Type E – Dr Jennifer Githaiga – Improving timely diagnosis of breast & cervical cancer in Sub-Saharan Africa
A travel grant was awarded to Dr Jennifer Githaiga from the Faculty of Health Sciences, Cancer Research Initiative & Women’s Health Research Unit, University of Cape Town to attend and present a poster at the AORTIC 2017 Conference in Kigali, Rwanda from 7th to 10th November 2017.
The major areas of study and how the visit have contributed to the understanding and/or management of cancer
Understanding reasons for delays in help-seeking behavior
One major area of interest and related to our current study is the question of why breast and cervical patients present late in hospitals even after discovering symptoms. During AORTIC, I learned more about this from other Sub-Saharan African studies and specifically the following reasons that may account for delays:
- Traditional misconceptions about cancer continue to prevail even in urban African cities;
- Incorrect breast self-examination practices further complicated by limited resources for clinical breast examinations and mammography;
- Access to healthcare services and affordability, where unavailability of public healthcare services renders private healthcare the feasible option;
- In resource-limited contexts, traditional healers are often the primary health-care option as they are readily available in communities and offer affordable services. This impacts timely help-seeking behavior in biomedical health care facilities;
- Positive aspects as well as negative cultural influences of culture on supportive cancer care offered by family and community members e.g. if a woman cannot find someone to care for her children for a few hours then she may not go to the health center even after noticing symptoms, no matter how serious such symptoms appear to be;
- Stigma around cervical cancer and particularly because of comorbidity with HIV.
Understanding these and other relevant reasons for delay in help-seeking is useful in knowing where public health interventions should focus e.g. community cancer education and health literacy, possible liaison between biomedical and ethno-medical (traditional) health practitioners, and prioritisation of primary public healthcare access even in rural areas. One notable intervention is The American Cancer Society and the Johns Hopkins University Center for Communications Programs who shared two practical and inspiring presentations demonstrating how the process of creating culturally appropriate cancer education materials in collaboration with scholars in Kenya, Uganda and Ethiopia (The Kenya and Uganda ones are currently in use while Ethiopia was awaiting final approval for the same at the time of AORTIC)
The role of behavioral science in cancer research and management
As a psychologist, I am very keen to see behavioral science integrated in cancer research and management. It was very refreshing and affirming to interact with scholars who share my interest in psychosocial aspects of cancer research and management. Two particular sessions are noteworthy:
- A round table focus group on care of families of cancer sufferers where (a) the critical role played by informal caregivers in cancer management was reiterated and particularly in Sub-Saharan Africa as a resource-limited context, and (b) the challenge of urbanisation and breakdown of family systems and its impact on caring for cancer patients was discussed.
- An oral presentation on behavioral science and cancer control, highlighting the role of behavioral science in (a) shedding light into the bigger picture i.e. at the level of understanding human behavior and attendant influences (b) assisting to make changes in peoples’ behavior which, in turn, may positively impact cancer risk behaviors e.g. smoking, over eating and obesity, and physical exercise. This presentation brought to the fore the reality that behavioral science is still in its early stages in Africa, thus has not Travel Report & Guidelines yet received adequate focus. The challenge, then is join together with like-minded scholars and build a resource-pool of behavioral scientists in Africa.
Networking with cancer researchers
AORTIC 2017 was a wonderful opportunity to meet with and establish networks with other cancer scholars in Africa as well as outside of Africa. It was inspiring hearing about others’ involvement in cancer research and management, some of whom share similar interests and whose work can inform our work. We definitely need to work as a team, combining our efforts towards fighting cancer in our continent.
I wish to express my sincere appreciation to CANSA for providing funding to enable me to attend AORTIC 2017. As evident in my comments regarding specific knowledge gained, this was indeed a worthwhile venture. I look forward to future collaborations with CANSA.