“Money was the Problem”: Financial Difficulty is the Main Reason for
Treatment Abandonment by Children with Cancer in South West Uganda
Introduction - Treatment abandonment contributes significantly to poor
survival of children with cancer in low-middle-income countries (LMICs).
In order to inform an approach to this problem at our Cancer Unit, we
investigated why caregivers withdraw their children from treatment.
Methods – In a qualitative study, in-depth interviews were conducted
with caregivers of children who had abandoned cancer treatment at the
Paediatric Cancer Unit (PCU) of Mbarara Regional Referral Hospital
(MRRH) in South Western Uganda, between May 2017 and September 2020.
Recorded in-depth interviews with caregivers were transcribed and
analyzed to identify themes of caregiver self-reported reasons for
treatment abandonment. Results - Seventy-seven out of 343 (22.4%)
children treated for cancer at MRRH abandoned treatment during the study
period; 20 contactable and consenting caregivers participated in the
study. The median age of children’s caregivers was 37 years and most
(65%) were mothers. At the time of this study, eight (40%) children
were alive and 5 (62.5%) were males; with a median age of 6.5 years.
Financial difficulties, other obligations, the child falsely appearing
cured, preference for alternative treatments, belief that cancer was
incurable, fear that the child’s death was imminent and chemotherapy
side-effects were the caregivers’ reasons for treatment abandonment.
Conclusions and Recommendation – Treatment abandonment among children
with cancer in Uganda is, most times, as a result of difficult
conditions beyond the caregivers’ control and needs to be approached
with empathy and support.