Knowledge and barriers to breast and cervical cancer screening in rural Nigerian communities: An ethnographic study.

Abstract

e23233 Background: There is a growing need for health researchers, policymakers, and practitioners in resource-limited settings to leverage ethnography for community-centered health interventions. By capturing both observed and reported experiences, ethnography offers critical insights into rural communities’ daily lives, perceptions, practices, and barriers to cancer prevention and care. This study aimed to explore the socio-cultural and structural dynamics shaping awareness, attitudes, and access to breast cancer (BC) and cervical screening (CC) in Nigeria, from a multi-stakeholder ethnographic perspective. Methods: The study adopted a qualitative ethnographic method, which involved daily community observation and engagement over a three-month period, face-to-face interviews and focus group discussions (FGDs) in six Nigerian communities across the Federal Capital Territory (Abuja), Rivers and Nasarawa States. The interview and FGD participants included community residents, traditional healers, healthcare workers, and traditional and religious leaders. A total of 12 FGDs and 60 interviews were conducted. Data was triaged from multiple sources (observation, FGDs and interviews), and analysed using thematic and content analyses. Results: Majority in two of the six communities had never heard of cancer, while the level of awareness and knowledge regarding the causes and care for BC and CC varied across the remaining four communities is very minimal. Barriers to cancer screening included travel distance, cost of transportation, and the fear of the mental burden of a positive diagnosis, religion and culture. Traditional medicine was perceived to play a significant role in addressing the needs of the people, often due to inadequate healthcare infrastructure. Women combined visits to local health facilities with consultations from traditional healers when seeking care for BC and CC. Traditional and religious leaders were seen to be influential figures in shaping the health-seeking behaviors of people within the communities due to their roles in promoting trust in health interventions. Conclusions: This study underscores the importance of ethnography in addressing social, cultural, and structural barriers to cancer screening, fostering equitable partnerships and sustainable health outcomes in underserved populations. It highlights the need for collaborative strategies that respect traditional beliefs while promoting evidence-based health interventions offering actionable insights for researchers, health providers and policy makers in resource limited settings.