Browsing by Author "Veronica Afework"

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    Adherence to ‘Choosing Wisely Africa’ Guidelines in Breast Cancer Care: A Cross-Sectional Survey of Public Hospitals in Addis Ababa, Ethiopia
    (Addis Ababa University, 2025-07-12) Veronica Afework; Endale Anberber,; Girmaye Tamirat
    Background: Breast cancer is the most common malignancy among women in Ethiopia, yet disparities exist in access to evidence-based care. The Choosing Wisely Africa (CWA) initiative provides recommendations to promote high-value breast cancer care, but hospital-level adherence in Ethiopia remains poorly documented. Objective: To assess hospital adherence to CWA guidelines in breast cancer care in Addis Ababa, focusing on multidisciplinary team (MDT) use, diagnostic staging, histopathology services, and neoadjuvant therapy provision. Methods: A descriptive cross-sectional survey was conducted among ten hospitals providing breast cancer care in Addis Ababa, comprising three teaching tertiary hospitals and seven non-teaching secondary hospitals. A structured questionnaire captured data on MDT practice, vi staging investigation, histology confirmation, and neoadjuvant therapy. Descriptive statistics were used to summarize adherence to CWA guidelines. Results: Two of the three teaching hospitals reported regular MDT meetings, access to mammography, ultrasound, and histopathology services, and routine provision of neoadjuvant therapy when indicated. In contrast, none of the non-teaching hospitals had an MDT, mammography, or histopathology diagnosis based on core needle biopsy. Neoadjuvant therapy was available only in one non-teaching hospital, which was reported to treat fewer than 25% of eligible patients, primarily due to long waiting times. Adherence to the CWA guidelines was substantially higher in teaching hospitals (66.7%), while none of the non-teaching hospitals attained it, resulting in an overall adherence of 20%. Conclusion: This study highlights important disparities in hospital-level adherence to CWA recommendations in Ethiopia. Strengthening MDT implementation, diagnostic services, and neoadjuvant treatment capacity in secondary hospitals is critical to ensuring equitable and evidence-based breast cancer care.