The impact of the COVID-19 pandemic on cancer care including innovations implemented in Sub-Saharan Africa: A systematic review
Open accessAbstract
Background: The coronavirus 2019 (COVID-19) pandemic has caused disruptions in the delivery and utilisation of cancer services. The impact of these interruptions is disproportionately borne by low- and middle-income countries in Sub-Saharan Africa (SSA). There are speculations of increased late-stage presentation and mortality as services are returning to the pre-pandemic state. This review aims to explore the extent to which the COVID-19 pandemic impacted cancer services across SSA and to identify innovations implemented across SSA to mitigate the impacts. Methods: Using database-specific search strategies, a systematic literature search was conducted in PubMed, Ovid (MedLine), Web of Science, and African Index Medicus. Eligible studies included original research, reports, perspectives and summaries of national or regional outcomes published in the English language. The primary outcome was changes in the delivery and utilisation of cancer prevention and screening, diagnosis, treatment and follow-up services. The secondary outcome was to identify implemented innovations to mitigate the impact of the pandemic on service delivery. Results: Out of the 167 articles identified in the literature search, 46 were included in the synthesis. A majority (95.7%) of the included articles described suspension and/or delay of screening, diagnosis, and treatment services, although two studies (4.3%) described the continuation of services despite the lockdown. Care was additionally impacted by transportation limitations, shortages of staff and personal protective equipment, disruption of the medication supply chain and patients' fears and stigma associated with contracting COVID-19. A major innovation was the use of telemedicine and virtual platforms for patient consultation and follow-up during the pandemic in SSA. Furthermore, drones and mobile applications were used for sample collection, medication delivery and scheduling of treatment. In some instances, medication routes and treatment protocols were changed. Conclusions: The delivery and utilisation of cancer services decreased substantially during the pandemic. Cancer centres initiated innovative methods of care delivery, including telehealth and drone use, with long-term potential to mitigate the impact of the pandemic on service delivery. Cancer centres in SSA must explore sustainable, facility or country-specific innovations as services return to the pre-pandemic state. Registration: The review was registered in PROSPERO with registration number CRD42022351455.
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The findings of this review are consistent with emerging international evidence that successful cancer care transformation increasingly relies on digital health, workforce innovation, team-based care, and community-oriented models of service delivery.
“The findings of this review are consistent with emerging international evidence demonstrating that successful cancer care transformation increasingly relies on digital health, workforce innovation, team-based care, and community-oriented models of service delivery”
From A Scoping Review of Implemented Innovations in Cancer Care: Implications for Pan-Canadian Scaling (2026) · cites this paper as [26]
The Results (Innovations implemented; page not provided) describe virtual training, teleconferencing, mobile clinics and home-based HPV self-sampling in sub-Saharan Africa. The Discussion (Telemedicine; page not provided) also describes virtual management-team meetings and potential long-term benefits. These examples support several elements of the claim, but the review does not establish that successful cancer care transformation internationally increasingly relies on all four models. (LLM, conf=0.83)
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- Authors
- Rine, S., Lara, S. T., Bikomeye, J. C., Beltrán-Ponce, S., Kibudde, S., Niyonzima, N., Lawal, O. O., Mulamira, P., & Beyer, K. M.
- Affiliations
- Medical College of Wisconsin (US)
- Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Uganda Cancer Institute (UG)
- University College Hospital, Ibadan (NG)
- Corresponding author
- Rine, Sarah
- ORCID
- Venue
- Journal of Global Health
- Published
- 2023-11-17
- Volume
- 13
- Pages
- 06048-06048
- ISSN
- 2047-2978 (ISSN-L)
- 2047-2986
- PMC
- PMC10656081
- OpenAlex
- W4388754313
- Cited by
- 16
- References
- 80
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 6
- FWCI
- 0.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Global Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Medical College of Wisconsin Cancer Center
- National Institute of General Medical Sciences (T32GM080202)
- Topics
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advances in Oncology and Radiotherapy
- Physical Sciences › Computer Science › Information Systems › Healthcare during COVID-19 Pandemic
- Keywords
- COVID-19 pandemic, cancer care, sub-Saharan Africa, telemedicine, unmanned aerial vehicles, mobile application, cancer screening, cancer diagnosis, cancer therapy, health workforce shortage, personal protective equipment, patient stigma, low- and middle-income countries
- MeSH terms
- COVID-19, Communicable Disease Control, Delivery of Health Care, Humans, Neoplasms, Africa South of the Sahara, Pandemics
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