Dr. Florence Dedey
Dr. Florence Dedey, a Senior Lecturer at the Department of Surgery has delivered the second Inter-College Lecture Series organised by the College of Health Sciences. She spoke on the topic; “Identifying the Root Causes of Delays in Breast Cancer Treatment in a Teaching Hospital in Ghana”.
In her welcome address, the Dean of the School of Medicine and Dentistry, Professor Margaret Lartey stated that characteristic of universities, scholarly lectures were one of the ways that universities showcase their research and also excite the public about their research endeavours. She added that such lectures were also a means through which the University interacts with its immediate society and informs the general public about research activities undertaken by the University, and to bring it closer to the society it serves.
Professor Margaret Lartey, Dean of School of Medicine and Dentistry
Professor Lartey recounted that the Inter-College Lectures replaced the Inter-Faculty Lectures when the University of Ghana adopted the collegiate system of governance in 2014. She indicated that the rationale for the University of Ghana Inter-College Lecture was to create a platform for faculty members to discuss their research findings with the University community and the general public. This according to her was to give Professors and other academic staff a public forum to share their ideas, unlike inaugural lectures which were only meant for Professors only. She added that the lectures were also meant to create a forum for the discussion of presentations on findings of on-going research. The discussion, according to her, will allow the audience to ask questions and make contributions to improve the project design.
The Provost of the College, Reverend Professor Patrick F. Ayeh-Kumi warmly welcomed the audience to the evening’s Lecture and urged them to listen attentively to the presentation by Dr. Dedey. He hoped that the presentation would help generate the needed discussions that will assist policy makers in taking decisions that will inure to the benefit of the citizenry. He also encouraged the audience to ask questions or make contributions to assist in the identifying the root causes of delays in the treatment of breast cancer in a teaching hospital in Ghana.
Reverend Professor Patrick F. Ayeh-Kumi, Provost of College of Health Sciences
Dr. Dedey discussed the causes of delay in treating patients with breast cancer in the Korle Bu Teaching Hospital (KBTH), and some measures that have been taken to minimise the delays. She described breast cancer as the commonest female cancer in the world with increasing incidence in low and middle income countries. In Ghana, relatively younger women are affected with the peak age between 40 – 49 years. Early detection and effective treatment of breast cancer results in good outcomes but majority of patients seen in KBTH present with advanced disease. Furthermore, there are also delays in starting treatment after presentation to hospital. These delays in presentation and treatment are associated with several factors including patient, health worker and health system factors.
Dr. Dedey noted that a hospital-based retrospective study of 205 breast cancer patients starting definitive treatment at Korle Bu Teaching Hospital between May and December 2013 was conducted to evaluate the duration and factors that influence waiting time from first presentation to start of definitive treatment of breast cancer. The patient, health system, and health worker factors associated with median waiting time were examined. A follow up qualitative study involving four focus group discussions (FGDs) with 20 breast cancer patients were conducted and the transcripts were analysed thematically.
Dr. Dedey stated that results showed the mean age of the patients was 51.1 ± 11.8 years and median waiting time to start of treatment was 5 weeks. The determinants of waiting time were level of education, age, income, marital status, ethnicity, disease stage, health insurance status, study sites, time interval between when biopsy was requested and when results were received and receipt of adequate information from health workers. The qualitative study provided insights on the multi-level causes of delay in treatment. Patient factors included misinterpretation of symptoms, fear, financial constraints, seeking alternative treatment, and spiritual causal theories of breast cancer. The health care providers’ factors were poor attitudes of health workers and perceived corruption in health service provision. The health systems’ factors were delays in providing pathology results, regular breakdown of machines, and the fragmentation of cancer treatment procedures.
Dr. Dedey’s findings indicate that reducing delays in breast cancer treatment will require multi-level interventions including: health systems strengthening with particular focus on improving health professionals’ attitudes and diagnostic and treatment timelines, shortening time to obtain biopsy reports, psychosocial counseling, education of patients and providers on timely treatment to improve prognosis and public education on breast cancer.
She continued that as a follow up to the findings of the studies, a multipronged approach to public education has been adopted by the Breast Unit of KBTH. In 2016, the ‘Changing Young Minds’ project was started with the main objective of educating young girls in the secondary schools about breast cancer. Taking advantage of October being breast cancer awareness month, a massive campaign was launched in Accra and its’ environs in October 2017 and 2018 and more than 5000 women were taught breast self-examination and clinically examined each year. Public education on breast cancer was also carried out using various media platforms.
The lecture which was held at the R.S. Amegashie Auditorium of the University of Ghana Business School was attended by faculty and staff mostly from the College of Health Sciences.
From L-R, Mr. Michael Opare Atuah, College Secretary, Prof. Margaret Lartey, Dean, SMD, Dr. Florence Dedey and Rev. Prof. Patrick F. Ayeh-Kumi, Provost, CHS.
A cross section of the audience
