Breaking barriers & closing the gap on breast cancer care in Kenya

Kenya has among the highest mortality rates of breast cancer globally, with eighty percent of women diagnosed unlikely to survive beyond five years1.

Changing this narrative was the challenge taken on by the Roche Kenya team. Engaging with theprogramme, we set out to overcome the barriers Kenyan women face in getting convenient and integrated cancer screening. But these barriers couldn’t be broken by us alone. We knew we needed a wide range of expertise to tackle the societal, clinical and policy issues from diagnosis to treatment and reimbursement.

Creating robust solutions starts with thoroughly defining the problem, so our first step was to conduct extensive research. A number of major gaps in breast cancer care emerged:

• Awareness: many women in Kenya were not aware of what symptoms to look out for

• Treatment: only few specialised healthcare providers and treatment centres existed, and those that did were few and far between, mostly in larger cities

• Reimbursement: there was an absence of institutional financial support, meaning patients often had to bear significant out-of-pocket treatment costs

These factors combined meant women with breast and cervical cancer were often seeking medical help late, occasionally only at advanced stages of cancer, or in some cases not having the right tools to seek help at all. Armed with a deeper understanding of the challenges, the team knew it was time to bring together a league of extraordinary organisations to create a system with a lasting impact.

The shift began with raising awareness and building visibility of breast cancer at the community level. “We partnered with thea community-oriented organisation of a network of women who are trusted and respected in each of the localities,” explained Angela Mule, MD, Patient Journey Partner, Roche. Having a trusted agent conveying the initiative was fundamental to localising the message and building trust in the new breast cancer health system. It allowed women to feel safe, motivated, and comfortable while being diagnosed and treated more quickly.

To improve the standard of breast cancer care at the clinical level, where treatment and observation of the patients take place, we collaborated with theKenya,of Kenya andto support training and mentorship of oncology healthcare professionals. We were able to help steadily establish national breast cancer screening, diagnosis and treatment guidelines through this process.

Finally, we formed collaborations with the Kenya National Health Insurance Fund and, with assistance from the Ministry of Health Kenya, we catalysed comprehensive policy reforms to ensure that patients had access to reimbursement for the entire duration of breast cancer treatment.

Thanks to our impactful partnerships, 19 specialised EMPOWER clinics have been established in Kenya since 2019, providing breast and cervical cancer screening to over 132,000 women throughout the country2.

Awareness of breast cancer has improved massively, and with specialist clinics that are more widespread and accessible, the wait time from diagnosis to treatment has dropped from on average 18-24 months, to 3-6 months.

But the impact does not stop there. Men accompanying women were also educated about their health, resulting in over 4,000 screenings for prostate cancer and its inclusion as a core service. This also inspired an integrated approach that facilitated screening for over 17,000 patients for diseases such as diabetes and hypertension2.

Women with concerns around breast cancer – as well as cervical cancer which is also covered by the EMPOWER clinics – are presenting to the healthcare system earlier, with a better understanding of their symptoms. With reimbursement in place, they can complete the full 18 cycles of treatment, giving them a chance to have improved health outcomes and allowing them to spend more time with their families and communities.

Together with partners across government entities, healthcare bodies, and community-oriented organisations, we aim to change healthcare systems by understanding the patient journey thoroughly.