Gatekeepers’ perceptions of the quality and availability of services for breast and cervical cancer patients in the English-speaking Windward Islands: an exploratory investigation
Although extensive screening services for breast and cervical cancers are available in the Caribbean, these cancers continue to be the leading causes of cancer death among women in this region. The purpose of this study was to determine the quality and availability of breast and cervical cancer treatment care and support services from the perspective of the gatekeepers who provide care for the patients in the Windward Islands of Dominica, Grenada, St Lucia, and St. Vincent.
A qualitative research design using semi-structured, in-depth interviews was used to gather data from gatekeepers who provided oncology prevention and care services to patients for at least one year. Data were collected on availability and quality of cancer care and treatment services and coded using the themes obtained via thematic analysis of the data.
Twenty-three current providers participated in the study (Dominica, 5; Grenada, 7; St. Lucia, 5; St. Vincent and the Grenadines, 6). The participants' years of work experience ranged from 2 to 45 years. The codes encompassed a range of social ecological factors that influence breast and cervical cancer screening and treatment in the Windward Islands. The emergent themes were availability of resources, cost of care, and social support.
The findings of this study emphasize the varying social determinants of health that affect breast and cervical cancer prevention and treatment. It also highlights the disparities in availability of treatment within the wider Caribbean. It is necessary to broaden the perspective on health from a purely biomedical paradigm to a social perspective.
KeywordsBreast cancer Cervical cancer Treatment services Caribbean Gatekeepers Perspectives
The authors would like to thank the project coordinators in each of the four English-speaking Windward Islands, Julie Blaize, Marva Primus-Joseph, Lydia Atkins, and Patsy Wyllie; who worked tirelessly to recruit and interview the participants in this study. Additionally, we are grateful to Shelena Ali and Allison Samuel who assisted with data analysis. Finally, we would like to express our gratitude to all of the service providers in the Windward Islands who volunteered their time and upon whom the success of this project depended.
Financial support for this research was provided by a generous grant from the Center for Global Health (CGH) of the US National Cancer Institute (NCI) and the Caribbean Public Health Agency (CARPHA).
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