Abstract
Background: Zambia has the third highest incidence of cervical cancer in the world. Patients with gynecological malignancy self-navigate by transmitting referral letters from practitioner to practitioner across different health levels and geographic localities. Specialized oncology services for women with gynecological malignancies are shared between two tertiary hospitals in the capital city: the Cancer Diseases Hospital and the Women and Newborn Hospital.
Methods: In 2020, a two-day gynecological malignancies multidisciplinary tumor board workshop targeted clinical oncologists, surgical oncologists, radiologists, pathologists, medical social workers, and nursing and palliative care practitioners. It aimed at harmonizing the functions, goals, and benefits of a multidisciplinary approach to patient navigation and cancer care.
Results: Eleven participants from the six specialties attended the workshop. More than 70 % of the workshop participants have consistently attended the weekly virtual gynecological malignancies multidisciplinary tumor board meetings. Attendance of these meetings has expanded from practitioners within the capital Lusaka to other practitioners from all the nation's ten provinces. A virtual referral platform and patient dashboard were created. These platforms have improved the navigation of patients through the system via enhanced communication among practitioners.
Conclusion: Patient navigation through a multidisciplinary approach in a low-middle-income country is feasible. Further quantitative work is required to establish how this intervention has improved patient care and clinical research efforts for women with gynecological malignancies in Zambia.
Policy summary: Health service leaders in low-middle-income countries need to re-examine the workforce and financing to determine how navigation support can be implemented across the cancer care continuum.