Global Patient Support

Male patient sitting on bed in Uganda hostel


Getting the right care sometimes means cancer patients must travel to a treatment center far from home. But very distant travel is often needed in the countries where we work overseas. This travel leads to intense physical, emotional, and financial burdens for many during such a challenging time.

The American Cancer Society Global Patient Support team works with organizations in low and middle-income countries (LMIC) to help cancer patients and their caregivers on their cancer journey. The team has four main patient support initiatives: accommodation, education, navigation, and transportation. These efforts address the challenges that can get in the way of a patient starting or finishing treatment. The goal of these initiatives is to reduce patient suffering, increase treatment adherence, and improve health outcomes. The team provides help and guidance to hospitals and cancer-focused civil organizations to ensure that cancer patient care and support services are coordinated, comprehensive, and effective. 

Patient Accommodation

"My family and village raised resources for transportation to Nairobi and for my treatment, but I had no money left for food or accommodations."

-A Kenyatta National Hospital patient who traveled from rural Kenya to the capital city of Nairobi
Female patient in bed at Uganda hostel

Many patients in LMIC must travel far distances to receive cancer treatment that is only available in the capital cities—or possibly even in neighboring countries. Many have no place to stay due to very limited financial resources or not having relatives or friends in the area. Because of these barriers, patients and their caregivers often need to sleep in hospital corridors or outside on hospital grounds where they are exposed to many hazards, and have no place to bathe or prepare a proper meal. Without a place to stay, there are great risks to patients’ well-being and hope for survival.

The American Cancer Society is committed to expanding accommodation services globally, so that patients have more options for free places to stay. This service allows patients to focus on getting better.

Building on our experience in developing patient support services to reduce barriers to care, we are currently providing financial and technical support to hospitals and patient hostels in Kenya and Uganda. We offer expertise in design, construction, management, operations, and added programs that support cancer services. Our work is focused on helping patient hostels:

  • set up effective referral systems,
  • establish minimum standards of care,
  • hire, train, and mentor patient hostel staff,
  • set up effective operations and management systems, and
  • develop other patient support services that are complementary to the patient hostel setting.  

ACS is currently working with the Kenyatta National Hospital to build a patient hostel called the KNH Hope Hostel.

All of the patient hostels we support also participate in our organizational-strengthening initiative, the ACS SOURCE Program. Through this program they can learn and use new skills for mobilizing resources, managing human resources, and providing leadership. Having these skills can increase the impact and sustainability of the patient hostel services.

Entrance to an ACS supported patient hostel
bedroom in an ACS supported patient hostel equipped with mosquito netting


Patient Education

“When people come and ask me what made me sick, I do not tell them it is cancer. I do not tell them because people will abandon me-they think it will ‘stick’ to them.”

-A patient in Ethiopia on why she didn’t tell people about her diagnosis
Hostel administrator discussing cancer basics with a caregiver of patient staying at Ugandan hostel

The American Cancer Society has been helping to raise public awareness about cancer in the US for more than 100 years. In the past, cancer was a disease regarded with such fear and denial that it was rarely mentioned in public. People in LMIC face those same challenges today. They often do not know much about cancer and its causes. Some have misperceptions about the disease, partly due to common myths and stigma. This is also because there are very few culturally-relevant resources available to better educate doctors, patients, and caregivers.

Working with local governments, national hospitals, and cancer organizations, ACS developed a set of cancer education materials for East African audiences based on some of our most helpful educational materials for patients and caregivers used in the US. Created using research, these materials explain what cancer is, including possible signs and symptoms; identify risk factors for cancer; describe the different types of treatment and related side effects; promote pain control and timely treatment; and explain how to take care of oneself on the treatment journey. These resources, used in Ethiopia, Kenya, and Uganda, are culturally-appropriate and easy to understand. The materials help open new channels for communication, reduce stigma, and offer hope to families affected by cancer. They help healthcare providers explain a cancer diagnosis and treatment, help patients navigate complex decisions and emotions, and provide tips for caregivers who are caring for a loved one with cancer.

Cancer treatment centers and local non-governmental organizations (NGOs) are now able to educate patients and caregivers using these materials in local language. Our hope is that these materials will help patients better understand their disease. We also hope they help break down the stigma and myths associated with cancer. 

To ensure effective use of the materials, ACS is supporting national cancer network organizations in these countries by training healthcare providers to use and distribute the materials in the best ways possible.

Finally, ACS encourages other countries to develop locally-appropriate cancer education materials in an online toolkit. The materials outline how to carry out an evidence-based development process like the one done in Kenya, Uganda, and Ethiopia.

Patient Navigation

“When I learned that I had cancer, I was very scared. However, after meeting with Helen, one of the navigators, I learned a lot more about cancer and felt encouraged to seek treatment. Helen served as an advisor throughout my difficult journey through chemotherapy, as she helped me learn about the side effects of treatment and how I could manage them. Now, I’m almost finished with treatment and am deeply grateful for all that the navigation team has done to help me through this time.”

–39-year-old patient with breast cancer at Kenyatta National Hospital
Clinical navigator meeting a patient and reviewing cancer basics with educational materials at the Kenyatta National Hospital's Patient Navigation Program

Patient navigation is a process that offers personal guidance for patients, their families, and caregivers as they move through complex care systems. In cancer care, patient navigation can help ensure timely diagnosis and treatment, and provide support when patients run into challenges along the way. Patient navigators can be nurses or lay people who are trained by organizations. The American Cancer Society has a long history of working to reduce barriers for cancer patients in the United States (US). We promote and offer patient navigation services throughout the US.

However, the needs of cancer patients and their families in the countries where we work overseas can be even greater than for patients in the US. These patients can be more vulnerable due to higher rates of poverty, health systems that are broken and don’t have enough resources, low levels of understanding cancer, and limited patient support services. All these factors contribute to poor health outcomes.

Cancer is the third leading cause of death in Kenya after infectious and cardiovascular diseases. There are an estimated 48,000 new cases of cancer diagnosed annually in Kenya and an estimated 33,000 Kenyans die of cancer every year. In 2016, ACS began supporting Kenyatta National Hospital (KNH) in Nairobi, Kenya, to launch the first patient navigation program in a national hospital in sub-Saharan Africa. KNH’s Patient Navigation Program includes 4 clinical nurse navigators, 1 lay navigator, and 4 navigators who can help people with limited mobility move through the hospital more easily. Each week, about 60 cancer patients receive their diagnosis and personal navigation services in the KNH Cancer Treatment Centre. KNH also has improved signage throughout the hospital and is educating patients, their family members, and caregivers to help increase cancer knowledge. The experience gained through this program is informing the development of other patient navigation initiatives throughout the world.

With a generous grant from the Merck Foundation (called the MSD Foundation outside of the United States), ACS has launched a new patient navigation initiative to strengthen health institutions and systems in LMIC to improve health outcomes and the patient experience during the cancer journey with a proven model of patient-centered care.

From 2019 through 2023, ACS will work to demonstrate that patient navigation can be effective and viable for health institutions in LMIC through our work with KNH and the UCI.  And, we will start to promote patient navigation in other LMIC settings outside of Africa.  Based on this work, ACS will create a comprehensive patient navigation program development and implementation guide that will be piloted in health institutions in Asia and Latin America.  This guide will enable health facilities in other resource-limited settings to develop navigation programs that best serve their patients’ needs. 

Patient Transportation

Man looking out of the window of a large bus in Addis Ababa

Lack of transportation to and from cancer treatment can be a great barrier for patients. It can lead to limited access to care and may cause patients to miss, delay, or not be able to complete their treatment. The challenges are more extreme in LMIC because many patients must travel long distances to the capital city which is often the only place where comprehensive cancer treatment is available. Once they are in the capital, patients must arrange for repeated trips to and from the hospital since treatment requires many visits over several weeks. The transportation problems continue when patients finish treatment because it can be hard to afford transportation to return home and then come back to the treatment center for follow-up care.

Since 2005, the American Cancer Society has provided transportation to and from treatment centers in the US for people with cancer who do not have a ride or are unable to drive themselves. Our team is exploring solutions based on appropriate and available transportation options that meet the unique needs of patients in the countries where we work overseas.

For more information, please contact GlobalPatientSupport@cancer.org