Table 2.

Challenges and proffered solutions to the neglected cancer care needs among the nomadic communities

Lack of data and research on nomadic health	Global studies to investigate epidemiological cancer patterns among nomads to ensure equity in care delivery. Innovative approaches to population-based registries can be adapted to capture some cancer epidemiological profiles and service utilisation among the nomadic population.
Cancer early detection among nomads	Recruiting and training community health workers (CHWs) can be attempted in introducing cancer screening and patient education among nomadic communities in designated villages or waterpoints
Cancer prevention strategies	Redefining the word ‘cancer’ with cultural synonyms; cancer information must be delivered in a culturally acceptable form and through a shared decision model. Community outreach programmes on cancer education; local oncologists and other healthcare providers need to address patients in a language they understand best or through a translator
Cancer diagnosis	Deploying mobile cancer screening services such as clinical breast exams, cervical cancer screening and digital rectal exams are real-world screening modalities that can be explored along the migration routes of nomads. One Health model—promoting healthcare services such as cancer diagnosis that are tailored to the nomadic pastoralist that integrates human and veterinary health services
Cancer treatment	Adopting continuity of care model that will not clash with nomadic lifestyle patterns of patients with cancer. On-site treatment and follow-up at converging water and grazing points and subsequent referral pathways to urban tertiary care.
Hospice and palliative care services	Provision of mobile drug caravans such as opioids and interventions towards alleviating pain and suffering. Culturally based end-of-life care approaches are key to improving compliance and acceptance.
Cancer survivorship	Recruiting and training CHWs on patient education and cancer survivorship by tracking nomads across their common migratory routes and designated villages or waterpoints well known to CHWs.
Effect of mobility on nomadic health	Timely resettlement and integration into urban healthcare facilities are vital in addressing the care gap for this unique population. Dynamic mobile cancer care services are urgently needed to bridge the gap of cancer care inequities.
Effects of droughts and wars on the cancer care of nomads	Addressing environmental injustice should translate into the funding of research and mobilisation of efforts of the international community to address the increasing health inequities these populations face due to climate change and conflicts.
Lack of nomadic community healthcare workers	Recruiting and training CHWs can be attempted in introducing cancer screening, patient education and palliative care services among the nomadic communities.
Lack of Nomadic Health Guidelines in National Cancer Control Programmes	Developing cancer care guidelines that are resource stratified but tailored to the inherent cancer care needs of the nomadic communities is urgently needed