Impact of a Childhood Cancer Awareness Program in Kenya: Sociodemographic Insights, Referral Trends, and Barriers to Care for Newly Diagnosed Children
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Introduction Children in low- and middle-income countries face barriers to timely access cancer care. Between January and June 2023, an awareness campaign in Bungoma County, Kenya, aimed to address this issue. This study describes sociodemographic and clinical characteristics of children diagnosed with cancer after the campaign, explores health-seeking behaviors and delays, and compares cancer referrals pre- and post- campaign. Methods Parental interviews were conducted for all children newly diagnosed with cancer from Bungoma County at Moi Teaching and Referral Hospital between January 2023 and December 2024 using semi-structured questionnaires. Hospital registry data from January 2014 to December 2024 were analyzed to compare referrals pre- and post-campaign. Results Following the campaign, 30 children were diagnosed with cancer (40% female, median age 5.5 years). Diagnoses included hematological cancers (23%), solid tumors (60%), rare solid tumors (7%), and brain tumors (10%), with 57% of solid tumors presenting at advanced stages. Delays were substantial: median patient-, physician-, diagnosis-, treatment-, health system- and total delay were 30, 104, 114, 6, 114 and 146 days respectively. Barriers included use of traditional medicine, cultural beliefs, financial strain, travel costs, lack of insurance, income loss, and fear. Mean annual referral rate showed no notable change (14.5 [7.6] pre- vs. 15 [0.7] post-campaign). Conclusion The campaign did not increase cancer diagnoses, highlighting ongoing barriers in timely accessing childhood cancer care. Addressing these barriers is essential for improving access to childhood cancer care. Factors such as healthcare worker strikes, supply shortages, and treatment seeking at other facilities may have contributed to the lower-than-expected numbers.