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. 2021 Sep 9;21(1):943.
doi: 10.1186/s12913-021-06963-7.

Geospatial analysis and impact of targeted development of breast cancer care in The Gambia: a cross-sectional study

Ousman Sanyang #  1   2   3 , Fidel Lopez-Verdugo #  1 , Meghan Mali #  1   4 , Moustafa Moustafa  1 , Jonathan Nellermoe  1 , Justin Sorensen  5 , Mustapha Bittaye  3   6 , Ramou Njie  2   3 , Yankuba Singhateh  6 , Ngally Aboubacarr Sambou  6 , Alison Goldsmith  1   7 , Nuredin I Mohammed  8 , Kirstyn E Brownson  1   4   9 , Raymond R Price  1   4   10 , Edward Sutherland  11   12
Affiliations

Geospatial analysis and impact of targeted development of breast cancer care in The Gambia: a cross-sectional study

Ousman Sanyang et al. BMC Health Serv Res. .

Abstract

Background: The Gambia has one of the lowest survival rates for breast cancer in Africa. Contributing factors are late presentation, delays within the healthcare system, and decreased availability of resources. We aimed to characterize the capacity and geographic location of healthcare facilities in the country and calculate the proportion of the population with access to breast cancer care.

Methods: A facility-based assessment tool was administered to secondary and tertiary healthcare facilities and private medical centers and clinics in The Gambia. GPS coordinates were obtained, and proximity of service availability and population analysis were performed. Distance thresholds of 10, 20, and 45 km were chosen to determine access to screening, pathologic diagnosis, and surgical management. An additional population analysis was performed to observe the potential impact of targeted development of resources for breast cancer care.

Results: All 102 secondary and tertiary healthcare facilities and private medical centers and clinics in The Gambia were included. Breast cancer screening is mainly performed through clinical breast examination and is available in 52 facilities. Seven facilities provide pathologic diagnosis and surgical management of breast cancer. The proportion of the Gambian population with access to screening, pathologic diagnosis, and surgical management is 72, 53, and 62%, respectively. A hypothetical targeted expansion of resources would increase the covered population to 95, 62, and 84%.

Conclusions: Almost half of the Gambian population does not have access to pathologic diagnosis and surgical management of breast cancer within the distance threshold utilized in the study. Mapping and population analysis can identify areas for targeted development of resources to increase access to breast cancer care.

Keywords: Access to cancer care; Breast cancer; Geospatial analysis; Global health; Global surgery; Sub-Saharan Africa.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Location of healthcare facilities and level of breast cancer care provided in each facility
Fig. 2
Fig. 2
Distance from centers providing A) screening, B) diagnosis, and C) surgical management services for breast cancer currently
Fig. 3
Fig. 3
Distance from centers providing A) screening, B) diagnosis, and C) surgical management services for breast cancer after a hypothesized targeted resource allocation
See this image and copyright information in PMC

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