Challenges in paediatric cancer care in the People's Republic of China - critical reflection from a socio-ecological perspective

Abstract

Treatment of childhood cancer is demanding and low and middle income countries struggle with provision of such care. This dissertation is a literature review and applies a socio-ecological framework as a means to identify key challenges facing children suffering from cancer in China and their families. Further, existing support services for this specific population are assessed and recommendations for additional interventions are made. Various obstacles that interfere with children's medical care are found at policy, community and institutional levels. For example, social health insurance does not cover total costs for cancer treatment, which means that many children drop out of care when parents can no longer afford it. Perceptions that cancer is not treatable may hinder some caregivers accepting medical care for their child, and China lacks both the facilities and health care professionals for childhood cancer treatment. Communication with children about their disease is a major issue at the interpersonal level, and psychological problems among family members are identified as challenges at the intrapersonal level. As of today, support at the different levels largely derives from the non-governmental sector, through organisations founded by concerned parents. A comprehensive multi-level approach from various agents is necessary to further address the identified problems, including provision of full insurance coverage for treatment, efforts to raise public awareness, and introduction of structured provider-child communication related to the disease.