article · BMC Cancer
Tanzania introduced National Cancer Treatment Guidelines in 2020 to standardise cervical cancer care and enhance patient safety. A case study was carried out at the Ocean Road Cancer Institute to investigate institutional management factors that affect adherence to these standards. Based on in-depth interviews with twenty experienced healthcare providers, researchers identified institutional elements that either support or hinder guideline adoption. Adherence is facilitated by clear organisational policies regarding guideline use, a supportive workplace environment, and established support systems. However, major operational challenges persist. High patient volumes relative to the number of healthcare providers, alongside medical equipment downtime, significantly obstruct regular compliance. Addressing personnel shortages by hiring additional oncologists, surgeons, and other key medical staff is vital to improving adherence and ensuring consistent, high-quality cervical cancer treatment.
Cervical cancer causes hundreds of thousands of deaths globally each year. While clinical guidelines are designed to standardise care and protect patients, they cannot succeed in isolation. Understanding the administrative hurdles and resource constraints inside specialized treatment centres helps health authorities address the operational bottlenecks that prevent standard protocols from delivering effective, life-saving care.
The abstract does not indicate a commercial application pathway, as it focuses on health system management, human resource capacity, and institutional policy implementation within a public cancer institute.
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Globally, cervical cancer is the fourth most common cancer among women, with approximately 604,000 new cases and 342,000 deaths reported in 2020. Like many other countries, Tanzania adopted the National Cancer Treatment Guidelines (NCTGs) in 2020 to improve the quality of care and ensure patient safety. However, despite the adoption of these guidelines, cervical cancer care in many healthcare facilities remains unstandardized. This study aimed to explore the institutional management factors influencing compliance with the NCTGs for cervical cancer care at Ocean Road Cancer Institute (ORCI). A case study design using a process evaluation approach was employed to assess the role of institutional management in influencing guidelines adherence. The study was conducted at ORCI, where 20 healthcare providers were purposively selected for in-depth interviews based on their experience and depth of knowledge on the topic. All interviews were audio-recorded, transcribed, and translated from Swahili to English. Thematic analysis was conducted by coding and organizing the transcribed texts to identify emerging themes and sub-themes. Findings revealed that key institutional management factors promoting compliance with the NCTGs at ORCI include the existence of a well-defined policy on guidelines utilization, a supportive working environment, and a well-established support system. Conversely, a significant barrier identified was the low healthcare provider-to-patient ratio and machine downtime. The study found that strong institutional management characterized by clear policies, a supportive work environment, and effective support systems facilitates adherence to the NCTGs at ORCI. Nonetheless, the shortage of healthcare personnel poses a major challenge. Therefore, it is essential for the Ministry of Health, in collaboration with ORCI management, to recruit additional oncologists, surgeons, and other critical healthcare professionals. Strengthening the provider-to-patient ratio is crucial for improving compliance with the NCTGs and ultimately enhancing the quality of cervical cancer care.
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DOI: 10.1186/s12885-025-14702-y
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