Browsing by Author "Nakaganda, Annet"

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    Challenges faced by cancer patients in Uganda: Implications for health systems strengthening in resource limited settings
    (Journal of Cancer Policy, 2021) Nakaganda, Annet; Solt, Kristen; Kwagonza, Leocadia; Driscoll, Deborah; Kampi, Rebecca; Orem, Jackson
    about 4000 new cancer patients a year. However, many cancer patients in Uganda never receive treatment due to a variety of challenges. We therefore conducted a study to identify and assess the challenges faced by cancer patients in Uganda. Methods: A cross-sectional study conducted in April-May 2017 among adult cancer patients. 359 participants participated in an interviewer-administered survey. We used stratified random sampling to select the study participants. Data was analyzed in SPSS Statistics 24. Results: 35 % of the patients delayed initiating cancer treatment and 41 % missed medical appointments along their care journey. Delayed and missed appointments were mainly due to lack of money for cancer medicines, transportation and accommodation. Patients also expressed challenges with side effects of cancer treatment: 52 % sought help from health workers when they experienced side effects; 14 % used alternative medicine; and 21 % did not inform anyone. In addition, 55 % of the participants had limited knowledge about their disease and treatment. Other challenges when at UCI included: being hungry and thirsty throughout the day, long waiting hours, not having a resting place, not understanding what comes next, and having their records lost by hospital staff. Conclusion: Challenges faced by cancer patients in Uganda result in enormous delays in initiation and continuation of cancer treatment. These challenges are often a result of the poor social-economic status of the patients; inadequate infrastructure for cancer care; and inefficiencies in the health care system. Policy Summary: To improve the experience of patients, the National Cancer Control Plan should consider establishing regional cancer centers; creating a reliable supply of cancer medicines; and integrating navigation programmes into cancer care. Strengthening the whole health system, in relation to cancer service delivery, should remain a top priority for Uganda and other resource limited settings.
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    Expanding best practices for implementing evidence-based cancer control strategies in Africa: The 2019–2020 Africa Cancer Research and Control ECHO Program
    (Journal of Cancer Policy, 2021) Nakaganda, Annet; Cira, Mishka K.; Abdella, Kunuz; Uwinkindi, Francois; Mugo-Sitati, Christine; Duncan, Kalina
    Cancer is a major public health problem which requires evidence-based, resourced and wellmanaged National Cancer Control Plans (NCCPs). However, challenges exist for African countries in developing and implementing functional NCCPs. Hence, the Africa Cancer Research and Control ECHO Program (Africa Cancer ECHO) aims to increase knowledge and utilization of evidence-based practices to strengthen NCCPs in Africa. Methods: The 2019–2020 Africa Cancer ECHO employed the Project ECHO® model™ to conduct monthly hourlong sessions about cancer control, among cancer control professionals in Africa and international partners. Sessions ran from March 2019 to August 2020. Sessions outcomes were documented throughout the year, followed by an online self-evaluation survey of the participants in July 2020. Quantitative data was analysed using Excel and qualitative data analysed thematically. Results: 157 participants registered for the Africa Cancer ECHO. 24 sessions were conducted for the year 2019–2020. More than 70 % of the participants increased their knowledge, confidence, and ability to implement evidence-based cancer control strategies in their settings. Over 80% indicated that sessions were relevant to their work and met their learning goals and expectations. Recommendations included: use of evidence from population-based cancer registries to direct cancer control; encouraging clinician scientists to generate locallyrelevant research questions; embracing information technology and electronic medical records systems; forming partnership and leveraging existing initiatives; and using regular costed cancer control priorities for advocacy and government involvement. Conclusion: The 2019–2020 Africa Cancer ECHO increased utilization of evidence-based cancer control practices among cancer control leaders; and recommends use of data, partnerships, and locally-driven solutions to direct the cancer control effort in Africa. Policy summary: The Africa Cancer ECHO is a viable method for engaging leaders and partners in a continuous learning and networking process. There is value to investing in such initiatives, as they advance knowledge, familiarity, confidence, partnerships, and leadership in cancer control.
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    Prevalence, trends and distribution of lifestyle cancer risk factors in Uganda: a 20-year systematic review
    (BioMed Central Ltd, 2023-04) Nakaganda, Annet; Mbarusha, Immaculate; Spencer, Angela; Patterson, Lesley; Gemmell, Isla; Jones, Andrew; Verma, Arpana
    Abstract Background Cancer is becoming an important public health problem in Uganda. Cancer control requires surveillance of lifestyle risk factors to inform targeted interventions. However, only one national Non-Communicable Disease (NCD) risk factor survey has been conducted in Uganda. This review assessed the prevalence, trends and distribution of lifestyle risk factors in Uganda. Methods The review identifed studies up to January 2019 by searching Medline, Embase, CINAL and Cochrane databases. Further literature was identifed from relevant websites and journals; scanning reference lists of relevant articles; and citation searching using Google Scholar. To be eligible, studies had to have been conducted in Uganda, and report prevalence estimates for at least one lifestyle cancer risk factor. Narrative and systematic synthesis was used to analyse the data. Results Twenty-four studies were included in the review. Overall, unhealthy diet (88%) was the most prevalent lifestyle risk factor for both males and females. This was followed by harmful use of alcohol (range of 14.3% to 26%) for men, and being overweight (range of 9% to 24%) for women. Tobacco use (range of 0.8% to 10.1%) and physical inactivity (range of 3.7% to 4.9%) were shown to be relatively less prevalent in Uganda. Tobacco use and harmful use of alcohol were more common in males and more prevalent in Northern region, while being overweight (BMI>25 kg/ m2) and physical inactivity were more common in females and more prevalent in Central region. Tobacco use was more prevalent among the rural populations compared to urban, while physical inactivity and being overweight were more common in urban than in rural settings. Tobacco use has decreased overtime, while being overweight increased in all regions and for both sexes. Conclusion There is limited data about lifestyle risk factors in Uganda. Apart from tobacco use, other lifestyle risk factors seem to be increasing and there is variation in the prevalence of lifestyle risk factors among the diferent populations in Uganda. Prevention of lifestyle cancer risk factors requires targeted interventions and a multi-sectoral approach. Most importantly, improving the availability, measurement and comparability of cancer risk factor data should be a top priority for future research in Uganda and other low-resource settings. Keywords Cancer, Lifestyle, Risk-factors, Prevalence, Trends, Surveillance, Control