Title
Psychosocial and economic challenges shaping breast cancer care trajectories in public hospitals in Ethiopia
Background
Breast cancer is the most commonly diagnosed cancer among women worldwide and a leading cause of cancer-related mortality in low- and middle-income countries (LMICs). In sub-Saharan Africa, late diagnosis, limited access to comprehensive cancer care, and health systems barriers contribute to poor clinical outcomes. In Ethiopia, beyond biomedical challenges, women experience substantial psychosocial and economic burdens that shape treatment adherence, quality of life, and survivorship; however, these dimensions remain underrepresented in cancer care and research.
Objectives
This study aims to explore the psychosocial and economic challenges experienced by women with breast cancer in public hospitals in Ethiopia.
Methods
The study was conducted at Tikur Anbessa Specialised Hospital and Jimma Medical Center in Ethiopia using a mixed-methods approach. This abstract reports preliminary findings from the qualitative component, which employed in-depth interviews and focus group discussions with 55 participants, including women with breast cancer (n=26; 4 FGDs), family caregivers (n=18), and healthcare providers (n=11). Data were analysed using a reflexive thematic approach. The analysis is ongoing, and findings presented here reflect the initial phase of thematic analysis.
Results
Preliminary findings indicate that women face interconnected psychosocial, economic, and health-system challenges throughout the cancer care continuum. Key themes include: (1) profound psychological distress related to timely diagnosis, fear of death, body image changes, and social stigma; (2) severe economic burden driven by out-of-pocket medical and non-medical costs, loss of income, and reliance on family support; (3) health-system constraints, including service delays, equipment shortages and limited insurance system; and (4) limited access to formal psychosocial oncology services, resulting in reliance primarily on informal family and faith-based coping mechanisms. These challenges collectively undermine treatment continuity, emotional well-being, and perceived quality of life.
Conclusions / Implications for practice or policy
Preliminary qualitative findings highlight critical gaps in psychosocial and economic support within breast cancer care in Ethiopia. Strengthening health-system resilience through the integration of psychosocial oncology services, improved financial protection mechanisms, and investment in health-system capacity building is essential to improve patient-centered outcomes. These findings provide contextually grounded evidence to inform holistic cancer care strategies, service delivery, and policy development in Ethiopia and comparable LMIC settings.