{"entity":{"id":"idea-moon-peer-navigator-workforce","kind":"idea","name":"Paid survivor peer-navigators as a recognised health workforce role","aka":[],"tldr":"Train and pay people who have been through cancer to guide newly diagnosed patients through the system, especially where oncologists and nurses are scarce.","summary":"Community health workers transformed HIV and maternal care delivery in low-resource settings. Cancer has peer support but rarely a paid, trained, supervised navigator role. The proposal is a certified curriculum (system navigation, plain explanation of treatment, side-effect triage, financial and legal signposting, misinformation response), a salaried role in cancer units and community clinics, and a supervision structure under nursing.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Patients lack understanding, navigation and agency): Basch et al., Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment (JAMA 2017)","url":"https://doi.org/10.1001/jama.2017.7156"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["tata-memorial"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-patient-voice","b-workforce","b-global-access"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Peer navigators reduce treatment abandonment (a major cause of death in low- and middle-income settings, especially in childhood cancer) by a third and increase completion of radiotherapy and chemotherapy courses.","rationale":"Abandonment is driven by cost, distance, confusion and fear, all of which peers address more credibly than clinicians. The workforce constraint is on scarce clinicians, not on trainable survivors.","test":"Cluster-randomised trial in cancer units in two middle-income countries; primary endpoint treatment completion, secondary time to treatment and patient-reported understanding.","maturity":"early-clinical","actor":"policy","cost":"medium","horizonYears":3},"route":"/ideas/idea-moon-peer-navigator-workforce/","neighbours":{"institution":[{"id":"tata-memorial","kind":"institution","name":"Tata Memorial Centre","route":"/institutions/tata-memorial/"}],"bottleneck":[{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-workforce","kind":"bottleneck","name":"Not enough oncologists, nurses, pathologists, physicists","route":"/bottlenecks/b-workforce/"},{"id":"b-patient-voice","kind":"bottleneck","name":"Patients lack understanding, navigation and agency","route":"/bottlenecks/b-patient-voice/"}],"technology":[{"id":"rejuv-mind-access-to-psychological-care","kind":"technology","name":"Getting psychological help after cancer: the stepped-care model, and what is actually commissioned","route":"/technologies/rejuv-mind-access-to-psychological-care/"},{"id":"rejuv-mind-the-word-survivor","kind":"technology","name":"The word survivor, and why the vocabulary is not a detail","route":"/technologies/rejuv-mind-the-word-survivor/"}],"roadmap":[{"id":"survivorship-roadmap","kind":"roadmap","name":"Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards","route":"/roadmaps/survivorship-roadmap/"}]}}