Care needs and considerations for implementing a community-based palliative care program for women with breast or cervical cancer in three Nigerian states.

Abstract

12068 Background: Breast and cervical cancer pose a significant public health burden in most sub-Saharan African countries including Nigeria. With ~70% of cases presenting at late stages (III & IV), high mortality is often a characteristic feature. This underscores the critical need for comprehensive palliative care services to improve the quality of life for Nigerian women with breast and cervical cancers. Despite the growing recognition of this need, there is limited evidence for integrating community resources into cancer-directed palliative care services in Nigeria, hence this study explored the needs of Nigerian women with breast or cervical cancer, and their caregivers, and sort to identify resources necessary for developing a robust palliative care initiative across the community and healthcare facility settings. Methods: We conducted a qualitative study including 45 purposively sampled adult female caregivers of women with breast or cervix cancers, from 3 states in Nigeria: Abuja-Federal Capital Territory, Nasarawa, and Rivers states respectively. Focus Group Discussions using semi-structured interview guide were carried out and included questions about cancer care needs of both caregivers and the patients, including considerations for implementing a community-based palliative care program. Data were analysed using thematic analysis for deductive identification of key themes, while allowing for new themes to emerge inductively, and then we phenomenologically investigated respondents' palliative care needs perceptions and their meaning. Results: Four overarching themes were identified namely, i) needs of women with breast or cervical cancer, ii) needs of caregivers, iii) human resources for community-based palliative care, and iv) feasibility of a community-based palliative care program. Respondents revealed that to attain wholistic wellbeing for women with breast or cervical cancer, their peculiar needs and those of their caregivers which were largely unrecognised deserve attention. Adequate human resources, including trained healthcare workers and support staff, and clearly defined feasibility criteria for palliative care, were identified as crucial for the successful implementation of a community-based palliative care program. Conclusions: A community-based palliative care program for Nigerian women with breast or cervical cancer will be acceptable and feasible if it is designed to address the peculiar medical and non-medical needs of both the cancer patients and their caregivers.