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Concerns and Needs of Support Among Guardians of Children on Cancer Treatment in Dar es Salaam

A Qualitative Study

Masika, Golden M., MSc; Gottvall, Maria, PhD; Kohi, Thecla W., PhD; von Essen, Louise, PhD; Dol, Justine S., MSc

doi: 10.1097/NCC.0000000000000722
Article: PDF Only

Background Cancer in children in Tanzania is a concerning health issue, yet there is a shortage of information about the experiences of the guardians of children who receive cancer treatment.

Objective To explore concerns and needs of support among guardians of children on cancer treatment in Dar es Salaam, Tanzania.

Method Using a qualitative design, 3 focus group discussions were held with 22 guardians of children aged 9 to 17 years. Guardians were recruited from Muhimbili National Hospital, Dar es Salaam, where their children were receiving cancer treatment. Data were analyzed using thematic content analysis.

Results Guardians experienced several issues during the initial stages of their child’s cancer treatment, including the process of seeking a diagnosis, and experiences with care at the peripheral (regional) hospitals and national hospital. They also shared what they felt would lessen their difficult experiences. Seven themes emerged in this study: financial concerns, emotional concerns, barriers to cancer care, need for improved cancer care, need for information, need for tangible support, and gratitude and hope.

Conclusion Guardians of children with cancer experience challenges during initial stages when seeking a diagnosis and have concerns and needs related to cancer care and treatment.

Implications for practice Improvements are needed regarding care at regional hospitals, the cancer diagnosis, and the recognition of early signs of cancer and quick referral to diagnostic centers, compassionate caring behaviors by healthcare workers, budgetary support from the government to meet the medication supply demands, and meeting stakeholders’ support needs.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Author Affiliations: School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania (Mr Masika); Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong (Mr Masika); Department of Women and Children’s Health, Uppsala University, Uppsala (Drs Gottvall and von Essen); and Department of Health Sciences, The Swedish Red Cross University College, Huddinge (Dr Gottvall), Sweden; School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (Dr Kohi); and Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada (Ms Dol).

The authors have no conflicts of interest to disclose.

Funding was provided by the Faculty of Medicine, Uppsala University, to the Clinical Psychology in Health Care research group, code Louise von Essen.

Correspondence: Golden M. Masika, MSc, School of Nursing and Public Health, 2nd F/ Administration building, College of Health and Allied Sciences, The University of Dodoma, P.O. Box 395, Dodoma, Tanzania, and Nethersole School of Nursing, Chinese University of Hong Kong (;

Accepted for publication February 28, 2019.

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