Abstract 15: Breast Cancer Patient Experiences in the Botswana Health System: Is it Time for Patient Navigators?
Authors: Sharma Kirthana , Baghirova Leyla , Gulubane G , Abkenari Shaheen , Leselwa Tapologo , Legwaila Morongwa , Antony Reena , Lebelonyane Refeletswe , Vuylsteke Peter , Marlink Richard , Gaolathe Tendani , Masupe Tiny 
Published: June 2023

Abstract
Purpose: New models of care are required to support women with breast cancer due to rising incidence and mortality in sub-Saharan Africa. We evaluated experiences of breast cancer patients and their caregivers in Botswana to identify opportunities to improve service provision.
Methods: Focus Group Discussions (FGD) were conducted to gather insights on the experiences of breast cancer patients navigating the healthcare system. A purposive sampling technique was employed to recruit participants from the oncology ward of Princess Marina Hospital in Gaborone, Botswana. FGDs included 7 female breast cancer patients and 7 caregivers (2 male and 5 females). A semi-structured interview guide with probes was used to collect data.
Results: Key emergent themes included patients’ experiences with healthcare professionals; delays in diagnosis; experiences with cancer treatment; information needs; views on cancer resources; the role of caregivers and attitudes towards cancer research. Patients reported experiencing poor communication or a lack of empathy from healthcare providers when receiving a diagnosis. Social support and spiritual beliefs were important to patients in handling the diagnosis. Delays in diagnosis were reported due to logistical challenges, poor appointment and referral systems, as well as delayed or missing laboratory results. Similar experiences with cancer treatment were reported including a lack of timely access to treatment and poor communication regarding chemotherapy and adverse effects. Patient and caregiver information needs, therefore, largely focused on a desire to understand chemotherapy side-effects and the biological nature of breast cancer. Discussions regarding availability of cancer resources revealed a lack of basic services to maximize patient comfort and difficulties accessing specialized cancer care infrastructure. Caregivers were found to have a largely positive role in providing emotional and practical support. Patients and caregivers appreciated the utility of cancer research in improving treatment.
Conclusion: A number of barriers exist across the cascade of care for breast cancer patients in the Botswana health system. Although patient navigator programs may not address all barriers, they have potential utility in the context of improving communication, meeting information needs and providing emotional or practical support by addressing logistical barriers to cancer diagnosis and treatment in Botswana.
Citation Format: Kirthana Sharma, Leyla Baghirova, G Gulubane, Shaheen Abkenari, Tapologo Leselwa, Morongwa Legwaila, Reena Antony, Refeletswe Lebelonyane, Peter Vuylsteke, Richard Marlink, Tendani Gaolathe, Tiny Masupe. Breast Cancer Patient Experiences in the Botswana Health System: Is it Time for Patient Navigators? [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 15.