussions (each with eight to 12 respondents). The participants were from communities without any affiliation to the treatment of children with cancer or treatment facilities. We transcribed, coded and analyzed data using a thematic-content approach with the support of NVIVO 12 software.RESULTS: Many had heard of breast or cervical cancer; however, most were unaware of childhood cancer. Adults believe that cancer in children is caused by witchcraft and cannot be cured by modern medicines available at hospitals. These beliefs lead parents to first seek care from traditional healers, which hence delay presentation to the hospital. Other community concerns included the cost of transportation, investigation-related costs, and the long duration of treatment. These have an influence on treatment adherence leading to seeking alternative treatment, such as spiritual or traditional treatment.CONCLUSION: Low community awareness, late hospital presentation, and treatment abandonment remain a challenge in childhood cancer in most parts of Tanzania. Belief about childhood cancer being a result of witchcraft and superstition contributes to limited health-seeking behaviours. Cultural and contextually relevant awareness campaign interventions are needed to increase cancer knowledge in Tanzanian communities.