Healthcare providers’ awareness, perceptions and experiences in integrating palliative care for women with HIV and cancer in Nigeria: a qualitative study on barriers and facilitators

Abstract

Women living with HIV face an increased risk of cancer due to compromised immune systems, necessitating integrated care approaches that include palliative care (PC). However, in resource-limited settings such as Nigeria, significant gaps in integrating PC into community healthcare persist, resulting in suboptimal outcomes for women managing HIV and cancer conditions. Understanding the barriers to and facilitators of PC integration from the perspective of healthcare providers is essential for improving care delivery. A qualitative study was conducted across Nigeria’s six geopolitical zones, involving 24 healthcare providers from primary and secondary facilities affiliated with the Nigeria Implementation Science Alliance-Model Innovation and Research Centers (NISA-MIRCs). Key informant interviews (KIIs) and in-depth interviews (IDIs) were used to collect data, which were analyzed thematically via NVivo 14. Key barriers included distance to healthcare facilities, inadequate training and resources, sociocultural stigmas, and fragmented care systems. The facilitators highlighted were healthcare worker incentives, community engagement, patient education, and infrastructural improvements. The participants advocated for holistic and standardized integration of PC into healthcare services to enhance patient outcomes. Significant gaps in the integration of PC into community healthcare systems in Nigeria impede the delivery of holistic care to women managing HIV and cancer. Addressing these gaps requires targeted policy interventions, healthcare worker training, and resource allocation to improve access to and delivery of PC services. These findings provide actionable insights for strengthening PC infrastructure in resource-limited settings.