Financial Toxicity Related to Advanced Cancer Patients’ Care: Case study of Selected Households of Kiambu County, Kenya

Abstract

Purpose: The aim of this study is to investigate family caregiver’s experiences on household financial burden related to cancer treatment/care following referral to a palliative care unit in Kenya.

Methodology: Case study approach was used to collect data from caregivers of advanced cancer patients following referral to a palliative care unit at Kijabe Mission Hospital in Kenya.

This approach is best suited to gain insight into economic implication of the rising cost of cancer treatment which has put a considerable financial strain on affected families, leading to adverse outcomes of caring for patients with advanced cancer. Semi-structured in-depth interviews, documentary data and field notes, observations were used to collect information relating to financial and economic impact of the careburden experiences from theoretical sample of 12 caregivers. This approach enabled an in-depth, multifaceted explorations of complex issues related to in their real-world contexts. The case study method was particularly chosen because of its richness to gain an in-depth understanding of an issue, event, or phenomenon of interest in its natural real-life context. A socio-technical coding matrix was used to analyze qualitative data thematically, along with additional themes that emerged from the data. All ethical considerations were observed accordingly.

Findings – Four (4) male and eight (8) female caregivers interviewed were between 18 to 67 years. The study reports families facing enormous financial strain and difficulties treating their patient with advanced cancer patient. Treating patient with advanced cancer is reported to drain resources threatening to bring vicious cycle of poverty and financial stability. Family members get frustrated at their inability to meet growing demands related to care, treatment and management of their patient in advanced stage of cancer. Financial concerns, catastrophic health expenditure (CHE) and distress financing (DF  as part of devastating effects of cancer, limited health insurance coverage and gaps in financing are among the key concerns identified.

Unique contributions to theory, practice and policy: This study builds evidence towards social and conomic consequences of treating advanced cancer diseases that affect household families and impact on life of patients with advanced cares. Hence, seeks to shape how multidisciplinary cancer care teams’ practices to become more aware of the costs of their clinical decisions. Findings of this study also form basis of review of already existing policies related to insurance coverage provided by state agency to tailor it to chronic diseases.  Further research is required to mitigate financial toxicity and additional financial safety nets

Key words: financial burden, cancer, economics, Kenya

DOI: 10.7176/JHMN/101-06

Publication date:June 30^th 2022