Program Manager AMPATH-Moi University/MTRH Projects ELDORET, Rift Valley, Kenya
Disclosure: Disclosure information not submitted.
Participants should be aware of the following financial/non-financial relationships:
Stephen Kiptoo, Msc: Disclosure information not submitted.
Introduction: Breast cancer is the most common cancer worldwide with high mortality rates in low- and middle-income countries. We developed a program to reduce morbidity and mortality by education and health promotion events.Our objective was to understand the resiliency of the program duringCovid.
Methods: We increased breast cancer screening and diagnostic capacity through clinical breast exams (CBE) by training healthcare providers in the exam and providing mobile biopsy events.Breast cancer screening was completed via CBE at mass-screening events as well as individual patient encounters at ministry of health facilities in nine counties. Teleconsultations were used for challenging diagnosis. We performed interim analysis on collected data to assess the program.
Results: From 2018-2021, we conducted training, connected 12 centers with telemedicine capacity and screened a total of 49,244 persons for breast cancer. During our first and second year of the program, 83 doctors were trained on cancer management, 341 nurses were trained on CBE and early diagnosis pathways, and 247 community health workers (CHWs) were trained on the importance of screening to provide community awareness. However, this training was suspended in year three due to COVID.Yearly trends demonstrate that the facility-based breast cancer screening improved: 4,591 (2018); 7427 (2019); 10,086 (2020) and 10582 (2021). However, the frequency of screening through organized mass events declined due to the onset of COVID (4,739 (2018); 7,691 (2019); 2,824 (2020), and 1,304(2021).The total number of screens increased by 47.5% from 2018 to 2021, andindividuals were almost nine times as likely to present to a facility-based screen in 2021 (OR: 8.8, 95% CI 8.4-9.1).
Conclusions: An integrated training program utilizing CHWs, nurses and doctors are an effective means for clinical breast cancer screening in Kenya. This capacity building allows flexibility and sustainability even during the global COVID-19 pandemic. We also demonstrated successful integration with the county government for program sustainability. The use of telemedicine has greatly enhancedhealthcare worker education for screening and patient care across several facilities in western Kenya.
Learning Objectives:
Upon completion, participant will be able to understand the need for capacity building to improve the breast cancer screening uptake in western Kenya
Upon completion, participant will be able to understand and recommend a sustainable breast cancer screening option that can withstand catastrophic events
Upon completion, participant will be able to use telemedicine to improve breast challenged diagnosis during a pandemic era
