By Suhani Patel
Delayed diagnosis and fragmented referral pathways remain significant barriers to timely cancer care across sub-Saharan Africa. In Botswana, the Upscaling of Patient Navigator Services in Botswana project is addressing these challenges by strengthening early detection, decentralized diagnostics, and continuity of care.
Led by the Botswana–Rutgers Partnership for Health (BRPH), under the leadership of Dr. Refeletswe Lebelonyane and the national stewardship of the Ministry of Health, the initiative is supported by the International Cancer Foundation (ICF) and the Merck Foundation, with in-kind support from Roche.
90
Nurse Navigators Trained
85
Medical Officers Trained
14
Facility Matrons Trained
workforce development
Building Capacity Across The Care Pathway
The initiative uses a bi-directional training model to strengthen two complementary areas of cancer care: frontline nurse navigation and diagnostic capacity at primary and district-level facilities.
Nurse navigators are trained to coordinate referrals, identify barriers to care, and support patients throughout their diagnostic and treatment journeys. In parallel, medical officers receive practical training in breast examination, fine-needle aspiration, and core needle biopsy procedures, bringing essential diagnostic services closer to where patients first seek care.
Early Implementation Results
Bringing Breast Health Services Closer to Patients
Early progress is emerging from Bontleng Clinic in Gaborone, designated as a dedicated Breast Health Clinic and referral site for women with abnormal breast findings.
Within one month, two trained medical officers assessed 15 patients referred for abnormal breast findings, identifying eight breast cancer cases. All eight patients were referred to Princess Marina Hospital for specialist management.
8 Breast cancer cases identified through assessment of 15 referred patients in one month.
Integrated Care
Strengthening Coordination Across Facilities
Workforce development is complemented by stronger clinical coordination. At Nyangabgwe Referral Hospital, the establishment of a multidisciplinary team (MDT) brings together pathology, radiology, surgery, oncology, and frontline care teams to support collective clinical decision-making.
By strengthening communication between departments and facilities, these efforts are helping build more connected referral pathways and improve continuity across the cancer care system.
Looking Ahead
A Pathway Toward National Scale
Implementation is currently active in the Gaborone and Francistown catchments, which are informing the phased expansion of the model across Botswana. Planned expansion includes additional referral and district-level facilities, building on operational lessons and strengthening connections between primary care and specialist oncology services.
