A mixed-method assessment of beliefs and practice around breast cancer in Ethiopia: Implications for public health programming and cancer control

Abstract

A large proportion of breast cancer patients in Ethiopia present for biomedical care too late, or not at all, resulting in high mortality. This study was conducted to better learn of beliefs and practices among patients accessing breast cancer services in a large referral centre in Ethiopia. Using a mixed-method design, we interviewed 69 breast cancer patients presenting for care at Tikur Anbessa Hospital in Addis Ababa, Ethiopia, about their beliefs, experiences and perspectives on breast cancer. Awareness of breast cancer is low in Ethiopia and even among those who are aware of the disease, a sense of hopelessness and fatalism is common. Early signs/symptoms are frequently ignored and patients often first present to traditional healers. Breast cancer is perceived as being caused typically from humoral anomalies or difficulties resulting from breast feeding, and study participants indicate that stigmatisation and social isolation complicate discussion and action around breast cancer. Consistent with other studies, this study shows that traditional beliefs and practices are common around breast cancer and that numerous barriers exist to identification and treatment in Ethiopia. Integrating health beliefs and practice into public health action in innovative ways may reduce stigma, increase awareness and promote survivability among breast cancer patients.

Keywords:

• Ethiopia
• breast cancer
• qualitative
• ethnomedicine
• beliefs

Acknowledgements

The Ethiopia Breast Cancer Project is funded by a grant from AstraZeneca to the Axios Foundation. This paper was presented, in part, at the 6th European Breast Cancer Conference (EBCC-6) – Berlin, Germany – 15–19 April 2008.

Notes

1. This analysis adopts a basic distinction between ‘ethnomedical’ and ‘biomedical’, reflecting Fabrega (1975) that roughly equates ‘ethnomedical’ with folk categories and indigenous (emic) perspectives and the latter with more western (etic) perspectives on modern medicine.

2. Mich is an Ethiopian construct that roughly corresponds to conditions created by the clash of cold and hot air, or the sudden exposure to air, or ‘bad’ air (see Teklehaymanot and Giday 2007).