通过对南非公共和私营部门的利益相关者进行深入访谈，我们试图确定哪些障碍和促进因素决定了南非目前认为获得儿童癌症护理的机会。对 29 个主要卫生系统利益相关者进行了定性半结构化访谈，其中包括政策- 制造商和监管者、医疗保险计划线人、药品供应商、医疗保健提供者和民间社会利益相关者。根据药品价值链 (PVC) 构建了获取药品和更广泛护理方面已确定的障碍和促进因素。PVC 的所有组成部分均确定了障碍和促进因素。主要障碍包括（1）缺乏对儿童癌症的政治承诺，（2）停止基本化疗，（3）儿童癌症保险覆盖不完整，（4）基本药物缺货，（5）无法获得护理，包括前往医疗机构；(6) 初级医疗保健 (PHC) 工作人员对儿童癌症的认识较低。拟议的优先干预措施包括定价灵活性、提高决策和医疗保健支出的透明度和一致性，以及改进初级卫生保健工作人员、护士和药剂师关于儿童癌症的培训。这是南非首次针对儿童癌症药物获取的决定因素进行全面研究为有针对性的政策制定提供具体背景的证据。© 2024 作者。由 Informa UK Limited 出版，以 Taylor 名义进行交易

We sought to identify what barriers and facilitators determine current perceived access to childhood cancer care in South Africa through in-depth interviews with stakeholders in South Africa's public and private sectors.Qualitative semi-structured interviews were conducted with 29 key health system stakeholders, including policy-makers and regulators, medical insurance scheme informants, medicine suppliers, healthcare providers and civil society stakeholders. Identified barriers and facilitators in access to medicines and broader care were structured according to the pharmaceutical value chain (PVC).Barriers and facilitators were identified across all components of the PVC. Key barriers included (1) a lack of political commitment to childhood cancers, (2) discontinuation of essential chemotherapeutics, (3) incomplete insurance coverage for childhood cancers, (4) stock-outs of essential medicines, (5) the inability to access care, including travel to healthcare facilities and (6) low awareness on childhood cancers among primary healthcare (PHC) workers. Proposed priority interventions included pricing flexibilities, increased transparency and consistency in decision-making and healthcare spending, and improved training of PHC staff, nurses and pharmacists on childhood cancers.This first comprehensive study of determinants of access to medicines used in childhood cancer in South Africa provides context-specific evidence for targeted policy development.© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.