Introduction
Comprehensive cancer care requires coordinated evidence-based policy to ensure equitable access and optimal outcomes. However, research demonstrates a lack of coherence and influence, undermining the relationship between policy and practice. Understanding the key determinants influencing policy formation and implementation is essential for developing effective interventions. The aim of this study was to identify stakeholder-informed national policy ecosystem determinants associate with the policy process.
Method
Qualitative interviews were conducted with cancer control actors working with City Cancer Challenge Foundation (C/Can), focusing on identifying key determinants associated with policy context, processes, and content. Interviews were conducted online in English or with an English-Spanish interpreter and analysed using Qualitative Thematic Analysis via NVIVO software. De-identified transcripts were coded thematically using both deductive and inductive approaches, with team discussion until consensus was reached.
Results
Twenty-six C/Can participants working across Latin America, Africa, and Europe shared their insights. Analysis identified critical features of the policy context influencing policy formation and application, including policy types, their interrelationships, and significant gaps. Key implementation barriers included inadequate resourcing, poor dissemination, misalignment between policy and healthcare system capacity, and workforce specialisation challenges. Private sector lobbying, policy fragmentation, and competing global health agendas emerged as significant disruptors. Findings were distilled into a process checklist to support cancer control policy development.
Implications
Effective cancer control policy implementation depends critically on systemic alignment, stakeholder engagement, and strategic navigation of policy gaps and disruptors. Participant expertise illuminated actionable determinants that bridge the persistent policy-to-practice gap. The resulting cancer control policy process checklist provides a practical tool for policymakers and implementers to enhance policy coherence, identify resourcing and action levers, and strengthen governance across all system