Presentation (CTI)

OBJECTIVES: Globally, there are 20 million new cancer cases and 9.7 million deaths each year, with survival rates at 40% in low- and middle-income countries compared to 80% in high-income countries. This study evaluates the limited implementation of adult cancer program at Jimma Medical Center in Southwest Ethiopia.
METHODS: A formative evaluation case study was conducted from February to May 2025 to assess adult cancer program implementation in three dimensions: (1) availability, (2) compliance, and (3) patient satisfaction, using 336 exit interviews. Data from document reviews, observations, and 12 key informant interviews were analyzed with Principal component analysis, a judgment matrix, and ATLASti. Predictors of satisfaction were identified through multivariable regression (p<0.05).
RESULTS: The overall implementation status was 75.32% (partially implemented). Service availability received a fair rating of 68.3%, while compliance was rated good at 83.27%. Patient satisfaction was 73.46%. Human resources were a significant gap, with only 21% of staff trained in cancer care, and 65% of equipment functional; Compliance showed high adherence rates for medication accuracy (100%), counseling (94%), and documentation (95%). Key predictors of satisfaction included longer wait times (β=−0.011, p=0.021) and larger family sizes (β=−0.070, p=0.026), which decreased satisfaction. In contrast, the wealth index (β=0.11, p=0.01), rural residence (β=0.25, p=0.023), and CBHI enrollment (β=0.245, p=0.03) improved satisfaction.
CONCLUSIONS: The adult cancer program at JMC demonstrates moderate success but faces resource limitations and moderate patient satisfaction. Recommendations include improving funding, training, and equipment; reducing wait times; and enhancing communication and insurance coverage.