Engaging with local communities to improve cancer care in Kenya

Researchers at Manchester are forging partnerships in East Africa to better understand local populations and develop the right interventions to reduce inequalities in cancer care.

Global problem: delayed diagnosis resulting in high mortality rates

Oesophageal cancer (OSCC) is the third most common cancer in Kenya and has the highest mortality rate. Late presentation at a more advanced stage of the disease is a common feature among local patients. Earlier detection is therefore crucial to save lives.  

The majority of OSCC research has taken place on patients in developed countries and as a result, the knowledge base for the African genome is not fit for purpose. There needs to be greater understanding of the potential underlying genetic signatures and environmental factors that may contribute to an increased risk of developing this cancer type. 

It is essential to start by understanding the population our research seeks to support and ensure our research and communication tools are appropriate. Only in doing so, can we work towards a collective vision for improved cancer care.

Manchester solution: Transformational research underpinned by community engagement

Researchers from The University of Manchester are building global relationships to achieve meaningful improvement in cancer care beyond the UK. The team are using engagement activities and models developed in Manchester to partner with communities in low and middle-income countries, aiming to empower community members and create a lasting legacy. In 2020, The Christie NHS Foundation Trust in Manchester signed a memorandum of understanding with Kenyatta University Teaching, Referral and Research Hospital (KUTRRH) in Nairobi and the Ministry of Health, Kenya to work in partnership to improve cancer outcomes in Kenya and East Africa.

Dr Suzanne Johnson, Social Responsibility Lead for the Division of Cancer Sciences at Manchester explains: “Manchester is the only UK university with social responsibility as a core goal and this project demonstrates how those values can be integrated into our research and teaching practices. We will use community engagement initiatives to underpin our clinical and research aims to benefit patients.”

“We are working with local teams in Kenya to understand how demographics and regional geographies impact on disease development, detection and treatment. More importantly, we are not just asking for samples; we are taking the time to build relationships and understand the individuals, communities and population to ensure all interventions are equipollent. We’re building on existing relationships, activities and capabilities to ensure that we meet genuine need in Kenya and don’t incorrectly impose what we think is needed.”

We’re working with local teams in different Kenyan counties to ensure engagement activities are not simply transactional, but more inclusive and collaborative... If we do this right, learning and evaluating as we go, we will be able to apply this approach to tackle other global inequalities.

Dr Suzanne Johnson / Lead for Social Responsibility for the Division of Cancer Sciences.

Building sustainable partnerships with local organisations

The specific type of oesophageal cancer found in Kenya is different from that found in the UK. In addition, improving the local population’s understanding and awareness, and overcoming barriers such as fear and mistrust alongside cultural and faith sensitivities, require different engagement strategies. There is much stigma attached to cancer diagnoses in rural African communities and understanding these barriers by listening and learning from those affected is key to improving outcomes.

Working closely with colleagues in Kenya, Manchester researchers have connected with existing Kenyan (KENCO) and pan-African (H3aArica) organisations where their research will complement and support activities and approaches on the ground. By refining a strategy together, they are learning from each other and creating a sustainable partnership through shared leadership, which will build trust and lead to meaningful, long-lasting change.

By bringing together experts across genomic medicine, health economics, nursing, participatory research, and clinical medicine, the University is ensuring a cohesive approach that will help to build infrastructure and provide training to uplift and improve current cancer detection and treatment. Manchester research will extend cancer knowledge and expertise so that more people can benefit during prevention, early detection and treatment.

Research impacts

The University of Manchester’s research is:

  • driving awareness of the signs of cancer; building up infrastructure; and training allied health professionals to support the research that will ultimately benefit their populations; 
  • enabling health equity by supporting the co-production of engagement and research with patients and communities who stand to benefit from it the most; 
  • aiming to reduce cancer incidence through training, education and community engagement;  
  • helping to address cancer disparities caused by health inequalities;  
  • co-creating educational resources to help communities better understand cancer risk and prevention strategies; 
  • training staff in engagement strategies, inclusive language and clinical skills; 
  • working with local teams to set up field hospitals; 
  • helping communities feel empowered and to take ownership for their cancer care. 

Meet the researcher