A Study on Community Perceptions of Common Cancers, Determinants of Community Behaviour and Program Implementation in New Delhi, India

Assessment of perceptions of the community, the determinants and development of their behavior regardingcommon malignancies, helps in establishing evidence-based activities for prevention and early diagnosis of cancer.However information on this important aspect is lacking in our country. Qualitative methods were here usedto obtain information through in depth interviews and Focus Group Discussions (FGDs) with all categories ofidentified stakeholders. Most were unaware of the activities of the cancer control program. Even the providerswere not fully conversant. All respondents mentioned lack of diagnostic and treatment facilities in government,primary and secondary level facilities. Perceptions of different categories of stakeholders regarding why manycommunity members did not attend screening camps and other services reflect the determinants of communitybehavior, acting independently as well as in combination. The cancer control program was thought to be restrictedonly to some private facilities and overcrowded government tertiary care facilities where the visits were timeconsuming. Almost all the facilities were considered curative oriented. Issues of supervision, monitoring andfeedback were inadequately addressed by providers who were inadequately trained in many program activities.The program lacked effective planning, coordination and appropriate implementation at the grass roots levelin Delhi. Social mobilization was grossly inadequate, as most of the community members were unaware of theexistence of the program. Misconceptions about the risk factors, signs and symptoms, diagnosis, and treatmentwere common amongst community members as well as many of the providers. Thus the national cancer controlprogram in our country needs further community participation and social mobilization. Accessibility, availability,acceptability and affordability of various preventive, curative and rehabilitative activities, as well as intersectoralcoordination, training, supervision and monitoring of program activities, all need to be addressed to ensure thesuccess of this important public health program.