Primary Submission Category: Health systems
Transforming Detection: Assessing the Impact of Task Shifting in Nurse-Led Breast Cancer Screening in Rural Ghana
Authors: Isabella Dunn, Nigel James, Charlotte Ofori,
Presenting Author: Callia Nickles*
Introduction
Breast cancer is the most prevalent cancer among women in sub-Saharan Africa, yet early detection remains low, especially in rural areas with limited access to specialized care. In Ghana, where breast cancer affects women in their prime working years, late-stage diagnoses contribute to poor survival outcomes. This study evaluates the effectiveness of task-shifting by training community health nurses to conduct clinical breast examinations (CBEs) in rural settings.
Methodology
This nested study is part of a broader initiative to enhance breast cancer screening in rural Ghana. Using a concurrent mixed-methods design, we assess feasibility, effectiveness, and challenges in task-shifting. Twelve community health nurses trained in CBEs will complete pre- and post-training surveys measuring knowledge, confidence, and preparedness. Semi-structured interviews with nurses, medical personnel, and screened women will provide qualitative insights into provider-patient perceptions, implementation barriers, and sustainability. Quantitative data will track changes in knowledge and preparedness, while thematic analysis will explore qualitative experiences.
Preliminary Findings
Early field reports indicate increased confidence among trained nurses and positive patient perceptions of nurse-led screenings. However, barriers such as lack of private examination spaces and socio-cultural factors hinder screening uptake. Data collection will conclude by June 30, 2025, with further analysis refining these findings.
Significance & Policy Implications
This research informs policies on workforce training and breast cancer screening expansion. Demonstrating the feasibility of nurse-led screenings as a cost-effective strategy, findings can guide task-shifting integration, scale-up efforts, and community-based healthcare strengthening to improve early detection, reduce mortality, and advance health equity in rural Ghana and similar settings.