Access to Breast Cancer Treatment Services in Mombasa County, Kenya: A Quality of Care Analysis of Patient and Survivor Experiences

Abstract

The increasing burden of cancer in Kenya has serious implications particularly for women. Understanding how women access breast-cancer treatment services is essential for mitigating its effects. The aim of this study was to examine access to breast cancer treatment services and implications on quality of care in Mombasa County, Kenya. Focus group discussions (N= 3), in-depth interviews (N=7) and a questionnaire were used in data collection. Qualitative data were analyzed using preset themes of access. Other emergent themes were identified and analyzed. Quantitative data were analyzed in SPSS V.23 and tabulated as descriptive. Lack of equipment, distance to facilities, unavailability of specialized personnel, high cost of care and cultural stigma, were the main barriers of access to cancer services. These barriers impacted on quality of care in terms of timeliness, equity, effectiveness, patient-centeredness, safety and efficiency. Poor quality of care was exhibited in reports of wrong and late diagnosis, poor outcomes in surgery, severe burns, broken down equipment, among others. There were also social consequences of being diagnosed with breast cancer including loss of business and termination from employment. Concerted efforts including investments in health workers, equipment and awareness creation are required to support access to quality breast cancer care.