# Improving Access to Radiotherapy in Gauteng: A Framework for Equitable Cancer Care

## TL;DR

This paper proposes a framework to improve radiotherapy access in Gauteng, South Africa, aiming to reduce cancer care disparities.

## Contribution

The novel 'House framework' integrates global health systems and access dimensions to address radiotherapy inequities in South Africa.

## Key findings

- Disparities in radiotherapy access exist between public and private institutions in Gauteng.
- Socioeconomic factors like transport costs and awareness hinder equitable cancer care.
- The House framework offers a structured approach to improve access and outcomes through policy and governance.

## Abstract

Radiotherapy, a critical component of cancer treatment, faces significant challenges in Gauteng, South Africa. These disparities hinder the achievement of Sustainable Development Goal 3, primarily due to systemic issues, socioeconomic barriers, and limitations within the health system. This article presents the House framework, designed to enhance access to radiotherapy services by integrating the WHO Health Systems framework with the dimensions of access proposed by Penchansky and Thomas. The framework is visually represented as a house, with Policy & Governance as the foundation, WHO building blocks as pillars, and Equitable Cancer Care and Improved Outcomes as the roof. A mixed-methods approach was utilized, combining quantitative data from radiotherapy facilities and qualitative insights from healthcare professionals to identify barriers and potential solutions. Findings indicate significant disparities in resource distribution and accessibility between public and private institutions, compounded by socioeconomic factors like transport costs and lack of awareness. The article discusses innovative proposed framework using the 5As of access as potential solutions. The House framework serves as a valuable tool for policymakers and healthcare providers aiming to improve radiotherapy access and promote equitable cancer care in Gauteng, ultimately working towards reducing disparities in cancer outcomes.