Navigation in the community

The success of navigation in the community is measured by the positive effect the service has on the patients and their families. Alice Banze explains how this type of navigation works.

Traditionally, healthcare awareness was conducted primarily by community healthcare workers to promote health or prevent disease. 

Whilst community outreach care workers would provide care to members of a community that did not have access to a certain service. In both cases, numerous people within a community were served. 

Navigation is a patient-centred care program which brings a unique and powerful perspective of providing comprehensive care to patient and family. 

It was started by teaching women how to conduct a self-breast examination. Navigators, like other community healthcare workers, provide primary prevention to the community by giving health education of cancer risks, identifying signs and symptoms of cancer, and awareness of diet, exercise, sun exposure, alcohol, smoking and vaccinations. 

The navigator will most likely be a member of the community. This is important so she/he can provide culture-sensitive education in the language that the community understands. Community navigators will actively search for individuals who need care. 

Navigating a symptomatic community member

A symptomatic individual is encouraged to attend screening services to confirm the diagnosis. 

Based on the identified symptoms, medical procedures, like a Pap smear, mammogram, faecal sample for occult blood, prostate-specific antigen (PSA), digital rectal exam (DRE), colposcopy and blood test, etc. would be performed. 

The navigator will coordinate the bookings, at a hospital, and orientate the patient to the preparation needed before, during and after the procedure so the patient if fully aware of what to expect.

Assessing barriers of care

Navigators assess patients for barriers of care which may include transportation, low income, and language. Some examples of their service include arranging transport, looking for low-cost screening, or bringing the screening services to the community. Thus, promoting timely access to care due to an early diagnosis.  

Once the diagnosis has been made, the patient is referred to the clinical setting for further management. Navigators, unlike other community healthcare workers, follow the patient throughout the cancer journey, from prevention and screening, diagnosis, treatment, survivorship, end-of-life care, death and bereavement. 

The navigator plans the education, coordination of care, communication and support needed throughout the journey. The goals of the patient are taken into consideration as they could impact on care decisions.

For example, if a patient is attending the unveiling of a tombstone for a family member, they might feel forced to skip treatment and fulfil a family obligation. It’s important to discuss this with the navigator so they can ensure that appointments are adhered to.

Psychosocial barriers addressed 

During the treatment phase, the navigator will ensure that psychosocial barriers of care are addressed. The community plays an important role in support. Courage is given by connecting patients to the community through support groups. They learn from fellow patients and survivors that have a similar type of cancer and have undergone similar treatments. Local support groups are therefore encouraged.

Reintegration back into the community

During survivorship, the navigator ensures proper reintegration back into the community. The navigator develops a survivorship care plan. 

The primary physician will be involved in monitoring and maintaining physical care. It’s normal for the patient to be emotional. They might question their role in society. They may be concerned that they will be considered weak, or fear that they might spread the disease. So, psychosocial well-being of the patient is important to alleviate the fear and worry. The fear of the return of disease can also be emotionally unsettling. 

The patient is introduced to community resources that can provide emotional support. Health is promoted by encouraging good nutrition, exercise, sleep habits, relationships and receiving preventive medical and dental care. 

So, please the next time you see an awareness campaign being conducted, stop and learn a little more on what might save a life. Start the journey by supporting healthcare awareness.

Alice Banze is a novice nurse navigator at Netcare. She is an oncology trained professional nurse and a former bone marrow transplant coordinator. She is also a member of Academy of Oncology Nurse and Patient Navigators (AONN).


Alice Banze is a nurse navigator at Netcare. She is an oncology trained professional nurse and a former bone marrow transplant coordinator. She is also a member of Academy of Oncology Nurse and Patient Navigators (AONN).

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