Breast health awareness campaign and screening pilot in a Kenyan County: Findings and lessons

Barriers to breast and cervical cancer screening among adolescent girls and young women in Kenya: A nationwide cross-sectional survey

Promoting regular screening remains one of the primary preventive measures for breast and cervical cancer. The study aimed to assess the prevalence and barriers to breast and cervical cancer screening among adolescent girls and young women (AGYW) in Kenya. The study used data from the 2022 Kenya Demographic and Health Survey (KDHS), with 12,026 AGYW who were selected by multistage sampling. The outcomes of interest were breast and cervical cancer screening. Multivariable logistic regression was used to assess factors negatively associated with the outcome variables, using SPSS (version 29.0). Of the 12,026 AGYW included in this study, only 6.0% (95%CI: 5.6-6.8) and 5.1% (95%CI: 4.8-6.0) had undertaken breast and cervical cancer screening, respectively. Low education (AOR = 0.08, 95%CI: 0.02-0.34 and AOR = 0.48, 95%CI: 0.28-0.83), not working (AOR = 0.67, 95%CI: 0.46-0.97 and AOR = 0.59, 95%CI: 0.42-0.82), low wealth index (AOR = 0.55, 95%CI: 0.32-0.92 and AOR = 0.45, 95%CI: 0.25-0.81), no visit to a healthcare facility in the last 6 months (AOR = 0.48, 95%CI: 0.33-0.69 and AOR = 0.50, 95%CI: 0.35-0.71), and no birth record (AOR = 0.29, 95%CI: 0.13-0.62 and AOR = 0.58, 95%CI: 0.27-0.74), were the major barriers to both breast and cervical cancer screening, respectively. Moreover, having no access to newspaper (AOR = 0.67, 95%CI: 0.46-0.97) was a significant barrier to breast cancer screening while having big problems with distance to a healthcare facility (AOR = 0.49, 95%CI: 0.33-0.73) and not using modern contraception (AOR = 0.60, 95%CI: 0.42-0.86) hindered cervical cancer screening. In conclusion, more efforts are needed from both the government and cancer stakeholders to increase accessibility of breast and cervical cancer screening services, especially to those with low social economic status. More targeted education and sensitization, improving livelihoods of AGYW through various women empowerment efforts, and improving screening capacity of low-grade healthcare facilities are among the useful strategies to improve the low screening rates.

Awareness and its determinant factors towards breast examination to detect breast cancer among reproductive age women in Kenya: Multi level analysis of the recent demographic and health survey data

INTRODUCTION

Worldwide, breast cancer accounts for about 2.3 million new cases and 685,000 deaths, making it the second most common cancer in women. It can be detected through breast examination like mammograms, self-breast examination and clinical breast examinations in the early stage potentially before it spreads to other organs. The current study aimed to determine the awareness of breast examination to detect breast cancer and its determinant factors.

METHODS

A total of 16,474 women of reproductive age were included. The 2022 Kenyan demographic and health survey dataset were used. The data were analyzed using STATA version14.0. Multilevel mixed-effects logistic regression was employed to identify potential factors of the outcome variable. Variables with p-values <0.05 were considered statistically significant.

RESULT

Nearly 44.4% of women were aware of breast examinations to detect breast cancer. Older age [AOR = 2.517, 95%CI: 2.11-3.00], higher educational level [AOR = 5.755, 95%CI: 4.631-7.153], being an active worker [AOR = 1.343, 95%CI:1.232-1.465], being the wealthiest [AOR = 1.526, 95%:1.336-1.744], use of the internet [AOR = 1.451, 95%CI:1.323-1.592], exposure to different media [AOR = 1.350, 95%CI:1.187-1.536] and health facility contact within 12 months [AOR = 1.496, 95%CI:1.385-1.615] were positively associated at the individual level, while low community poverty [AOR = 0.777, 95%:0.676-0.892] and high literacy level [AOR = 1.412, 95%CI:1.190-1.677] were significant factors at the community level.

CONCLUSION AND RECOMMENDATION

Less than half of the women were aware of breast examination to detect breast cancer. Older age, high level education, being active worker, exposure for media, using internet, being rich were favorable covariates at the individual level while high literacy and low poverty were found to be enabling factors at the community level. This study recommends that educating women, engaging them in different occupational activities, decreasing poverty, improving media and internet accessibility can bring positive change of women's awareness towards breast examination.

The effect of a pilot universal health coverage program on hospital workload: A comparative study of two counties in Kenya

Aim

Universal health coverage (UHC) aims to provide individuals with the healthcare they need without predisposing them to catastrophic health expenditures. The Kenyan government piloted UHC in four select counties in 2019. Nyeri County was one of the selected counties. Area residents accessed health services from government-owned health facilities at no cost. This study assessed the effect of this pilot on the workload of major health facilities in Nyeri.

Material and methods

The monthly workload of six health facilities in Nyeri was compared with that of similar facilities in the non-participating county of Embu. A difference-in - differences analysis was done for workload indicators. Workload was downloaded from the Kenya health information system. The level 5 hospital recorded an increase in eight workload indicators with four having statistically significant increases. Three indicators recorded non-significant declines. The level 4 and 3 health facilities also recorded an increase in outpatient workload.

Conclusion

The pilot UHC program increased workload and by extension utilization of healthcare among major health facilities in Nyeri.

Prevalence and associated factors of breast cancer screening among nuns in the Catholic Archdiocese of Nairobi

Introduction

breast cancer is a significant global challenge. The risk of breast cancer among nuns is high mainly due to the basis of nulliparity. Among the effective approaches to addressing breast cancer is early screening. However, there are concerns over the uptake of screening across all populations, including nuns. The objective of the study is to determine the prevalence and the associated factors of breast cancer screening among nuns in the Catholic Archdiocese of Nairobi.

Methods

this research used the analytical cross-sectional design. A total of 384 nuns in the Catholic Archdiocese of Nairobi were recruited using a stratified sampling. Structured questionnaires were used to collect data. Chi-square and binary logistic regression were used to determine association between social-demographic factors and breast cancer screening. Statistical package for social sciences (SPSS version 26) was used for analysis. The level of significance was investigated at p<0.05.

Results

our findings revealed that the prevalence of breast cancer screening among nuns was 30.7%. The findings established that those who had knowledge on breast cancer screening (AOR=25.52, 95%CI: 8.87 - 73.45, p<0.001) and those who had congregational financial support (AOR=1.97, 95%CI: 1.68 - 5.74, p=0.021) were more likely to undergo breast cancer screening. Those who had hospital check-up for in more than six months prior to the study (AOR=0.001, 95%CI: 0.000 - 0.008, p<0.001) and those who never had a hospital check-up, (AOR=0.001, 95%CI: 0.000 - 0.006, p<0.001) were less likely to undergo breast cancer screening.

Conclusion

the findings have shown low uptake of breast cancer screening amongst nuns in the Catholic Archdiocese in Nairobi. Knowledge on breast cancer screening access to congregational support and hospital check-up have been identified as key factors associated with breast cancer screening. Therefore, there is a need to create adequate awareness be created and the Catholic reverend sisters educated through aggressive education campaign programs so as to eliminate misconceptions relating to the topic. Also, to integrate free access to screening services in the government health institutions for nuns.