Asuncion

Diagnostic laboratories (clinical and pathology labs) and blood bank

• The assessment revealed a lack of standardisation in the pathology reporting process.
• Many laboratories lacked quality standards for processing samples and handling other procedures.
• Immunohistochemical tests were not available in some public sector pathology labs.

Surgical care

• There was no quality assurance programme for surgical cancer care.

Medical oncology (adult and paediatric)

• The national list of essential cancer medicines was not aligned with the latest WHO guidance.

Medical imaging (radiology and nuclear medicine)

• The assessment data revealed that equipment in some public sector centres was faulty, outdated or simply insufficient.
• To compound this problem, equipment was often used and distributed poorly.

Palliative and supportive care

• The supply of opioids was limited.

Radiotherapy

• The capacity of both equipment and human resources was insufficient.

• The healthcare system was fragmented and segmented.
• There was no standardisation in the education and training of healthcare professionals involved in cancer diagnosis, treatment and care.

• Service provision was hampered by a lack of standardisation and accreditation.
• Occupational health and safety measures were limited.
• A shortage of trained oncology specialists impacted workforce time. management: specialists had to support various institutions, work part-time and multitask frequently.
• Most healthcare institutions lacked ethics committees.
• There was no institutional multidisciplinary approach or city-adapted treatment guidelines.
• In addition, there was no data management system.

• The needs assessment found inequity in the classification and treatment of disabled and indigenous patients.
• There were not enough strategies for tracking and accompanying patients through diagnosis and treatment.
• A lack of cancer education/awareness in the general public often resulted in delayed diagnosis.