A mixed methods protocol for a framework to improve access to radiotherapy services for cancer patients in Gauteng Province, South Africa

Background: Cancer is a burden on public health worldwide, with its prevalence and mortality continually rising. Radiotherapy, a commonly used modality for the management of cancer, can be used alone or adjuvantly with other cancer treatment modalities for radical and palliative care. However, access to radiotherapy cancer care remained a challenge in many low- and middle-income countries, including South Africa, due to a shortage of equipment, trained personnel, and limited financial resources. This resulted in long waiting times and poor treatment outcomes. A comprehensive strategic framework is being developed to address these issues and improve overall access to radiotherapy for cancer patients in the region. This protocol was for a research study that aimed to develop a strategic framework encompassing policy reforms, infrastructure development, capacity building, and technology integration to enhance access to radiotherapy for cancer patients in Gauteng. Methods: The study employed a concurrent triangulation mixed methods approach to address the four research objectives, namely: Objective 1: To quantify the current effectiveness of radiotherapy treatment delivery; Objective 2: To assess the socio-economic parameters and demographics that govern access to radiotherapy services for cancer patients in Gauteng Province, South Africa; Objective 3: To explore radiotherapy quality indicators and their impact on patient outcomes, and Objective 4: Based on objectives 1 to 3, develop a practical framework that provides a roadmap for enhancing access to radiotherapy services in Gauteng. Quantitative data (Objectives 1 & 3a) was analysed using IBM SPSS software, while qualitative data (Objectives 2 & 3b) was analysed using ATLAS.ti version 23 through thematic content analysis. Ethical considerations were observed throughout the study. Discussion: The research has the potential to improve access to radiotherapy services. The developed framework will be valuable for policymakers, healthcare providers, and stakeholders in planning and implementing interventions addressing the identified barriers. Enhanced access to radiotherapy services will lead to timely treatment and improved outcomes for cancer patients.