Experiences and perceptions regarding clinical breast exam screening by trained laywomen in Malawi.

Journal Article (Journal Article)

PURPOSE: Despite the increasing burden, breast cancer control in sub-Saharan Africa is insufficient. Late diagnosis and lack of early detection and screening services contribute to high mortality. Clinical breast exam (CBE) screening can be valuable in low-income countries, including use of community health workers and non-health professionals to conduct exams. We assessed experiences of women who underwent CBE screening by trained laywomen in Lilongwe, Malawi, as part of a pilot program. METHODS: The pilot study invited women attending urban health clinics to a breast cancer educational talk followed by CBE screening by trained laywomen. We purposively sampled participants from the pilot study and interviewed them about the screening experience and future cancer education programs and services. RESULTS: Overall participants had positive experiences and were willing to undergo CBE screening by trained laywomen. Participants were motivated by the educational talk, shared newly acquired cancer knowledge with their social networks, and encouraged others to seek screening. Screened women suggested strategies for future interventions including combining breast and cervical cancer screening, using female providers, partnering with community leaders to increase uptake, and expanding services into the community. CONCLUSIONS: Asymptomatic Malawian women accepted CBE screening by trained laywomen and considered breast cancer an important health issue. Women appreciated combined education and screening services and proposed further linkage of breast and cervical cancer screening. Based on our results, training laywomen to educate the public on breast cancer and conduct CBE is a feasible breast cancer control strategy in sub-Saharan Africa.

Full Text

Duke Authors

Cited Authors

  • Kohler, RE; Miller, AR; Gutnik, L; Lee, CN; Gopal, S

Published Date

  • February 2017

Published In

Volume / Issue

  • 28 / 2

Start / End Page

  • 137 - 143

PubMed ID

  • 28097471

Pubmed Central ID

  • PMC5419072

Electronic International Standard Serial Number (EISSN)

  • 1573-7225

Digital Object Identifier (DOI)

  • 10.1007/s10552-016-0844-0


  • eng

Conference Location

  • Netherlands