Patient Navigation: Breaking the Barriers of Care While Empowering Patients to Fight Cancer in Nigeria

Background and context: Through the UICC and Pfizer Oncology SPARC MBC grant, Project PINK BLUE - Health and Psychological Trust Centre implemented Breast Cancer Navigation and Palliative Program (BCNPP) with strategic activities focused on metastatic breast cancer with the goal “to empower women at risk of, or living with advanced breast cancer and to reduce incidence of stage III or IV breast cancer”. The project established Nigeria´s first patient navigation program which trained 138 health workers and social workers across the 6 area councils of Abuja and connected 116 breast health facilities, 58 in Abuja and another 58 across Nigeria (diagnostic centers and hospitals) in a Web-based navigation map application. The program was designed to train only 18 patient navigators for Abuja only, however, we trained 44 patient navigators from National Hospital Abuja, Enugu and Kebbi states whom are currently working on establishing BCNPP programs in their respective states. The trained oncology nurse navigators are providing optimum palliative care and navigation to patients across the mapped health facilities in Abuja. While 72 institutions have been engaged through diverse partnerships, 27 resources were produced including videos, documents, and palliative/navigation book for healthcare workers; 10 ECHO palliative care training were organized for nurses and pain doctors, with additional 8 face-to-face workshops on palliative care and patient navigation and 5 patient support group meetings. Seventy-two news articles were published including TV, radio, and interviews. Aim: To empower women at risk for, or living with advanced breast cancer and to reduce incidence of stage III or IV breast cancer. Strategy/Tactics: The program used training of nurses, cancer survivors and nurses to become patient navigators at National Hospital Abuja and across the 6 area councils of Abuja. Currently, Niger state and Enugu state have also been trained on patient navigation and more cancer patients have been tracked and followed up through their journey with cancer in Nigeria. Outcomes: The program has transited to lead national advocacy at Nigeria's Parliament for the establishment of National Institute on Cancer Research and Treatment and has also establish some initiatives, such as Abuja's first cancer support group and patient-led advocacy and campaign. Several metastatic breast cancer patients were navigated through their journey with cancer. What was learned: Metastatic breast cancer patient needed more support to live a quality life, they needed more than just pain drugs. They need listening ear and caregiver who would show their care and love. Patient navigation is an emerging area of oncology, hence, there is a need to support the patient navigators to devote more time for the impact.