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.
Keywords: access; cancer care; framework; health equity; health policy; healthcare system;
public health; radiotherapy; South Africa; sustainable development goal