Date of Award

10-2025

Degree Type

Thesis

Degree Name

Master of Science in Advanced Practice Nurs​ing (MSc-APN)​

First Advisor

Dr Diana Kassaman

Second Advisor

Dr Gladys Mbuthia

Department

School of Nursing and Midwifery, East Africa

Abstract

Background: Breast cancer is the most diagnosed cancer in all women worldwide, with women in low and middle-income countries dying of the disease in disproportionate numbers because of late diagnosis and access to screening services. Sub-Saharan Africa is an under-researched area, and the level of screening uptake in Kenya, especially in rural and semi-arid areas, including Makueni County, is low. This research assessed the factors that determine the reproductive age women's screening uptake of breast cancer in Makueni County.

Methodology: The cross-sectional design was analytical and was conducted in Makueni County Referral Hospital, where 301 randomly chosen women between the ages of 18 and 49 years were used. Structured questionnaires administered by the interviewer were utilized to collect data that were analyzed using descriptive statistics, correlation, as well as linear and binary logistic regression in SPSS (Version 27).

Results: The results indicate that there was mixed knowledge on screening procedures: 61.7% of the women knew the screening technique known as breast self-examination, but most of them were unaware of the right technique to use; 49.9% knew about the clinical breast examination, yet most of them were unsure of the frequency; the awareness of mammography was the least, as 67% were completely unfamiliar with this kind of screening and only 13.6% understood the recommended age at which one should begin the test. The sociocultural predictors included cultural norms (OR = 1.550), peer support (OR = 1.538), income (OR = 1.711) and stigma (OR = 1.312) significantly predicted screening uptake. Most facility-related predictors were accessibility (OR = 1.453), the presence of specialists (OR = 1.454), cost (OR = 1.396), and waiting time (OR = 1.282).

Conclusion: Overall, to enhance the practice of breast cancer screening in Makueni, it is necessary to implement combined interventions to address the knowledge gaps, sociocultural determinants, and health system barriers.

First Page

1

Last Page

120

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