Introduction

Being a new entrant in the Philippine Cancer Health Information Network, the Philippine Cancer Center (PCC) saw the need to establish the National Cancer Registry as this was mandated by the National Integrated Cancer Control Act (NICCA) (Republic Act No. 11215, 2018). The PCC will navigate through political determinants that influence and connect the various groups and information available at primary to tertiary cancer centers nationwide. 

This study used the political determinants of health model by Dawes (2020) to understand the different elements or factors affecting the Philippine cancer health information system as revealed through the successful development of the Philippine National Cancer Registry Development Plan (NCRDP). According to Dawes (2020), the “political determinants of health involve the systematic process of structuring relationships, distributing resources, and administering power, operating simultaneously in ways that mutually reinforce or influence one another to shape opportunities that either advance health equity or exacerbate health inequities. (Dawes, 2020, 44)” 

Objectives

         The objectives of the study were to document the process of building a comprehensive information system needed for a national cancer registry, in the context of policy-making challenges. This was done through a rapid review of cancer registries in the Philippines, along with stakeholder consultations.

Methods

A rapid review approach together with a total of 43 key informant interviews and focus group discussions were conducted in order to create the National Cancer Registry Development Plan, which includes the data process flow and system architecture with roadmap plans for the next ten years. The approach used in this study followed elements from the rapid realist review (RRR) protocol (Saul et al., 2013) and rapid review method by the World Health Organization (WHO) (Tricco et al., 2017). The study included published and grey, which is necessary given the research aim of summarizing the current landscape of Philippine cancer registries.

Results and Discussion

 The rapid review in the initial phase revealed a landscape built by a fragmented approach to cancer data collection information in the Philippines. It also showed an imbalance of capacity and capability of various cancer institutions around the country. This shows the need for strategic collaboration where the influence of more powerful organizations could benefit the smaller registries still looking to grow. A strategic focus must also be given to better evaluate and further refine the ability of underdeveloped cancer registries. Other challenges revealed included the inconsistent management of data by publicly run offices (highly possibly attributed to the devolved health system), the varied types of software used in hospitals, and the ongoing simultaneous work of building advanced and basic comprehensive health centers (Department of Health, 2020). 

Based on rapid review, the strategic data process flow and system architectures were designed and incorporated into the National Cancer Registry development plan draft. Through the stakeholder analysis, their influence and capacity to participate were assessed in order to come up with ways for effective engagement (Partridge et al., 2005). This was essential in the creation of the data process flow design and system architecture which will serve as the model in building the registry. The National Cancer Registry Development Plan contains the following sections:

• Background and Purpose – The Philippine Cancer Registry serves to collect and report timely national data on cancer. According to the National Integrated Cancer Control Act of 2018 (Republic Act No. 11215, 2018), the PCC shall receive data from population based cancer registries, hospital based cancer registries, the PSA and Philhealth. It will collect clinical, cancer awareness and vaccination data. Data quality and completeness is prioritized which ensures appropriateness of policy.
• Implementation – This section provided details on the roadmap for the Short Term (Phase 0), Medium Term (Phase 1), and Long Term (Phase 2) Goals, the System Architecture, Data Process Flow, and Essential Data Variables that need to be included in the registry according to international standards (Bray et al., 2014). Lastly, monitoring and evaluation plans were also included.
• Action Plan, Communication, and Risks – This last section contains the strategies and specific activities to be carried out by PCC. Aside from implementation activities, it also includes the communication strategies and projected financial plan based on the activities.

Conclusion

The study showed how the development of a national cancer registry policy that seeks to unite existing population-based cancer registries (PBCRs) and hospital-based cancer registries (HBCRs) is possible through extensive collaboration and effective stakeholder engagement. The Philippine National Cancer Registry Development Plan is an example of an e-health policy that was created through collaboration and engagement of the relevant stakeholders. Other developing countries can learn from the strategies employed to create the system architecture model of the Philippine National Cancer Registry Development Plan amidst the challenges and barriers from resistance and limited resources.