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How can integration of oncology and palliative care services be achieved for optimal patient benefit? Stakeholders’ perspectives in Zimbabwe
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How can integration of oncology and palliative care services be achieved for optimal patient benefit? Stakeholders’ perspectives in Zimbabwe
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Journal Article
How can integration of oncology and palliative care services be achieved for optimal patient benefit? Stakeholders’ perspectives in Zimbabwe
2026
Overview
Abstract
Background
Cancer is a main driver of death and serious health-related suffering. The growing body of evidence for early integration of palliative care alongside oncological treatment to optimizes patient-reported outcomes is almost exclusively from high-income countries, while the greatest need is in low- and middle-income countries (LMICs). We aimed to explore the perspectives of patients, families and clinical staff on what constitutes a feasible, acceptable and appropriate model of integrated palliative and oncology care in Zimbabwe.
Materials and Methods
We conducted an exploratory qualitative study underpinned by indicators for integrated oncology and palliative care. Participants comprised healthcare professionals, patients, and families. Semistructured guides were developed and iteratively refined. Deductive framework analysis was conducted to Hui’s evidence-based framework of integrated oncology and palliative care indicators. The data were then further inductively coded into the framework.
Results
Analysis of data from 45 stakeholders (n = 15 per group) identified 19 of 38 indicators (50%) aligned with Hui’s model, indicating partial and uneven integration. Alignment was strongest in clinical processes (n = 9) and education (n = 5), with more limited support for administration (n = 3) and structure (n = 2). No findings aligned with the research domain. Inductive coding identified 3 indicators that aligned with clinical processes (routine discussion of prognosis, advance care planning and goals), clinical structure (physical environment) and education (training needs).
Discussion
While the Hui model is broadly applicable, substantial contextual adaptation is required. Integration cannot be achieved through coordination alone and requires system-level investment in workforce, training, infrastructure, and policy. We propose a phased “minimum package” for integration tailored to Zimbabwe and similar LMIC settings.
Publisher
Oxford University Press
