Implementation of a Specialized Prostate Cancer Clinic in a Resource Limited Setting: A Mixed Methods, Retrospective, Process Evaluation study.

Introduction: Prostate cancer (PCa) is the leading cause of male cancer incidence and mortality in Zambia, with disparities in care made worse by fragmented services and diagnostic delays. Despite its prevalence, less than 10% of healthcare facilities in the country offer specialized PCa services. We evaluated the implementation of a dedicated PCa clinic at Ndola Teaching Hospital to address systemic gaps in care delivery. Methods: A mixed methods process evaluation was conducted from October 2023 to December 2024, guided by the Consolidated Framework for Implementation Research (CFIR). The intervention focused on service consolidation, file identification, and record integration. Outcomes included clinic flow efficiency, accuracy of PCa diagnoses (vs. benign prostatic hyperplasia, BPH), and time-to-diagnosis. Data were collected via direct observation, staff interviews, and audits of OPD registers and analyzed using SPSS v23. Results: Post-intervention, Time-to-diagnosis decreased by 72% (from 83 to 23 days), while recorded PCa diagnoses increased significantly from 7.33 cases to 14.58 cases /month (p=0.002), with a decline in BPH recordings. Qualitative data revealed improved patient flow following file labelling and implementation of a dedicated prostate cancer clinics. Conclusion: A low-cost, context adapted Prostate Cancer clinic enhanced diagnostic recording accuracy and clinic efficiency, demonstrating the feasibility of implementation science approaches in clinical settings.