Access to cancer pain management in Ecuador from health workers' perspective: a qualitative study

Background: Ecuador is facing increasing health-related suffering due to cancer; however, the distributed opioid analgesic in the country is below the global average. Aim: This study explores the access to cancer pain management (CPM) from the healthcare professionals' perspective in a middle-income country. Methods: Thirty problem-centered interviews with healthcare providers were conducted in six cancer facilities and were analyzed thematically. Results: Limited and unequal access to opioid analgesics was reported. Structural weaknesses of the healthcare system restrain access for the poorest, at the primary care level, and for people living in remote areas. The lack of education among the healthcare personnel, patients, and society was identified as the main barrier. Conclusion: Access barriers were interrelated; therefore multisectoral strategies must be considered to improve access to CPM.