Health-care providers' perspectives on childhood cancer treatment in Manado, Indonesia

S. Mostert, S. Gunawan, J. A.P. Van Dongen, P. M. Van De Ven, M. N. Sitaresmi, E. E. Wolters, A. J.P. Veerman, M. Mantik, G. J.L. Kaspers

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Background: Childhood cancer survival in low-income countries is low. Objective: Our study investigated health-care providers' perspectives on childhood cancer treatment in Indonesia. Their health beliefs and attitudes toward parental financial difficulties, protocol adherence, parental education, and communication were explored. Methods: A self-administered questionnaire was filled in by 222 health-care providers (156 doctors, 51 nurses, 6 social workers, 9 administrators) Results: Health of children with cancer is beyond doctor's control and determined by luck, fate or God according to 35% of health-care providers, 30% were uncertain about this statement, and 35% disagreed. Combination of chemotherapy and alternative treatment is best to achieve cure according to 15% of health-care providers, 50% were uncertain, and 35% disagreed. Prosperous parents adhere better with treatment (67%). Doctors adhere better with cancer treatment for prosperous patients (55%). When dealing with poor families, less elaborate explanation is given (62%), more difficult vocabulary is used (49%), and less cooperation is offered (46%). Reasons for non-adherence with treatment protocol were as follows: financial difficulties parents (82%), side-effects (77%), lack of motivation parents (75%), and inadequate drugs supply at pharmacy (70%). Information about cancer and treatment makes parents more afraid or depressed about future, and parents prefer not to know according to 27% of health-care providers, 20% were uncertain, and 53% disagreed. Communication with parents is hindered by differences in status and social hierarchical structures (83%). Conclusions: Health-care providers' beliefs about childhood cancer treatment are characterized by much uncertainty and contradiction. This likely affects adherence of health-care providers, parents, and childhood cancer treatment outcome.

Original languageEnglish
Pages (from-to)2522-2528
Number of pages7
Issue number11
Publication statusPublished - Nov 2013
Externally publishedYes


  • adherence
  • attitude
  • beliefs
  • childhood cancer
  • health-care providers
  • low-income countries


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