OnCo
ideasIdea

Paid survivor peer-navigators as a recognised health workforce role

Train and pay people who have been through cancer to guide newly diagnosed patients through the system, especially where oncologists and nurses are scarce.

Community health workers transformed HIV and maternal care delivery in low-resource settings. Cancer has peer support but rarely a paid, trained, supervised navigator role. The proposal is a certified curriculum (system navigation, plain explanation of treatment, side-effect triage, financial and legal signposting, misinformation response), a salaried role in cancer units and community clinics, and a supervision structure under nursing.

Hypothesis
Peer navigators reduce treatment abandonment (a major cause of death in low- and middle-income settings, especially in childhood cancer) by a third and increase completion of radiotherapy and chemotherapy courses.
Rationale
Abandonment is driven by cost, distance, confusion and fear, all of which peers address more credibly than clinicians. The workforce constraint is on scarce clinicians, not on trainable survivors.
What would test it
Cluster-randomised trial in cancer units in two middle-income countries; primary endpoint treatment completion, secondary time to treatment and patient-reported understanding.
Maturity
early clinical
Who has to act
policy
Cost to try
Medium ($1M to $50M)
Years to first evidence
3
Bottlenecks it attacks

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