Barriers and Enablers for Implementing Health Navigators in Paediatric and Adolescent Oncology in Chile: Local Insights From a Qualitative Study

Background: Childhood cancer poses significant public health challenges globally, with survival disparities between high-income countries (HICs) and low- and middle-income countries (LMICs). In response, the World Health Organization (WHO) launched the CureAll initiative to strengthen childhood cancer care. Despite being a HIC with a national oncology network, Chile faces fragmentation and unequal resource distribution similar to challenges in LMICs. The country recently introduced the role of gestores oncológicos, inspired by international health navigator models, to support patients and families through care coordination. This study describes the implementation of health navigators in paediatric and adolescent oncology in Chile from the perspective of healthcare professionals and health navigators, emphasising barriers and enablers to introduce this role in healthcare. Methods: A qualitative multiple case study was conducted through 30 semi-structured interviews with health navigators and healthcare professionals from public hospitals across Chile. Participants were purposively selected to capture diverse experiences. Interviews were analysed using content analysis, supported by triangulation and reflexivity to ensure rigour. Results: Barriers to implementation include structural issues, such as the lack of a national role definition and resource limitations, and team dynamics challenges linked to poor integration into clinical teams. Enablers included team openness to new roles and proactive strategies to introduce the navigator within the team, as well as individual qualities of navigators such as initiative, communication skills, and prior experience in paediatric oncology. Participants recommended that health navigators be full-time management roles focused exclusively on paediatrics. Key competencies include leadership, empathy, coordination, and organisational skills. Conclusion: Implementing health navigators aligns with the CureAll strategy by improving care coordination and system responsiveness in paediatric oncology. This experience in Chile highlights how barriers, particularly at the team dynamics level, can be addressed through communication and role clarity, offering valuable insights for other Latin American countries pursuing similar models of care.