Uganda Cancer Institute Launches Patient Navigation Program
By Julius Adiga
Uganda Cancer Institute has launched a comprehensive cancer patient navigation program, an innovative method of alleviating barriers to health care access for cancer patients by providing personal guidance and support to patients and their caregivers to help ensure timely cancer screening, diagnosis, treatment, and supportive care.
According to the Executive Director of Uganda cancer institute (UCI) Dr Jackson Orem, The program provides clinical navigation to adult cancer patients seeking care for their first time and those new to treatment and physical navigation and resource navigation to all patients. Patient navigation services are provided for free.
He says the patient navigation program has been successfully implemented in the USA for over 30 years. Globally, patient navigation has largely been implemented in high income countries (HICs), with very little implementation in low-and-middle-income-countries (LMICs). Kenya started a patient navigation program at Kenyatta National Hospital (KNH) with support from the American Cancer Society (ACS) and evidence has demonstrated that patients are better informed and supported.
Uganda Cancer Institute, in partnership with the American Cancer Society, has designed a patient navigation program as a quality improvement intervention to improve the quality of cancer care. The program will increase patients’ knowledge of their diagnosis, self-care, and the services available to them; improve patients’ experience with care; and enhance staff practices in providing patient-centered care to increase the number of patients adhering to their treatment plan. The UCI Patient Navigation Program has been designed and is being integrated in the UCI system to address barriers to care. UCI has received a 3.5-year grant from American Cancer Society for the program. Additionally, the Uganda Cancer Society is supplying UCI with a suite of culturally and linguistically-appropriate cancer education materials in 5 languages which will both be used in the clinical setting for education as well as provided to patients and carers to take home.
The program will provide three types of navigation: 1) physical navigation to improve access to care by moving with patient from one care point to another or wheeling them and providing guidance and information about services and their locations in national languages; 2) clinical navigation to increase patients understanding of the disease and their treatment plan and to coordinate patients’ care; and 3) resource navigation to mobilize local resources to meet the psychosocial, spiritual, and economic needs of patients. The program works hand in hand with the medical social workers who assist patients and family members to address their psycho-social needs and provide supports that enhances patients’ adherence to care and treatment.
Worldwide, almost 10 million people die each year from cancer. That is more than HIV/AIDS, Malaria and Tuberculosis combined. According to GLOBOCAN 2020, 34,008 new cancer cases and 22,992 cancer deaths were reported in Uganda. Unfortunately, many of the cancer patients come to Uganda Cancer Institute with advanced disease due to multiple barriers in obtaining the diagnosis, and while seeking care at UCI, cancer patient continues to experience barriers that lead to poor treatment outcomes.
Multiple studies were conducted between 2016-2019, which identified barriers cancer patients face to access care at UCI. These studies are the SPARC Metastatic Breast Cancer Patient Needs Study (2016) conducted by UCI and UWOCASO; UCI Quantitative Patient Needs Study (2017) and Qualitative Patient Needs Study (2018) conducted by UCI and ACS, and the UCI Quality Improvement Assessment 2019 by UCI. The need to address the barriers identified by these studies initiated the collaboration between UCI and ACS to introduce patient navigation.
 Number of Deaths in 2020, Both Sexes, All Ages. The Global Cancer Observatory (Globocan), December 2020. https://gco.iarc.fr/today/data/factsheets/cancers/39-All-cancers-fact-sheet.pdf Date accessed: March 5, 2021
Cancer Fact Sheet Uganda. The Global Cancer Observatory (Globocan), December 2020. https://gco.iarc.fr/today/data/factsheets/populations/800-uganda-fact-sheets.pdf Date accessed: March 5, 2021