Introduction Implementing cancer survivorship guidelines in resource-limited settings poses unique challenges. While the National Comprehensive Cancer Network (NCCN) has developed harmonized survivorship guidelines for sub-Saharan Africa, little is known about the contextual factors that may affect their implementation in Nigeria, which bears the second-highest cancer burden in Africa. The objective of this study was to explore barriers and facilitators that may influence the implementation of NCCN harmonized survivorship guidelines based on perceptions, experiences, and attitudes of patients, caregivers, and healthcare providers at a major Nigerian cancer center using the Consolidated Framework for Implementation Research (CFIR). Methods The study used qualitative methods and interviewed 22 key informants to explore experiences and perceptions. Data collection and analysis were guided by CFIR domains: inner setting, outer setting, intervention characteristics, and individual characteristics. Results Nine patients, nine healthcare providers, and four caregivers were interviewed via Zoom. The study highlighted several factors that may influence the implementation of guidelines. Healthcare workers perceived barriers to implementing the guidelines included human resource shortages, financial constraints, and limited awareness of the guidelines. However, strong communication practices and the existing infrastructure were seen as potential facilitators. Among patients and caregivers, social and religious influences emerged as factors that could either support or hinder implementation, while financial-related constraints remained the most prominent barrier. Conclusion This study underscores the need for context specific guidelines. In this setting, such guidelines should more effectively address financial hardship, recognize and leverage the central role of caregivers, and consider the influence of faith and social networks in shaping patient experiences.
Shirima et al. (Wed,) studied this question.