article · BMC Health Services Research
Cervical cancer presents a major public health challenge in Rwanda, where many patients present with advanced disease and incur substantial treatment costs despite national health insurance. A cross-sectional investigation conducted between October 2022 and October 2023 evaluated financial toxicity among 221 cervical cancer patients receiving active care or follow-up at the Rwanda Cancer Center. Overall, 25.8 percent of participants experienced financial toxicity. The primary predictors of this financial hardship were belonging to Ubudehe socioeconomic category 2, working primarily in farming, and lacking sufficient income to cover medicine, transport, food, or housing costs. Addressing these financial burdens requires systemic reforms in health financing, the decentralisation of cancer treatment services, and targeted social protection programmes such as conditional cash transfers and transport subsidies to enhance treatment adherence, patient outcomes, and equitable access.
Even when health insurance exists, the non-medical and out-of-pocket costs of cancer care can severely strain vulnerable households. Identifying the specific socioeconomic drivers of financial toxicity enables healthcare administrators and policymakers to design targeted social safety nets, such as transport subsidies and food support, ensuring that low-income patients can complete life-saving cervical cancer treatments without falling into severe economic distress.
The abstract does not indicate a commercial application pathway. Instead, the findings point toward policy and operational public health interventions, such as decentralising oncology services and deploying public social protection mechanisms, including transport subsidies and conditional cash support programmes for vulnerable patients.
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Cervical cancer remains a major public health challenge mainly in low- and middle-income countries, including Rwanda, where most patients present at advanced stages and face significant treatment-related expenses. Despite the presence of national health insurance schemes, many patients continue to experience financial distress associated with cancer care. This study assessed the proportion and determinants of financial toxicity (FT) among cervical cancer patients receiving treatment at the Rwanda Cancer Center (RCC). A cross-sectional study conducted among patients with cervical cancer under active treatment or follow-up at the Rwanda cancer center of the Rwanda Military from October 2022 until October 2023, convenience sampling were employed to interview recruited participants until the target number. Among 221 enrolled participants, 25.8% met criterial for financial toxicity.Predicators of FT included Ubudehe category 2,farming as primary occupation, lack of sufficient income for medicineor transportationand patients with not enough income for food and housing costs. FT is prevalent among cervical cancer in Rwanda especially in those with preexisting insufficient household income and those who engaged in farming, even among insured patients. Given the direct consequence of financial constraints on cervical cancer care, it is urgent to address financial hardships cancer patients face withsystemic reforms in health financing, decentralization of cancer care, and social protection interventions such as transport subsidies and conditional cash support might improve adherence, treatment outcomes, and equity in cancer care.
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DOI: 10.1186/s12913-026-15402-4
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