Abstract
Background
Individuals with cancer in low- and middle-income countries face significant barriers to care, which were exacerbated by the COVID-19 pandemic. Limited research exists on the pandemic’s impact on cancer care in these settings. This qualitative study examines the experiences of individuals with cancer at the Uganda Cancer Institute (UCI) during the COVID-19 pandemic to inform future policy and emergency preparedness.
Methods
Thirty individuals with cancer (11 male, 19 female, aged 18-71) receiving care at UCI were purposively sampled and interviewed between June – July 2022. Semi-structured interviews, conducted in English or Luganda, explored impacts of COVID-19 on treatment, access, and vaccination. Thematic analysis was completed on verbatim transcripts.
Results
Participants reported significant delays in treatment and appointments, some rescheduling up to four times, due to staffing shortages, travel bans, and loss of income. Transportation costs increased up to eightfold for rural patients, while lack of affordable accommodation and personal protective equipment further strained resources. Overcrowding at UCI forced some to sleep outside, and 41% of participants were not vaccinated, citing concerns about side effects. Misinformation, fear of infection, and reliance on social connections to access care were common.
Conclusions
COVID-19 exacerbated longstanding inequities in cancer care access at UCI, disproportionately affecting rural and low-income patients. Policy responses must address subsidized transportation, expanded UCI infrastructure and low-cost accommodations, provision of PPE, and investment in telehealth. Policymakers should prioritize cancer patients in emergency preparedness to ensure continuity of care for vulnerable populations during future public health crises.