Barriers To Quality Care In Breast Cancer Management In Kenyatta National Hospital's Cancer Treatment Unit

Abstract

Background: Breast cancer management involves providing quality care that begins from the time of diagnosis to palliative/hospice care but despite increased efforts to increase access to breast cancer services, through a strategic policy in Kenya, the quality and accessibility to breast cancer management provided to breast cancer patients at a referral facility is still limited. Objective: To determine the barriers to quality care on breast cancer management in Kenyatta National Hospital- Cancer Treatment Unit. The study aimed at determining how institutional, socio-economic, cultural and service provider barriers impacted on knowledge, attitude and practice of subjects and influenced quality care in breast cancer management. Design: This was a descriptive cross-sectional institution based quantitative and qualitative study that determined barriers to quality care in breast cancer management in Kenyatta National Hospital- Cancer Treatment Unit. Study sample: A total of 100 randomly selected, histological confirmed breast cancer patients were interviewed using standard pre-tested questionnaires. Focus group discussions and key informants interview were also conducted after ethical approval of study from Ethics committee and clients consenting for participation in the study. Data Analysis: Data was entered into Microsoft Access software and transferred into STAT A version 10 for analysis. Descriptive and inferential statistical statistics were generated to describe relationship between outcome and explanatory variables. The research was conducted for 16 weeks. Research results: Of the n=100 clients accrued, through Principal Component Analysis -socioeconomic status grouped 40% in poorest category and 60% in richest category. Barriers to quality care included client's employment status, health insurance coverage, cost of illness, cost of transport, inadequate resources and health care provider communication skills Conclusion: Permanent interventions should be formulated to help patients, health care providers and breast cancer institutions deal with barriers to quality of care Recommendations: Building of a comprehensive cancer centre by the government will enhance quality care in all aspects, to breast cancer patients and cancer patients in general.