A model to develop and promote knowledge and practice of breast self-examination among African women in rural KwaZulu-Natal province of South Africa

Abstract

Background Breast self-examination (BSE) is considered one of the screening methods used for the early detection of breast cancer in addition to mammography. BSE is a safe, easy, free, and painless method used to identify any abnormalities of the breast and it is highly recommended for breast cancer screening among women in low resourced areas. Despite these recommendations, a low uptake of BSE in low middle-income countries (LMIC) is of concern. To date, a lack of knowledge, awareness, cultural influences, and socio-demographic factors have been highlighted as an influence on the uptake of BSE globally. However, much uncertainty still exists from a South African viewpoint, considering the different sociocultural backgrounds. Aim This study aims to explore and describe knowledge, perceptions, and factors that influence BSE uptake among rural African women in the KZN province of South Africa, and ultimately develop a model to develop and promote the knowledge and practice of BSE. Methodology The research was guided by the Care-Seeking Behaviour (CSB) theoretical framework. The research objectives were achieved by employing a qualitative case study design and an interpretivist paradigm. The data collection process consisted of an in-depth semi-structured one-on-one interview. The sample was selected based on a purposive sampling approach. This study was conducted in the iLembe District of KZN province of South Africa, a predominantly rural district. Study participants were African women aged 20 or older who resided in the rural iLembe District of the province of KZN. Data saturation was achieved with 22 participants. After the data were collected, they were transcribed verbatim and analysed using deductive thematic analysis. Findings In this study, several factors were found to influence the practice of BSE among rural South African women. This included, knowledge and awareness, clinical and socio-demographic influences, preventative healthcare habits, sociocultural factors, breast cancer beliefs, healthcare perception, and delayed healthcare services. In this study, the researcher noted that participants with higher levels of education were more likely to practice BSE. In addition, several participants had various traditional interpretations of breast cancer. Furthermore, there were participants who reported using complementary and self-treatment practices as a habit for health-related concerns. The findings of this study also indicate that participants perception of breast cancer and breast cancer screening may influence their willingness to participate in BSE programmes. Moreover, it was found that social support from family, friends, and community members encourage women to discuss their breast health. A lack of confidence in conventional medical methods of preventative health practices (BSE) was also attributed to clinical and socio-demographic factors and delayed access to healthcare services. Based on the findings of this study, a model was developed to promote BSE knowledge and practice among rural African women in KZN.