Sociocultural Factors Influencing Late Presentation for Health Care Among Cervical Cancer Patients: A Qualitative Exploratory Study
ABSTRACT
Introduction
Malawi has the highest cervical cancer mortality rates in the world. Late presentation for care associated with late diagnosis and poor survival rates remain a huge issue. Research into social and cultural factors and how these influence women's access to early healthcare in Malawi is still scanty.
Objective
This study aimed to explore sociocultural factors that influence late presentation for healthcare among cervical cancer patients at Zomba Central Hospital, Malawi.
Methods
This qualitative exploratory descriptive study recruited purposively selected women with advanced cancer of the cervix attending Zomba Central Hospital in Southeastern Malawi. Data were collected through one‐on‐one audio‐taped interviews using a pilot‐tested semi‐structured interview guide. Thematic data analysis was used. Data saturation was reached at the 21st interview.
Results
21 patients living with cervical cancer participated. Two broad domains and six main themes; three themes under each domain emerged: Domain 1: Sociocultural barriers (knowledge gap about cervical cancer, influence of culture and social networks, poverty and financial cost as a barrier) and Domain 2: Healthcare system‐related barriers (access barriers related to limited health (cancer) care services, delays in the healthcare and referral system, human resource and knowledge gaps among health professionals).
Conclusion
All the participants in this study narrated that they presented late when the cancer was already advanced with no possibility of cure. Ignorance about cervical cancer was common to all the participants in this study and appeared to be a wider sociocultural issue. There is an urgent need for multistakeholder and multicultural involvement and strengthening mass education of the community about cancer to improve awareness, destigmatize cancer, and dispel harmful cultural beliefs and practices regarding causes and treatment of cervical cancer. Training of health professionals at all levels about early detection and effective referral pathways is also urgent.