Breast-cancer training for primary care providers; a step towards establishing breast centres in eastern Uganda
Introduction: One of every two Ugandan women diagnosed with breast cancer (BC) will survive past 5 years, mostly due to late stage at diagnosis. Despite ongoing efforts to implement Uganda’s National Cancer Control Plan (NCCP), BC specialists, infrastructure and diagnostic equipment remain scarce. However, Primary care providers (PCPs) are a critical link between the community and healthcare system. Eastern Uganda has only 19% of all health facilities in Uganda, with 3 regional referral hospitals, and 37 general hospitals. Objective: We evaluated the impact of BC training for PCPs in eastern Uganda. Methods: A cross-sectional survey was conducted among 25 PCPs attending a BC training workshop organized by the Uganda Cancer Institute (UCI). Participants were purposively selected to constitute BC teams of; general surgeon, medical officer/clinical officer, radiographer, nurse and a cytotechnologist/laboratory technician. The course content was adapted from the “Handbook for the management of breast cancer in a general hospital” and delivered in 12 modules. A Likert score was used evaluate each training session in terms of information delivered, format of delivery, time management, content, and applicability. Results: The majority (18, 72%) PCPs were female, age group 35 – 44 years, and had a bachelor’s degree and higher (n= 15, 60%). Nearly one-third were medical officers, and 80% PCPs reported at least 5 years of working experience. At three months, two hospitals were providing BC services constituting breast centres. Collectively, PCPs provided health education and early detection services to 1,265 Uganda women, through 15 community BC outreaches in the eastern region of Uganda. Also, PCPs attended 4 of the 12 BC multidisciplinary team meetings. Overall, nearly 70% strongly agreed with all the five dimensions regarding the overall evaluation of the training, with the highest score on module for staging and treatment decisions. Conclusions: Primary care providers play a key role in breast cancer control through improving early detection, initial surgical management, timely referral and supporting post-treatment care and survivorship.
Keywords: Capacity building, Breast cancer, regional clinics, Eastern Uganda.