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Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

Perception of Cervical Cancer Patients on their Financial Challenges in Western Kenya

Authors: Jane A. Owenga, Erick Otieno Nyambedha

Published in: BMC Health Services Research | Issue 1/2018

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Abstract

Background

The number of cervical cancer cases is reported to increase among women of reproductive age in the recent past with patients facing challenges with care and management of the illness. However, little is known about the financial challenges these patients undergo in contexts such as western Kenya. This study assessed financial challenges and sources of financial assistance for cervical cancer patients in western Kenya.

Methods

A cross-sectional study involving 334 cervical cancer patients was conducted in Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu from September 2014 to February 2015. Structured questionnaire, in-depth interview guide and key informant interview guide were used to collect data. Quantitative data was analyzed using Statistical Package for Social Scientists (SPSS) Version 20 at a statistical significance of P ≤ 0.05, descriptive statistics and crosstabulations were performed. For qualitative data, the responses were transcribed verbatim and the content was then analyzed by searching for emerging themes on the financial challenges faced by cervical cancer patients. Qualitative data was presented in textual form with verbatim reports for illustrations.

Results

The key financial challenges from the study were costs of medication 291 (87%), cost of travel 281 (84%) and cost of diagnostic tests 250 (75%). Other costs incurred by the patients were cost of cloths and wigs 91 (27%), and cost of home and child care 80 (24%). Most 304 (91%) of the cervical cancer patients admitted and referred to JOOTRH did not have insurance cover and only 30 (9%) had National Hospital Insurance Fund cover which catered for only bed component of inpatient costs. Results showed that no patient received any assistance from well-wishers. Only a few received assistance from charity organizations 43 (13%), friends 91 (27%) and colleagues 31 (9%). Some patients received some assistance from relatives 32 (10%) and church 32 (10%).

Conclusion

Cervical cancer patients experience several financial challenges yet only few of them had insurance cover which catered for only bed component of inpatient costs. There is a need for the Kenyan health care system to develop mechanisms for provision of financial support for cervical cancer patients.
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Literature
1.
go back to reference Globocan. International Agency for Research in Cancer. France: WHO; 2012. Globocan. International Agency for Research in Cancer. France: WHO; 2012.
2.
go back to reference ICO, Information Centre on HPV and Cancer. 2017. ICO, Information Centre on HPV and Cancer. 2017.
3.
go back to reference Sharp L, Timmons A. The financial impact of a cancer diagnosis. Ireland: N.C.R.I.C. Society; 2010. Sharp L, Timmons A. The financial impact of a cancer diagnosis. Ireland: N.C.R.I.C. Society; 2010.
4.
go back to reference Berkman BJ, Sampson SE. Psychosocial effects of cancer economics on patients and their families. Cancer. 1993;72(9 Suppl):2846–9.CrossRefPubMed Berkman BJ, Sampson SE. Psychosocial effects of cancer economics on patients and their families. Cancer. 1993;72(9 Suppl):2846–9.CrossRefPubMed
5.
go back to reference Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H. Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: a population-based study. J Clin Oncol. 2004;22(23):4829–36.CrossRefPubMed Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H. Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: a population-based study. J Clin Oncol. 2004;22(23):4829–36.CrossRefPubMed
6.
go back to reference Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H. Persistence of restrictions in quality of life from the first to the third year after diagnosis in women with breast cancer. J Clin Oncol. 2005;23(22):4945–53.CrossRefPubMed Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H. Persistence of restrictions in quality of life from the first to the third year after diagnosis in women with breast cancer. J Clin Oncol. 2005;23(22):4945–53.CrossRefPubMed
7.
go back to reference Timmons A, Gooberman-Hill R, Sharp L. The multidimensional nature of the financial and economic burden of a cancer diagnosis on patients and their families: qualitative findings from a country with a mixed public-private healthcare system. Support Care Cancer. 2013;21(1):107–17. https://doi.org/10.1007/s00520-012-1498-4. Timmons A, Gooberman-Hill R, Sharp L. The multidimensional nature of the financial and economic burden of a cancer diagnosis on patients and their families: qualitative findings from a country with a mixed public-private healthcare system. Support Care Cancer. 2013;21(1):107–17. https://​doi.​org/​10.​1007/​s00520-012-1498-4.
8.
go back to reference Longo CJ, Deber R, Fitch M, Williams AP, D'Souza D. An examination of cancer patients’ monthly ‘out-of-pocket’ costs in Ontario, Canada. Eur J Cancer Care (Engl). 2007;16(6):500–7.CrossRef Longo CJ, Deber R, Fitch M, Williams AP, D'Souza D. An examination of cancer patients’ monthly ‘out-of-pocket’ costs in Ontario, Canada. Eur J Cancer Care (Engl). 2007;16(6):500–7.CrossRef
9.
go back to reference Bennett JA, Brown P, Cameron L, Whitehead LC, Porter D, McPherson KM. Changes in employment and household income during the 24 months following a cancer diagnosis. Support Care Cancer. 2009;17(8):1057–64.CrossRefPubMed Bennett JA, Brown P, Cameron L, Whitehead LC, Porter D, McPherson KM. Changes in employment and household income during the 24 months following a cancer diagnosis. Support Care Cancer. 2009;17(8):1057–64.CrossRefPubMed
10.
go back to reference Arozullah AM, Calhoun EA, Wolf M, Finley DK, Fitzner KA, Heckinger EA, Gorby NS, Schumock GT, Bennett CL. The financial burden of cancer: estimates from a study of insured women with breast cancer. J Support Oncol. 2004;2(3):271–8.PubMed Arozullah AM, Calhoun EA, Wolf M, Finley DK, Fitzner KA, Heckinger EA, Gorby NS, Schumock GT, Bennett CL. The financial burden of cancer: estimates from a study of insured women with breast cancer. J Support Oncol. 2004;2(3):271–8.PubMed
11.
go back to reference Chapple A, Ziebland S, McPherson A, Summerton N. Lung cancer patients’ perceptions of access to financial benefits: a qualitative study. Br J Gen Pract. 2004;54(505):589–94.PubMedPubMedCentral Chapple A, Ziebland S, McPherson A, Summerton N. Lung cancer patients’ perceptions of access to financial benefits: a qualitative study. Br J Gen Pract. 2004;54(505):589–94.PubMedPubMedCentral
12.
go back to reference Chirikos TN, Russell-Jacobs A, Cantor AB. Indirect economic effects of long-term breast cancer survival. Cancer Pract. 2002;10(5):248–55.CrossRefPubMed Chirikos TN, Russell-Jacobs A, Cantor AB. Indirect economic effects of long-term breast cancer survival. Cancer Pract. 2002;10(5):248–55.CrossRefPubMed
13.
go back to reference Dockerty JD, Skegg DC, Williams SM. Economic effects of childhood cancer on families. J Paediatr Child Health. 2003;39(4):254–8.CrossRefPubMed Dockerty JD, Skegg DC, Williams SM. Economic effects of childhood cancer on families. J Paediatr Child Health. 2003;39(4):254–8.CrossRefPubMed
14.
go back to reference Finocchiaro CY, Petruzzi A, Lamperti E, Botturi A, Gaviani P, Silvani A, Sarno L, Salmaggi A. The burden of brain tumor: a single-institution study on psychological patterns in caregivers. J Neuro-Oncol. 2012;107(1):175–81.CrossRef Finocchiaro CY, Petruzzi A, Lamperti E, Botturi A, Gaviani P, Silvani A, Sarno L, Salmaggi A. The burden of brain tumor: a single-institution study on psychological patterns in caregivers. J Neuro-Oncol. 2012;107(1):175–81.CrossRef
15.
go back to reference Weaver KE, Rowland JH, Bellizzi KM, Noreen MA. Forgoing Medical Care because of Cost: Assessing Disparities in Health Care Access among Cancer Survivors living in the United States. Cancer. 2010;116(14):3493–504. Weaver KE, Rowland JH, Bellizzi KM, Noreen MA. Forgoing Medical Care because of Cost: Assessing Disparities in Health Care Access among Cancer Survivors living in the United States. Cancer. 2010;116(14):3493–504.
16.
go back to reference Masika GM, Wettergren L, Kohi TW, von Essen L. Health-related quality of life and needs of care and support of adult Tanzanians with cancer: a mixed-methods study. Health Qual Life Outcomes. 2012;10:133.CrossRefPubMedPubMedCentral Masika GM, Wettergren L, Kohi TW, von Essen L. Health-related quality of life and needs of care and support of adult Tanzanians with cancer: a mixed-methods study. Health Qual Life Outcomes. 2012;10:133.CrossRefPubMedPubMedCentral
17.
go back to reference Sepulveda C, Habiyambere V, Amandua J, Borok M, Kikule E, Mudanga B, Ngoma T, Solomon B. Quality care at the end of life in Africa. BMJ. 2003;327(7408):209–13.CrossRefPubMedPubMedCentral Sepulveda C, Habiyambere V, Amandua J, Borok M, Kikule E, Mudanga B, Ngoma T, Solomon B. Quality care at the end of life in Africa. BMJ. 2003;327(7408):209–13.CrossRefPubMedPubMedCentral
18.
go back to reference Mostert S, Njuguna F, Langat SC, Slot AJ, Skiles J, Sitaresmi MN, van de Ven PM, Musimbi J, Vreeman RC, Kaspers GJ. Two overlooked contributors to abandonment of childhood cancer treatment in Kenya: parents’ social network and experiences with hospital retention policies. Psychooncology. 2014;23(6):700–7. https://doi.org/10.1002/pon.3571. Mostert S, Njuguna F, Langat SC, Slot AJ, Skiles J, Sitaresmi MN, van de Ven PM, Musimbi J, Vreeman RC, Kaspers GJ. Two overlooked contributors to abandonment of childhood cancer treatment in Kenya: parents’ social network and experiences with hospital retention policies. Psychooncology. 2014;23(6):700–7. https://​doi.​org/​10.​1002/​pon.​3571.
20.
go back to reference Gitonga SN. The Cost Burden of Breast Cancer Treatment at Kenyatta National Hospital: A Patient’s Perspective: Nairobi University Repository; 2015. U51/69344/2013. Gitonga SN. The Cost Burden of Breast Cancer Treatment at Kenyatta National Hospital: A Patient’s Perspective: Nairobi University Repository; 2015. U51/69344/2013.
21.
go back to reference Inzaule S, Otieno J, Kalyango J, Nafisa L, Kabugo C, Nalusiba J, Kwaro D, Zeh C, Karamagi C. Incidence and predictors of first line antiretroviral regimen modification in western Kenya. PLoS One. 2014;9(4):93106.CrossRef Inzaule S, Otieno J, Kalyango J, Nafisa L, Kabugo C, Nalusiba J, Kwaro D, Zeh C, Karamagi C. Incidence and predictors of first line antiretroviral regimen modification in western Kenya. PLoS One. 2014;9(4):93106.CrossRef
22.
go back to reference Aniebue UU, Tonia CO. Ethical, Socioeconomic, and Cultural Considerations in Gynecologic Cancer Care in Developing Countries. International Journal of Palliative Care. 2014;2014(2014):6. Aniebue UU, Tonia CO. Ethical, Socioeconomic, and Cultural Considerations in Gynecologic Cancer Care in Developing Countries. International Journal of Palliative Care. 2014;2014(2014):6.
23.
go back to reference Murray SA, Grant E, Grant A, Kendall M. Dying from cancer in developed and developing countries: lessons from two qualitative interview studies of patients and their carers. BMJ. 2003;326(7385):368.CrossRefPubMedPubMedCentral Murray SA, Grant E, Grant A, Kendall M. Dying from cancer in developed and developing countries: lessons from two qualitative interview studies of patients and their carers. BMJ. 2003;326(7385):368.CrossRefPubMedPubMedCentral
Metadata
Title
Perception of Cervical Cancer Patients on their Financial Challenges in Western Kenya
Authors
Jane A. Owenga
Erick Otieno Nyambedha
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3073-2

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