Background and context: Despite being a growing public health concern in Africa, access to effective cancer treatment and pain relief is still limited in sub-Saharan Africa. The African Palliative Care Association (APCA) in collaboration with the American Cancer Society and the Ministry of Health of eSwatini (formerly Swaziland) have successfully implemented a South-to-South partnership which has facilitated the development and operation of a cancer unit in Mbabane National Hospital.
Although the cancer burden continues to rise in Africa, many countries do not have established oncology services. They rely on cancer treatment, care and support through referral to neighboring countries or overseas, which is costly for governments and poses multiple challenges for patients and their families. Until recently, eSwatini has relied on cancer treatment and care in South Africa. This paper presents a model where the Uganda Cancer Institute (UCI) in Uganda was facilitated to support the establishment of the first cancer unit in eSwatini.
The intervention aimed at providing technical assistance to the Ministry of Health of eSwatini to initiate and operate a cancer unit in Mbabane Government Hospital through a formal arrangement with the UCI.
The planning and execution of activities was done by a tripartite of APCA, Uganda Cancer Institute a government entity and the Swazi Ministry of Health.
Over a period of one year (Decemeber 2016 to December 2017) APCA, through a grant from the ACS formerly engaged the UCI to support the initiation and operation of a cancer unit in eSwatini. This was through expert exchange visits through which on-job training and mentorship was provided to a team of staff at Mbabane Government Hospital, with coordination by the eSwatini Ministry of Health. Experiential visits to Uganda were also organized for the lead pharmacist in eSwatini and a doctor to enable them set up and run a cancer unit in their country. The exchange visits provided a forum for both observation and application of knowledge and skills.
A cancer unit was successfully established at Mbabane Government Hospital in eSwatini, which now provides services for patients, with breast cancer and expanding to include other cancers. The eSwatini Ministry of Health has been key to the success of this development and continues to identify human, financial and other resources to sustain the cancer unit.
To date 69 patients have successfully undergone chemotherapy: 43 breast cancer, 22 Kaposi sarcoma, 2 colorectal cancer, 1 bladder cancer, 1 multiple myeloma. 21 health care workers were trained on cancer management; 9 doctors, 7 nurses and 5 pharmacists.
What was learned:
There are many opportunities for South-to-South partnership to support the establishment or improvement of cancer care. This model implemented in eSwatini can be replicated in other African countries. Documenting the model for replication in other countries is recommended.
This work was presented as e-poster at the UICC conference in Malaysia in 2018 under Track 3 – IMPROVED AND SUSTAINABLE HEALTHCARE SYSTEMS FOR BETTER OUTCOMES. The abstract was also published in the Journal of Global Oncology. https://ascopubs.org/doi/abs/10.1200/jgo.18.21200