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Sayed S, Ngugi AK, Mahoney MR, Kurji J, Talib ZM, Macfarlane SB, Wynn TA, Saleh M, Lakhani A, Nderitu E, Agoi F, Premji Z, Zujewski JA, Moloo Z. Breast Cancer knowledge, perceptions and practices in a rural Community in Coastal Kenya. BMC Public Health 2019; 19:180. [PMID: 30755192 PMCID: PMC6373063 DOI: 10.1186/s12889-019-6464-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 01/21/2019] [Indexed: 11/13/2022] Open
Abstract
Background Data on breast healthcare knowledge, perceptions and practice among women in rural Kenya is limited. Furthermore, the role of the male head of household in influencing a woman’s breast health seeking behavior is also not known. The aim of this study was to assess the knowledge, perceptions and practice of breast cancer among women, male heads of households, opinion leaders and healthcare providers within a rural community in Kenya. Our secondary objective was to explore the role of male heads of households in influencing a woman’s breast health seeking behavior. Methods This was a mixed method cross-sectional study, conducted between Sept 1st 2015 Sept 30th 2016. We administered surveys to women and male heads of households. Outcomes of interest were analysed in Stata ver 13 and tabulated against gender. We conducted six focus group discussions (FGDs) and 22 key informant interviews (KIIs) with opinion leaders and health care providers, respectively. Elements of the Rapid Assessment Process (RAP) were used to guide analysis of the FGDs and the KIIs. Results A total of 442 women and 237 male heads of households participated in the survey. Although more than 80% of respondents had heard of breast cancer, fewer than 10% of women and male heads of households had knowledge of 2 or more of its risk factors. More than 85% of both men and women perceived breast cancer as a very serious illness. Over 90% of respondents would visit a health facility for a breast lump. Variable recognition of signs of breast cancer, limited decision- autonomy for women, a preference for traditional healers, lack of trust in the health care system, inadequate access to services, limited early-detection services were the six themes that emerged from the FGDs and the KIIs. There were discrepancies between the qualitative and quantitative data for the perceived role of the male head of household as a barrier to seeking breast health care. Conclusions Determining level of breast cancer knowledge, the characteristics of breast health seeking behavior and the perceived barriers to accessing breast health are the first steps in establishing locally relevant intervention programs. Electronic supplementary material The online version of this article (10.1186/s12889-019-6464-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shahin Sayed
- Department of Pathology, Faculty of Health Sciences - East Africa, Aga, Khan University Nairobi, 3rd Parklands Avenue, P.O. Box 30270-00100, Nairobi, Kenya.
| | - Anthony K Ngugi
- Centre for Population, Faculty of Health Sciences - East Africa, Aga Khan University, Nairobi, 3rd Parklands Avenue, P.O. Box 30270-00100, Nairobi, Kenya
| | - Megan R Mahoney
- Department of Medicine General Medicines Discipline Stanford, University, Palo Alto-C, 291 Campus Dr.Palo Alto, California, CA, 94305, USA
| | - Jaameeta Kurji
- University of Ottawa, School of Epidemiology, Public Health & Preventive Medicine, Alta Vista Campus 600 Peter Morand Crescent,Ottawa, Ontario, K1G 5Z3, Canada
| | - Zohray M Talib
- Department of Medicine and of Health Policy and Management, The George Washington University (GWU) Medical School, Ross Hall, 2300 Eye Street, Washington D.C., NW, 20037, USA
| | - Sarah B Macfarlane
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, Mission Hall: Global Health & Clinical Sciences Building 550 16th Street, 2nd Floor Box #0560, San Francisco, CA, 94158-2549, USA
| | - Theresa A Wynn
- University of Alabama at Birmingham, School of Medicine, Division of Preventive Medicine, University of Alabama, Medical Towers, MT-621. 1720 2nd Ave South, Birmingham, AL, 35294-4410, USA
| | - Mansoor Saleh
- Department of Medicine, University of Alabama Comprehensive Cancer Center, Birmingham, Alabama, USA Wallace Tumor Institute, WTI 202. 1720 2nd Ave South, Birmingham, AL, 35294-3300, USA
| | - Amyn Lakhani
- Mombasa Research Office, Faculty of Health Sciences - East Africa, Aga Khan University, 3rd Parklands Avenue, P.O. Box 30270-00100, Nairobi, Kenya
| | - Esther Nderitu
- School of Nursing and Midwifery, Aga Khan University Nairobi Kenya, 3rd Parklands Avenue, P.O. Box 30270-00100, Nairobi, Kenya
| | - Felix Agoi
- Mombasa Research Office, Faculty of Health Sciences - East Africa, Aga Khan University, 3rd Parklands Avenue, P.O. Box 30270-00100, Nairobi, Kenya
| | - Zul Premji
- Department of Pathology, Faculty of Health Sciences - East Africa, Aga, Khan University Nairobi, 3rd Parklands Avenue, P.O. Box 30270-00100, Nairobi, Kenya
| | - Jo Anne Zujewski
- JZ Oncology, JZ Oncology , 4525 North Chelsea Lane, Bethesda, MD, 20814, USA
| | - Zahir Moloo
- Department of Pathology, Faculty of Health Sciences - East Africa, Aga, Khan University Nairobi, 3rd Parklands Avenue, P.O. Box 30270-00100, Nairobi, Kenya
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