Breast cancer is the most common cancer among women worldwide, and Ethiopia is no exception. It accounts for a third of all cancer deaths among women in the country. Despite this high burden, Ethiopia has made significant strides to prevent breast cancer deaths. The government has collaborated with CHAI, the Norwegian, and American Cancer societies through a multi-year initiative (2018-2024) to expand breast cancer services in Ethiopia. The program, aligned with the WHO Global Breast Cancer Initiative strategy, established a sustainable and scalable healthcare model to address the growing need for cancer care.
Expanding access to breast cancer treatment services
Since 2018, Ethiopia has invested significantly in improving access to breast cancer treatment for more women, expanding access to chemotherapy and breast surgery services from only two to 24 hospitals across the country. This transition, led by the Ministry of Health with support from CHAI, means that thousands of women can access cancer care closer to their home. Helen, a mother of four, is one of these women.
Helen thought she was protected from breast cancer because she had breastfed all her children. While nursing her youngest, she noticed a lump in her right breast.
“I remembered an awareness campaign in our town about breast cancer and how important it is to get lumps checked”, she says.
Helen’s doctor at her local hospital recently trained in breast cancer early detection, quickly referred her to Hawassa hospital, a regional facility, where doctors confirmed her cancer. She then underwent surgery and chemotherapy just a few hours from home—a far cry from the days when women would need to travel to the capital for treatment. Helen now volunteers to support other women, encouraging them to perform self-exams and seek early care.
Helen with her four children
Before the government brought these services closer to communities, many women had to travel long distances to the capital. Their treatment was often delayed and it caused them financial strain. Now, hospitals throughout the country are equipped to provide these essential services, drastically reducing the time women wait to start treatment—from months to a couple of weeks. In the past six years, the number of women receiving cancer treatment each year has multiplied by ten. More than 26,000 patients have benefited from these expanded services, including 12,000 women diagnosed with breast cancer like Helen.
Bringing breast cancer diagnosis closer to home
While treatment services have become more available, over 70 percent of women are still diagnosed at advanced stages, when their chances of survival are lower. Recognizing that early detection saves lives, CHAI and the Ministry of Health focused on making it easier for women to get detected and diagnosed earlier. This effort achieved a major milestone by decentralizing tissue biopsy services—a necessary procedure to confirm breast cancer—at primary hospitals.
Previously, women like Helen had to travel to larger hospitals for this procedure, and then wait weeks for their results. In this program, trained physicians at primary hospitals can collect tissue samples and send them through the existing transport network for testing at referral hospitals. Women can now receive an initial diagnosis within just one week instead of a month. Fast diagnosis is critical to starting treatment early, which dramatically improves survival rates.
Scaling early detection and empowering communities
Through a strategic partnership with the Ministry of Health and select Regional Health Bureaus, CHAI launched a pilot program establishing early detection services at nearly 90 primary centers. This woman-centered approach brings care to the community level, reaching women who might never have sought medical help due to distance or fear. Health workers, trained on breast cancer awareness and clinical breast examination, now help patients recognize the early signs of breast cancer and the importance of seeking medical care promptly.
Asnakech, a nurse at Chelenko Hospital, is one such example. After attending one of the CHAI-supported training sessions, Asnakech performed a self-exam and discovered a lump. “I never thought I would be a victim of breast cancer, despite working in a medical unit, but that training opened my eyes.”
After receiving her diagnosis within three days, Asnakech underwent surgery and chemotherapy at Hiwot Fana hospital. Receiving treatment at Hiwot Fana hospital saved her from a 10-hour journey to the capital. Today, Asnakech advocates for more awareness: “Most women lack essential knowledge around breast health. Increasing awareness is the most important step to empower women to be proactive about their breast health.”
Asnakech, a nurse at Chelenko Hospital, Ethiopia
As part of this program, close to 40,000 women received a clinical breast examination with 132 women diagnosed with breast cancer. This pilot demonstrated how the healthcare system can integrate early breast cancer detection alongside cervical cancer screening services into primary care.
Looking ahead
This program significantly contributed to developing Ethiopia’s first National Breast Cancer Guideline, providing a structured framework for the country to advance breast cancer care. Our goal goes beyond short-term relief. We aim to build lasting capacity, so that these services remain available for generations of women to come, benefiting women like Helen and Asnakech. Their stories are among thousands that highlight how these changes have saved lives and reduced the burden of breast cancer in Ethiopia.
“At CHAI, our focus is on building sustainable, resilient, and women-centered health systems that ensure equitable access to early cancer detection, diagnosis and treatment. We remain committed to working alongside the Ministry of Health to continue expanding these life-saving services and making early intervention possible for every woman, no matter where she lives,” said Dr Yared Tilahun, CHAI Ethiopia Program Manager, “As we celebrate these achievements, let us remember that sustained efforts in early detection, timely diagnosis and comprehensive treatment are key to defeating breast cancer – not just in Ethiopia, but worldwide.”
