The Perspectives of Healthcare Providers, Traditional Healers, and Other Key Informants on the Late Diagnosis of Breast Cancer in Northern Tanzania: A Qualitative Study

Purpose: Breast cancer (BC) is the most common cancer among women in Tanzania and has one of the highest mortality rates worldwide due to late-stage diagnosis and suboptimal treatment. However, the role of traditional healers in late-stage diagnosis has not been widely studied. We aimed to identify the barriers to early BC diagnosis in Tanzania and possible solutions by interviewing healthcare providers (HCPs), traditional healers (THs), and other key informants (KIs). Methods: Semi-structured, in-depth interviews were conducted with 20 HCPs (including 10 doctors and 10 nurses), 10 THs, and 9 KIs in community settings in the Kilimanjaro region. A focus group discussion with 8 THs was also conducted. Demographic data were collected from the participants, and the interview data were transcribed, translated, coded and analyzed using NVIVO 12 software to identify themes. Results: The findings were synthesized into five themes to explain late diagnosis: 1) HCPs and THs have limited knowledge and misconceptions about the causes, signs, and symptoms of breast cancer; 2) patients experience stigma 3) treatment is expensive and difficult to access; 4) patients perceive barriers based on myths, misperceptions and spiritual beliefs; and 5) HCPs and THs often blame each other for ineffective treatment and delays in effective treatment. The participants also provided suggestions to reduce delays in diagnosis and treatment, including enhancing knowledge and awareness among THs and HCPs to help them recognize the signs and symptoms of BC through education campaigns, addressing the cost of access to care and treatment, addressing stigma associated with BC, and developing collaborative efforts between HCPs and THs. Conclusion: In this study, we successfully identified several themes related to barriers to early BC diagnosis that help to explain the late diagnosis of BC from the perspective of various participants. Raising community awareness and improving understanding of breast cancer is crucial in reducing misconceptions and stigma. Collaboration between healthcare providers and traditional healers could be beneficial in the development of strategies to recognize the early signs and symptoms of BC.