Improving Breast Cancer Control via the Use of Community Health Workers in South Africa: A Critical Review.

Brianna M Wadler,Marianne Prout,Christine M Judge,Alan C Geller,Jennifer D Allen

doi:10.1155/2011/150423

Brianna M Wadler, Marianne Prout + Show 3 more

Open Access

https://doi.org/10.1155/2011/150423

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Abstract

Breast cancer is a growing concern in low- and middle-income countries (LMCs). We explore community health worker (CHW) programs and describe their potential use in LMCs. We use South Africa as an example of how CHWs could improve access to breast health care because of its middle-income status, existing cancer centers, and history of CHW programs. CHWs could assume three main roles along the cancer control continuum: health education, screening, and patient navigation. By raising awareness about breast cancer through education, women are more likely to undergo screening. Many more women can be screened resulting in earlier-stage disease if CHWs are trained to perform clinical breast exams. As patient navigators, CHWs can guide women through the screening and treatment process. It is suggested that these roles be combined within existing CHW programs to maximize resources and improve breast cancer outcomes in LMCs.

Highlights

While breast cancer has long been recognized as a major public health burden in high-income countries, the majority of cases occur in low- and middle-income countries (LMCs), and it is expected that incidence rates will rise most rapidly in these locations [1]
The purpose of this paper is to examine the potential for community health worker (CHW) programs to improve access to breast health resources in LMCs
We briefly review the effectiveness of CHW programs in LMCs and identify key components of a CHW-based breast health program

Summary

Introduction

While breast cancer has long been recognized as a major public health burden in high-income countries, the majority of cases occur in low- and middle-income countries (LMCs), and it is expected that incidence rates will rise most rapidly in these locations [1]. South Africa represents a middle-income country, according to its World Bank classification [8], has a growing cancer control infrastructure including many of the cancer centers in Africa, with welltrained oncologists and radiologists [9, 10], has historical experience with community-based health worker programs [11, 12], and has a higher breast cancer mortality : incidence ratio compared to the world standard (Table 1), indicating lower survival from breast cancer [2, 13]. We present evidence to develop a program model for a successful breast health program focusing on these areas along the continuum

Community Health Workers

Suggested Implementation

Findings

Discussion