Abstract
BackgroundEarly detection of breast cancer is known to improve its prognosis. However, women in most low and middle income countries, including Uganda, do not detect it early hence present at an advanced stage. This study investigated the perceived barriers to early detection of breast cancer in Wakiso district, Uganda using a multilevel approach focused through a socioecological framework.MethodsUsing qualitative methods, participants were purposively selected to take part in the study. 5 semi-structured interviews were conducted among the community members while two focus groups were conducted amongst women’s group and community health workers (CHWs) in Ssisa sub county, Wakiso district. In addition, 7 key informant interviews with health professionals, policy makers and public health researchers were carried out.ResultsFindings from the study revealed that barriers to early detection of breast cancer are multifaceted and complex, cutting across individual, interpersonal, organizational, community and policy barriers. The major themes that emerged from the study included: knowledge, attitudes, beliefs and practices (KABP); health system and policy constraints; and structural barriers. Prominent barriers associated with KABP were low knowledge, apathy, fear and poor health seeking behaviours. Barriers within the health systems and policy arenas were mostly centred around competing health care burdens within the country, lack of a cancer policy and weak primary health care capacity in Wakiso district. Distance, poverty and limited access to media were identified as the most prominent structural barriers.ConclusionBarriers to early detection of breast cancer are complex and go beyond individual behaviours. These barriers interact across multiple levels of influence such as organizational, community and policy. The findings of this study could provide opportunities for investment in multi-level interventions.
Highlights
Detection of breast cancer is known to improve its prognosis
Almost all the participants thought that low knowledge or complete lack of it was the key barrier to early detection of breast cancer
Community members identified low knowledge at primary health care (PHC) level as a key barrier as health workers, and community health workers, who are the first point of contact, focus more on communicable diseases primarily maternal health, diarrhoea and malaria
Summary
Detection of breast cancer is known to improve its prognosis. Women in most low and middle income countries, including Uganda, do not detect it early present at an advanced stage. Women in Uganda and most low and middle income countries (LMICs) are disproportionately affected by high mortality associated with breast cancer, compared to their counterparts in western countries such as the United Kingdom, Canada or the United States of America [3]. While early detection is known to improve breast cancer prognosis and offset costs associated with care [6], women in these LMICs present at an Ilaboya et al Globalization and Health (2018) 14:9 advanced stage, usually at stages III and IV characterized by large and almost incurable tumours, thereby reducing chances of survival [4]. The factors responsible for these delays have not been examined within the Ugandan context
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
