Strengthening Nursing Capacity for Comprehensive Oncology Care in Sub-Saharan Africa: A Breast-Specific Training Intervention Focused on Sustainment in Ethiopia
Lesley Taylor, Bedilu Deribe, Betty FerrellPURPOSE
Breast cancer mortality is highest in sub-Saharan Africa, where oncology nursing capacity is limited. A train-the-trainer strategy was used in Ethiopia to build regional capacity and support local sustainment.
MATERIALS AND METHODS
An education intervention focused on breast cancer was purposely designed, implemented, and analyzed. Training materials included lectures, videos, discussions, and skills laboratories. Cohort 1 included nurses from an oncology unit and nursing faculty. Cohorts 2 and 3 nurses worked in peripheral hospitals. Participants completed demographic, precourse, and 6-month surveys. Chi square, repeated measured analysis of variance, and paired
RESULTS
The intervention reached 79 nurses: 29 in cohort 1 and 50 in cohorts 2 and 3. In total, 65 (82%) completed baseline and 6-month surveys. Of these, 2 of 3 were male. The mean professional experience was 10 years. The majority had a bachelor's degree. The average percent of clinical time spent with patients with cancer was 62% for cohort 1 and 24% for cohorts 2 and 3. Cohort 1 more often provided spiritual care, discussed goals of care, performed clinical breast examination, and communicated to patients of different religious backgrounds. For all participants, there was a significant improvement in knowledge, confidence, and motivation at 6 months, with no differences between cohorts 1 and cohorts 2 and 3.
CONCLUSION
The short-term breast cancer training program for nurses addressed barriers to providing comprehensive care in the local context. The multimodality course leveraged local resources and faculty expertise to build foundational knowledge and practical skills. The intervention can be scaled up regionally and adapted to reach other audiences.