EFFECT OF A COMMUNITY BASED HEALTH EDUCATION PROGRAM ON KNOWLEDGE AND PRACTICE OF BREAST SELF EXAMINATION AMONG WOMEN IN KONTAGORA, NIGER STATE
Introduction: The incidence of breast cancer is rising world wide, Nigeria was found not to be an exception. It is the most common cancer among women in Nigeria where the incidence doubled from 15.1/1000000 to 33.6/100000 between 1976 and 1992. In 1998, the prevalence was 40/100000. By the year 2000, reports from breast cancer registries in Nigeria revealed the relative frequencies of breast cancer compared to other female cancers to be between 17-37.5% with majority occurring in pre menopausal women. In addition, over 70% of breast cancer cases in Nigeria present late with a 5 year survival rate of less than 10%. There is therefore the need to create awareness and increase the level of knowledge on breast cancer and practice of methods known to lead to early detection of the scourge among Nigerian women.
This study was carried out to determine the effect of a community based health education programme on knowledge and practice of breast self examination (BSE) among women in Kontagora, Niger State.
Materials and methods: The study was an intervention study which utilized a multistage probability sampling method to select respondents in was conducted in both groups which assessed the levels of knowledge of breast
cancer/BSE and levels of practice of BSE using an interviewer administered structured questionnaire. Subsequently, the intervention group was given health education on breast cancer and BSE which involved question and answer sessions, demonstrations, video clips of BSE and posters. Post intervention questionnaire administration was carried out after 3 months. Data was analysed with epi info and win pepi statistical softwares.
Results: Pre intervention, the study found that less than half (48.5%) of respondents in the intervention group were aware of breast cancer and slightly more than one quarter (17.5%) were aware of BSE but slightly more than half (60.0%) of respondents in the control group were aware of breast cancer and about one quarter (15.6%) were aware of BSE. Only 2.5% in the intervention group and 1.2% in the control group had good knowledge of breast cancer/BSE. Mean knowledge score was low in both the intervention and control groups at baseline (12.5±18.2%, 12.2±14.8%) respectively. Practice of BSE was also low in both the intervention (5.0%) and control (3.1%) groups. Age, level of education, occupation and income were significantly associated with level of knowledge while level of education was significantly associated with prior practice of BSE. There was a statistically significant association between level of knowledge of breast cancer/BSE and practice of BSE.
The health education program significantly increased the level of awareness and knowledge/practice concerning breast cancer/BSE in the intervention group. The mean knowledge score in the intervention group increased significantly from 12.6±18.2% to 79.4±14.0% while that in the control group increased from 12.2±14.8% to 14.2±11.6% but not significantly. Similarly, the level of practice of BSE in the intervention group increased significantly from 5.0% to 66.9% when compared to that in the control group (3.1% to 3.9%).
Conclusion: The community health education program was effective in significantly increasing the awareness, level of knowledge and practice of the intervention group on breast cancer and BSE.
Recommendation: Periodic community outreach programs on breast cancer and BSE should be carried out by Local Governments in order to increase levels of awareness, knowledge and practice concerning breast cancer and BSE among Nigerian women.