As in other low resource countries in Sub Saharan Africa, most Nigerians diagnosed with cancer are identified at late stages. Women diagnosed through breast cancer screening programmes often already have metastatic breast cancer (MBC) and the healthcare delivery system and infrastructure are ill-equipped to manage the disease. Nigeria has a population of over 206 million , and the 27 cancer treatment centres that exist in the country are not sufficient to address the need. The cost of treatment options is also out of reach for most women, nationally, the six-course chemotherapy treatment has an average cost of $2,300 in a country where 77% of the population live on under $2 a day . For those who can afford treatment, waiting lists at treatment centres force them to travel to foreign destinations to seek treatment.
Within this context, there is a considerable emotional and psychological toll on MBC patients in Nigeria, with depression, anxiety, and a consuming feeling of helplessness being recurring themes. Access to treatment and psychosocial services are critical to prolong and maintain the quality of life for individuals with MBC.
Founded in 2009 and registered in 2012, Medicaid Cancer Foundation (MCF) is an NGO founded out of the need to create a much-needed support system for patients, families and caregivers faced with cancer.
MCF provides support throughout the cancer care continuum – from diagnosis to the myriad of questions and answers associated with treatment and care, through the journey to full survivorship, and managing this life-changing experience for the patients, families, and caregivers. Their cancer awareness and screening programme reached 428,127 persons between 2015 and 2018, carrying out free screening for 4,366 individuals (974 mammograms) during this period. Lessons learnt in over ten years of working to help Nigerian women access screening and treatment options have informed the One Call Away project.
“The UICC SPARC grant helps ‘One Call Away’ link women diagnosed with Metastatic Breast Cancer to treatment solutions appropriate for their unique circumstances and address the psychological specificity of MBC, prioritising the quality of life.”
Diagnosis with MBC is a life altering event. The One Call Away project, launched as a result of a SPARC grant in 2019, aims to help patients across Nigeria to have a better access to screening, diagnosis, treatment and supportive care.
One Call Away operates primarily by providing a nationally available toll-free helplines (telephone, online community chatroom access and a web-based resource centre) in English and Hausa (one of the major local languages). The platform serves as a one-stop shop where women can access all the information they need to identify appropriate healthcare and psychosocial services with the help of personal trained counsellors/navigators.
“One Call Away has opened up another pathway in coping with cancer. The meetings give the women a chance to ask the doctor questions that may not have come up during the routine clinic visits. They also have the opportunity to have a chat and exchange experiences with other 'sisters' in the cancer struggle in a relaxed ambiance, making the terminal stages of their cancer journey a bit more tolerable.”
Dr J.D Jimeta Tuko, Oncologist, Federal Medical Centre in Birnin-Kebbi
The main objective of the project is to improve the quality of life of women diagnosed with MBC by supporting them to access appropriate treatment solutions within eight weeks of contacting One Call Away. This was accomplished through four main objectives:
Through One Call Away, the infrastructure was created to link women diagnosed with MBC to appropriate treatment solutions and help to address the psychological aspects of MBC. In addition to enhancing access to treatment, the platform helps patients to acquire new coping skills for relieving stress and enhances optimism and quality of life.
The key achievements and the foundation of this project was the launch of a toll-free helpline and expansion of the organisations drug access program. During the lifespan of this project One Call Away helped over 1650 women remain in control of their lives, ensuring they have access to the information they need to make informed choices about their health and facilitating a strong support network. Additionally, Medicaid access to treatment programmes enables patients to access medication 40% less than retail rates easing the cost of care and is an important step forward to ensuring patients in the region have access to the medicines they need. Aiding family members and caregivers with the tools they need to care for their loved ones was also prioritised. The hotline has received ongoing support from government that has pledged funding to continue to support the program until 2023.
The helpline is led by a network of 40 counsellors/navigators trained by this project. The navigators now serve to help engage beneficiaries and follow-up, there is an active WhatsApp group of counsellors where beneficiaries are assigned to them for support.
Building on the establishment of the helpline, support group centres have also been set up in two Nigerian hospitals: the Federal Medical Centre (Birnin Kebbi, Kebbi); and the National Hospital cancer care centre (Abuja, FCT). In Birnin, the group successful supported 35 women during the project and bi-weekly sessions were led by a cancer survivor and oncologist. One support group member commented;
“The One Call Away meeting has been very helpful to me because it has given me the opportunity to meet with other breast cancer patients/ survivors and hearing from them gives me hope that I too will survive the disease. I've also learned a lot on dieting and what food to avoid as a breast cancer patient but most importantly, my interaction with other participants and healthcare professional is what I enjoy the most.”
Hajara Musa, One Call Away Support Group Member
One Call Away also provides psychosocial services through the dedicated helpline and the support group meetings. Services have included counselling, education, group and spiritual support. The support has extended to meeting material needs, with a number of the emotional struggles raised being attributed to neglect and poverty. The organisation was able to partner with the state government to provide a monthly welfare pack to each member of the support group.
In this project, the SPARC grant enabled One Call Away to build the technical infrastructure needed to launch the interactive website as well as the hotline. The initial investment has enabled other sources of funding to continue the project in the long term with the state government committed to continue to fund the platform in the coming years, enabling a continued support for breast cancer patients across Nigeria.
In addition to the achievements accomplished during this project, the group was also able to contribute to The Kebbi State’s Strategic Plan for cancer control and which is critical for the long-term sustainability of the services.