Enabling community-led integrated women health care models for women cancers screening and early detection through EMPOWER (Enabling and Motivating Partnerships Owned by Women who Engage and Reclaim their lives) project.

Abstract

1541 Background: With the growing burden of Women cancers in East Africa, integrating cancer screening and prevention to optimize horizontal care delivery models is a paramount approach to strengthening women-centered and cost-effective primary healthcare. EMPOWER is a unique partnership with the government of Kenya, County referral hospitals, County First Ladies Association, International Cancer Institute, Patient organizations and Roche Kenya to demonstrate integrated cancer prevention and treatment within primary healthcare shared across the Kenyan Health system. Methods: EMPOWER clinics were launched with over 300 community health workers (including women living with disabilities) and HCPs were identified and trained to provide facility and community-based screening and early detection for breast cancer, cervical cancer, hypertension and diabetes through an integrated health systems strengthening approach. Mentorship was provided to HCPs through routinely held joint screenings and clinics, weekly Tumor Boards, Teleclinics, Telemedicine and Digital Pathology platforms. In addition, training support was provided through virtual preceptorships, skills-training workshops, hub-and-spoke oncological services provision and robust patient navigation. Results: 14 EMPOWER clinics have been launched across Kenya to increase community awareness of breast, cervical, and NCDs, strengthen capacity to deliver integrated Women cancer management services in County health clinics. In Kenya out of 25,502 people screened, 13,192 were screened for breast cancer with 97 abnormal findings identified; 10,349 screened for cervical cancer with 200 abnormal cervical screenings identified and 1,664 screened for prostate cancer with 32 abnormal findings. In addition, an integrated approach in Non Communicable Disease (NCD) care, diabetes and hypertension screening; 4,298 screened for diabetes and 6,116 screened for hypertension. All those diagnosed with cancers were linked to existing cancer care delivery systems and continuous support offered through the strengthened health care systems. Prostate cancer was added as more men turned up for screening events. Conclusions: This model is replicable and scalable across LMIC and recently the model inspired health providers’ from Tanzania and Nigeria to adopt the same for women’s cancers. EMPOWER has demonstrated a scalable care model in Kenya contributing to investments in pathology training and clinical treatment to improve challenges in referrals and updating guidelines to enable multi-disease tissue testing and handling and treatment with Standard of Care.