Breast Cancer Rehabilitation Services in South Africa and Survivor Experience of These Services in Two Dedicated Cancer Units

Abstract Purpose Integrated rehabilitation health care pathways are implemented to meet both physical and clinical needs of breast cancer survivors as they transition from medical treatment to long term survivorship. The aim of this study was to assess current South African upper limb rehabilitation service provision, and perspectives of these from health professionals and breast cancer survivors.Methods A sequential explanatory mixed-methods design informed this study. Service provision was evaluated via an online survey questionnaire completed by health practitioners working in public and private breast cancer units. Focus groups were conducted with both public health practitioners providing the services and breast cancer survivors accessing the services. Results This study has revealed a dearth of rehabilitation services for breast cancer survivors in the public health sector of South Africa. Data reveal an overstretched, understaffed and poorly trained public health sector, unable to deliver adequate upper limb services to breast cancer survivors. Focus group data suggests that this is due to financial austerity rather than poor recognition of the need. Limited patient education is driving poor upper limb outcomes and barriers to change in exercise behaviour.Conclusion Current South African upper limb rehabilitation services do not cater for the needs of breast cancer survivors, leading to poor health outcomes.