Abstract
Breast health data were collected from October 2019 to Decembers 2020 at the participating facilities and were anonymized for secondary analysis. Health care providers at the public primary health clinics or district hospitals were trained on Clinical Breast Exam (CBE) and on how to collect specimens for cytology and histology (Fine Needle Aspiration (FNA) and biopsy). Patients and health care providers were contacted by phone and interviewed on their experiences in accessing or providing breast health services. Breast health data collected from October 2019 to Decembers 2020 at the participating facilities was anonymized for secondary analysis. Clients and health care provides were contacted by phone and interviewed on their experiences in accessing or providing breast health services. 28 nurses and 6 doctors were trained on Breast diagnostics. 1,103 patients received education on breast cancer, and were exposed to a self-breast exam demonstration followed by a CBE. Of those, 199 (18%) had an abnormal breast exam and were referred to a doctor. This resulted in 139 being eligible for further diagnostic test, but only 99 of them presented for these tests. Of those 81% had non-malignant results while 7% were confirmed with cancer of which 71% received treatment. Interviews revealed that delays in accessing referral facilities could be addressed by a one-stop model were all the essential exams are collected as opposed to referring them to different entities. Patients reported the need for navigation assistance and follow up reminders for their appointments and results at the different levels of their journey. Reducing late diagnoses of breast cancer can be achieved by strengthening early detection through capacity building of Primary Health Care (PHC) providers and strengthening the patient pathway by institutionalizing patient navigation and streamlining the referral process to reduce the time it takes from diagnosis to treatment.
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