Cancer Kitso

Cancer Kitso: A New Oncology Education and Training Program

In Botswana, where the cancer mortality rate is over 63 percent, there is a grave need to strengthen health systems and provide comprehensive, patient-centered oncology care. Continuing education for health care providers has proven effective and feasible in improving care delivery around the world.

Cancer Kitso is an education and training initiative that responds to Botswana’s specialty workforce needs in oncology. The concept is based on the Kitso AIDS Training Program, Botswana’s national training program for HIV/AIDS treatment and care that was established more than 20 years ago. The word kitso means knowledge in the local Setswana language.

The aim of Cancer Kitso is to improve cancer care and prevention capabilities throughout Botswana and, eventually, other countries in Africa.


Provider Training

A locally created and adapted course on clinical management of oncology patients was launched in fall 2022 with support from Bristol Myers Squibb. This synchronous hybrid course is designed for members of the Botswana health care workforce who care for cancer patients. The course covers fundamentals of cancer care and prevention, including knowledge, responsibilities, and clinical management. Participants discuss cancer basics, cancer screenings, treatment modalities of the common cancers, palliative care, patient navigation, and referral pathways within Botswana health systems.

The course includes five sessions scheduled within a two-month timeframe, followed by a final exam. The sessions are:

  • Cancer Basics and Navigation, from Symptoms to Treatment Planning
  • Cancer Treatment Modalities, Drug Therapies, and Adverse Effects
  • Chemotherapy in Cancer Treatment and Care
  • Palliative Care for Cancer Patients
  • Putting It All Together: A Patient’s Journey in Oncology Care and Strengthening Health Systems

Participants who complete the course and pass the exam receive a digital badge issued by Rutgers Global Health Institute.

Additional courses are being developed to cover fundamentals for primary care providers, oncologic emergencies for hospital teams, and advanced care and treatment for specialized cancer care teams.

Overall, the provider training program aims to:

  • improve non-oncology health care professionals’ knowledge and skills in cancer care and prevention through a novel, hybrid (on-site and virtual) oncology course on clinical management;
  • strengthen partnerships with the African Ministries of Health and academic institutions in sub-Saharan Africa to enhance the skills and capacity of public sector health care professionals in oncology;
  • translate clinical science to evidence-based practices applicable for African and global settings; and
  • tailor to the unique needs of health care professionals in Africa an education initiative that comprises training courses and an online global oncology education and resource center to maximize impact on global cancer control.


Solid Foundation

Modeled after KITSO AIDS
The Cancer Kitso training concept is based on the KITSO AIDS Training Program, a national workforce development program that was launched in the late 1990s in Botswana, when that country had the highest HIV/AIDS infection rate in the world. The success of KITSO AIDS led to its adoption by multiple other countries in sub-Saharan Africa. Today, KITSO AIDS is one of the gold standard programs acknowledged by UNAIDS 90-90-90 treatment targets.

Program Development
Using a similar workforce development framework, Cancer Kitso provider training was created and piloted in Botswana to educate health care professionals on the clinical management of the common cancers. The program’s development was informed by a quantitative and qualitative needs assessment, broad stakeholder engagement, and an interprofessional team of oncology and curriculum development experts. Clinical subject matter experts were faculty and staff from Botswana’s Ministry of Health, Princess Marina Hospital, and University of Botswana and at Rutgers’ Ernest Mario School of Pharmacy, Robert Wood Johnson Medical School, Rutgers Cancer Institute of New Jersey, Rutgers Global Health Institute, and School of Nursing. Curriculum development specialists from the University of Botswana facilitated the entire process.

Read an interview with Botswana-Rutgers Partnership for Health colleagues who served as clinical subject matter experts for Cancer Kitso.

Established Telehealth Capabilities
A grant from the U.S. Department of State, initially focused on COVID-19, enabled the creation of a clinical telehealth program in Botswana. The funding was part of the University Partnerships Initiative, which seeks to strengthen existing ties and foster new collaborations between U.S. and African universities.

The initiative, completed in 2022, included a health information technology needs assessment, expansion of commercial bandwidth, and support for a pilot telementoring initiative as an urgent training intervention for COVID-19 infection and disease management. The project supported the Government of Botswana’s pandemic mitigation efforts in remote and under-resourced communities across the country. It also laid the groundwork for applying telehealth throughout Botswana to improve care and prevention in many other infectious and noncommunicable diseases.

Botswana’s improved telehealth capabilities were essential to the launch of Cancer Kitso and will continue to be crucial to the program’s success.