Anticipated help seeking behaviour and barriers to seeking care for possible breast and cervical cancer symptoms in Uganda and South Africa

Moodley, Jennifer; Constant, Deborah; Mwaka, Amos Deogratius; Scott, Suzanne; Walter, Fiona M

doi:10.3332/ecancer.2021.1171

Cited by 12 publications

(14 citation statements)

References 32 publications

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“…1,5 A sub-Saharan communitybased study has highlighted that healthcare system barriers, such as long waiting periods, past adverse experiences and language barriers, prevent these women from seeking the appropriate care for noticeable symptoms. 6 Furthermore, those who are HIV positive are at an even higher risk of contracting cervical cancer. 7 Within South Africa, cervical cancer causes more than 6000 deaths annually 8 and accounts for 15.85% of all female cancers within the country.…”

Section: Introductionmentioning

confidence: 99%

Cervical cancer knowledge and screening uptake by marginalized population of women in inner-city Durban, South Africa: Insights into the need for increased health literacy

Ducray

Kell

Basdav

et al. 2021

Womens Health (Lond Engl)

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Background: Cervical cancer in South Africa accounts for 15.85% of all female cancers and 30.29% of African female cancers, resulting in over 5000 deaths annually. South Africa’s proposed move towards universal healthcare places emphasis on health promotion through education and screening, but there is little data on the baseline levels of knowledge and screening uptake regarding cervical cancer. This study explored the levels of knowledge and screening rates of cervical cancer among vulnerable women living in the inner-city of Durban, South Africa. Methods: A mixed-method study was conducted within the context of a Women’s Health outreach initiative. Data were collected from women attending the outreach ( n = 109), many of whom were from marginalized communities. A pre-intervention survey was used to collect the data. This was followed by cervical cancer education sessions and the opportunity for a free Pap smear. Results: Knowledge of cervical cancer was low (<25%) and only a third of the women had previously been screened. After the educational sessions, 64% of women ( n = 70) took advantage of the opportunity for Pap smears, with many expressing the need for wider cervical cancer education, screening centres and support groups. Only 20% of the Pap smears were normal ( n = 14). Half of the women tested positive for infections ( n = 36; 51.4%), and a small proportion ( n = 8; 11.4%) tested positive for human papilloma virus. Abnormal cervical intra-epithelial neoplasia (CIN1 and CIN 2) were also detected in this population ( n = 12; 17.1%). Conclusion: Cervical cancer knowledge and screening among vulnerable women in Durban, South Africa, is inadequate, especially considering the high levels of abnormality found in the Pap smears. Education drives, accompanied with the provision of free testing, are required. Community health outreach initiatives in collaboration with non-government organizations set in accessible locations could be a possible course of action.

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Section: Introductionmentioning

confidence: 99%

Cervical cancer knowledge and screening uptake by marginalized population of women in inner-city Durban, South Africa: Insights into the need for increased health literacy

Ducray

Kell

Basdav

et al. 2021

Womens Health (Lond Engl)

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“… Author(s), year of publication Country, region Cancer type Purpose Study design Targets; No. of samples Excerpts of descriptions relating to help-seeking [ 23 ] Moodley et al, 2021 Uganda, South Africa (Africa) Breast cancer, uterine cancer To identify the factors that impede timely help-seeking behaviors when symptoms appear. Quantitative South Africa: 428 people in rural areas; 445 in cities Uganda: 427 people in rural areas; 458 in cities In South Africa, those living in rural areas felt strongly that, compared with urban residents, they lacked the money to travel to and pay for medical institutions and that their dialect and culture would not be understood by medical professionals.…”

Section: Methodsmentioning

confidence: 99%

Factors related to help-seeking for cancer medical care among people living in rural areas: a scoping review

Oshiro

Kamizato

Jahana

2022

BMC Health Serv Res

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Despite the importance of timely diagnosis and access to treatment, previous studies have not adequately explored help-seeking behavior in cancer treatment among rural and remote residents. The barriers preventing help-seeking behavior also remain unclear. To address this research gap, this study conducted a scoping review to suggest a framework for eliminating barriers and facilitating help-seeking for cancer treatment among rural and remote residents. To conduct the scoping review, three English medical databases (PubMed, MEDLINE, and CINAHL) were examined for the keywords “rural,” “remote,” “cancer,” and “help-seeking.” The research objectives and study designs, participants, and excerpts describing help-seeking of the selected papers were recorded in a data charting form. Descriptions of help-seeking behavior were organized and summarized according to their meaning and integrated into factors using thematic analysis. All extracted factors related to help-seeking were sorted into four main themes according to the Ecological Model of Health Behavior, the theoretical lens for this scoping review: (1) Intrapersonal; (2) Interpersonal; (3) Groups, culture, and organizations; and (4) Policy/environment. Factors were categorized as barriers and facilitators of help-seeking. A total of 13 papers were analyzed. Intrapersonal factors such as self-reliance, symptom appraisal, and fatalism, were identified as barriers to help-seeking, whereas presentation of abnormal and serious symptoms facilitated help-seeking. Interpersonal factors such as lack of understanding of family members, influence of surrounding people, role obligations, and lack of trust in experts hindered help-seeking, whereas understanding from surrounding people such as family and friends, promoted help-seeking. Groups, cultural, and organizational factors such as prejudice, social stigma, shame, lack of anonymity, and social norms acted as barriers to help-seeking. Policy-related barriers to help-seeking included lack of medical services and physical distance from medical institutions, leading to a time burden. The study discussed the identified factors from a rural context. Future studies should consider the identified barriers and facilitators according to the four main themes in rural areas when formulating interventions to promote help-seeking. Our findings can offer a theoretical foundation to develop actionable policies, preventive strategies, and relevant interventional tools that may facilitate oncological service utilization in rural areas.

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“…Ten intrapersonal barriers to help-seeking were identi ed: age, low education levels, di cult economic conditions, minority status, fatalism, self-reliance, symptom appraisal, lack of knowledge, fear, and health service utilization habits. Six papers identi ed di cult economic situations [23,25,28,32,34,35]; ve papers, lack of knowledge [26,30,32,33,35]; ve papers, self-reliance [23,26,29,31,34]; and four papers, symptom appraisal [26,27,29,31]. The appearance of symptoms was identi ed as a facilitator of helpseeking in three studies [26,31,32].…”

Section: Intrapersonalmentioning

confidence: 99%

“…Four interpersonal barriers to help-seeking were identi ed: lack of understanding of family members, the in uence of surrounding people, role obligations, and unreliable experts. In particular, four studies identi ed the lack of understanding of family members [23,25,28,34]; four, role obligations [23,25,26,31]; and three, unreliable experts (e.g., the doctor did not listen carefully or displayed a lack of cordiality) [28,29,34]. Understanding the surrounding people were identi ed as a facilitator of help-seeking in three papers [26,32,35].…”

Section: Interpersonalmentioning

confidence: 99%

Factors Related To Help-Seeking For Cancer Medical Care Among People Living In Rural Areas: A Scoping Review

Oshiro

Kamizato

Jahana

2022

Preprint

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Background: People residing in rural areas have lower cancer survival rates than those living in urban areas. Nonetheless, few studies have focused on help-seeking among patients residing in rural areas. We aimed to identify the factors associated with help-seeking for cancer treatment in rural areas. Methods: This scoping review involved the collection of data from three databases (PubMed, MEDLINE, and CINAHL). Data were extracted according to factors related to help-seeking from studies published in English that (1) targeted adults living in rural areas and (2) focused on cancer-related help-seeking. The exclusion criteria were: (1) samples with children; (2) evaluated interventions effects of related help-seeking; and (3) discussed special tests, such as genetic testing. These factors were classified into four categories according to the ecological models of health behavior as follows: intra-personal; inter-personal; groups, cultures, and organizations; and policy/environment.Results: Thirteen papers were examined, wherein the barriers to help-seeking were identified : ten factors from the “intra-personal” category, including difficult economic circumstances; four factors from the “inter-personal” category, such as lack of understanding from family members; four factors from the “groups, cultures, and organizations” category, such as prejudice and social stigma, shame, lack of anonymity, and social norms; and three factors from the “policy/environment” category, such as lack of medical resources. Presentation of symptoms and understanding from surrounding people were identified as facilitators of help-seeking.Conclusions: The barrier and facilitator factors were identified, such as understanding the people, self-reliance, fatalistic views, lack of anonymity, social norms, lack of medical resources, etc. Future studies should consider interventions to promote help-seeking, which must involve Intrapersonal and Interpersonal and rural community groups, culture, and organizations of each rural area.

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Anticipated help seeking behaviour and barriers to seeking care for possible breast and cervical cancer symptoms in Uganda and South Africa

Cited by 12 publications

References 32 publications

Cervical cancer knowledge and screening uptake by marginalized population of women in inner-city Durban, South Africa: Insights into the need for increased health literacy

Cervical cancer knowledge and screening uptake by marginalized population of women in inner-city Durban, South Africa: Insights into the need for increased health literacy

Factors related to help-seeking for cancer medical care among people living in rural areas: a scoping review

Factors Related To Help-Seeking For Cancer Medical Care Among People Living In Rural Areas: A Scoping Review

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