Transforming breast cancer control campaigns in low and middle-income settings: Tanzanian experience with ‘Check It, Beat It’

ABSTRACT

Breast cancer incidence and mortality rates are similar in low resource settings like Tanzania. Structural and sociocultural barriers make late presentation typical in such settings where treatment options for advanced stage disease are limited. In the absence of national programmes, stand-alone screening campaigns tend to employ clinical models of delivery focused on individual behaviour and through a disease specific lens. This paper describes a case study of a 2010 stand-alone campaign in Tanzania to argue that exclusively clinical approaches can undermine screening efforts by premising that women will act outside their social and cultural domain when responding to screening services. A focus on sociocultural barriers dictated the approach and execution of the intervention. Our experience concurs with that in similar settings elsewhere, underscoring the importance of barriers situated within the sociocultural milieu of societies when considering prevention interventions. Culturally competent delivery could contribute to long-term reductions in late stage presentation and increases in treatment acceptance. We propose a paradigm shift in the approach to stand-alone prevention programmes.

KEYWORDS:

• Breast cancer
• screening
• low and middle-income countries
• sociocultural barriers
• culture and cancer control

Acknowledgements

The authors wish to thank the participants for their contribution to this study and the generous donors, volunteers and the Tanzania Breast Cancer Foundation for making the campaign possible. We also thank the Aga Khan Health Services Tanzania, the National Health Insurance Fund and Mnazi Mmoja Hospital for implementing the campaign.

Disclosure statement

No potential conflict of interest was reported by the authors.