Patient navigation: more than accompanying, transforming health services

Background: In Costa Rica, breast cancer care has been characterized by fragmented services and access barriers, limiting continuity of care and support for women throughout their health–illness process. To address these gaps, the University of Costa Rica, in partnership with public hospitals and civil society organizations, developed the Patient Navigation Program in 2011. This model became a space for articulation between the health system and the community, where women who had been patients and users of the program later assumed the role of volunteer navigators to guide, accompany, and support other women during their journey through health services. Patient navigation thus emerged as an innovative and equitable strategy capable of humanizing care, bringing services closer to users, and promoting the democratization of information for women diagnosed with breast cancer.

 

Approach: A sequential explanatory mixed-methods study (DEXPLIS) will be conducted with women involved in the breast cancer Patient Navigation Program (users with and without navigation support, trained navigators, and volunteers). First, the clinical and sociodemographic profiles of participants from the 2016–2019 period will be characterized.

 

Then, stakeholders will be mapped and the four stages of the process (suspicion, diagnosis, treatment, and training) will be documented, describing and categorizing the types of navigation support. Subsequently, the training, participation, and commitment processes that foster empowerment will be identified. Finally, quantitative and qualitative data will be organized to determine the empowerment and support factors that position navigation as a driver of equity in health services.

 

Results: The active participation of women with lived experience of breast cancer has improved communication channels between patients and health professionals, reduced access barriers, and fostered a more empathetic, person-centered understanding of care. Navigation is thus consolidated as a driver of equity by creating real opportunities for users to participate in decisions about their health. Peer-to-peer support contributes to democratizing information, generating more balanced power relations within the system, and strengthening women’s empowerment over their health.

 

Implications: The patient navigation model offers valuable insight into how inclusive leadership and interprofessional learning can transform services and the health system through equity and participation. Viewing navigation as a driver of equity leads to the hypothesis that the systematic incorporation of navigation as an organizational strategy, articulated with the voice and experience of users in the training of health professionals, accelerates service transformation towards more competent, empathetic, and co-responsible teams, improves care continuity, and reduces access gaps. Consequently, navigation not only enhances the quality of support but also constitutes an effective pathway to building more equitable, inclusive, and person-centered health systems.