Barriers to the timely initiatiion of breast cancer treatments and social support status among women with breast cancer in Tikur Anbessa specialized hospital oncology unit, Addis Ababa, Ethiopia, 2018

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Addis Ababa Universty


Background: Worldwide breast cancer is a major life threatening and has become the major public health problem of great concern. The higher breast cancer mortality rates in lower and middle income are thought to be due to diagnosis in advanced stages and access barriers to medical care. Identifying barriers to treatment is the main component of breast cancer control programs. However the information on barriers of barriers of breast cancer treatment in Ethiopia is scarce. Objective: To identify barriers to timely initiation of breast cancer treatments among breast cancer patients at Tikur Anbessa Specialized Hospital. Methods: A cross sectional study based with both quantitative and qualitative approach was employed at Tikur anbessa specialized Hospital from March 2018 to May 2018. A total of 394 women were involved for quantitative study and simple random sampling method was used to select patients from the follow up list. For qualitative in depth interview was conducted for six health care providers. The data was analyzed using descriptive statistics and logistic regression model was used to identify factors associated with outcome variable and the finding presented using OR with the corresponding 95% CI. The qualitative data was transcribed and translated and coded using open code software. Finally the codes were categorized and described thematically. Results: from the total of 394 women 220 (55.8%) patients initiated the breast cancer treatment lately. Majority of women were within age group of 40-49. Almost half of participants (48.7%) were on chemotherapy treatment. Patients mentioned different barriers for their late initiation. Place of residency was associated with a higher rate of treatment initiation (AOR = 2.594, CI = 1.610-4.182, P - 0.000). Patients who came from out of Addis Ababa are more likely to initiate the treatment lately compared to those who are living in Addis Ababa. Patients who are taking radiotherapy are more likely initiate the treatment lately as compared to other treatment. Those patients who were appointed was for a long time as a barrier are more likely to initiate the treatment late and lack of money to cover treatment fee was found to be another factor for the late initiation of treatment. Patients’ late presentation, lack of equipments and supply and queues in health care facility were major barriers mentioned by care providers. Conclusion and recommendation: The late initiation of treatment is high. More than half of participants initiated breast cancer treatment lately. Embarrassments, lack of money, place of residence, long waiting, and transportation problem was some barriers mentioned by participants. Provider level barriers were found to be queues in health care facility, patients’ late presentation and lack of equipment. There should be an effort in access and availability of treatment service for all patients and attention to be given for those who cannot afford and coming from rural or very distance geographic context.



Barriers, timely initiation of treatment, breast cancer