What influences cancer treatment service access in Ghana? A critical interpretive synthesis

Abstract

Objectives Multiple social-cultural and contextual factors influence access to and acceptance of cancer treatment in Ghana. This research aimed to assess the existing literature on how these factors interplay and could be susceptible to local and national policy changes. Design This study uses a critical interpretive synthesis approach to review qualitative and quantitative evidence about access to adult cancer treatment services in Ghana, applying the socioecological model and candidacy framework. Results Our findings highlighted barriers to accessing cancer services within each level of the socioecological model (intrapersonal, interpersonal community, organizational and policy levels), which are dynamic and interacting, for example, community-level factors influenced individual perceptions and how they managed financial barriers. Evidence was lacking about determinants of treatment non-acceptance across all cancers and in the most vulnerable societal groups due to methodological limitations. Conclusions Future policy should prioritize multilevel approaches, for example, improving the quality and affordability of medical care while also providing collaboration with traditional and complementary care systems to refer patients. Research should seek to overcome methodological limitations to understand the determinants of accessing treatment in the most vulnerable populations.