Abstract
Rural African women present late with cervical cancer at both biomedical facilities and to traditional healers. Late presentation poses several risks, mainly cancer of the cervix that has metastasized, therefore too late for treatment leading to death. However, the complexity of reasons that underpin late presentation by rural African women at different kinds of healthcare facilities are under-researched. It is important to find out the myriad of personal and contextual elements that contribute to rural African women presenting late with cervical cancer in different healthcare facilities, to avoid unnecessary death from cervical cancer. Therefore, this study explores the knowledge, perceptions and responses to symptoms of cervical cancer of rural African women and traditional healers. It was imperative to study this phenomenon to understand what influences rural African women to seek health care and from whom. Understanding this phenomena will help with formulating programmes suited for similar rural communities that will be of benefit to those who live in rural areas or similar communities to deal more effectively with cervical cancer.
A qualitative study was conducted with women and traditional healers from rural communities in South Africa. Twenty four rural African women were recruited for the focus group discussions, four traditional healers with more than ten years experience in the field of traditional healing were interviewed, two men and two women. Most importantly, four rural African women who were clinically diagnosed with cervical cancer and undergoing biomedical treatment were also recruited for the study.
The findings of the study have been presented in the form of four research articles, as well as an introduction chapter and a conclusions chapter. The first article is perceptions and experiences of African rural women regarding cervical cancer (CC) and showed that the majority of African rural women in this study did not perceive themselves to be at risk of CC, only a few women have ever been screened for the illness. African rural women attest to women seeking cervical screenings, in the first instance from traditional healers, after experiencing uncomfortable symptoms or by recommendations from a healthcare professional, as opposed to engaging in routine cervical screening tests. The second article explores the socio-cultural factors influencing African rural women’s perceptions, understanding, screening, and treatment for CC. The second article revealed that major socio-cultural factors played a role in the help-seeking behaviour of African rural women, such as the belief that cervical cancer means automatic infertility of a woman and fear that cervical cancer would affect their womanhood which is associated with bearing children. Moreover, many African women felt ae lack of support from their spouse/partner. Women also raised issues related to the biomedical system such as the gender of biomedical practitioners, language barriers and the costs of access to care. However, overall women were more comfortable with traditional healers than biomedical practitioners because they could express themselves fully in their language and traditional healers incorporate their traditions and culture in their practice. The third article explores personal accounts and experiences of African rural women confronted with cervical cancer. The findings in this article foreground voices of African rural women diagnosed with both CC and HIV, highlighting their challenges as well as their points of triumphs such as how they overcame the shock of being diagnosed and dealing with the aches and pains of cervical cancer symptoms. The last article explored the knowledge, perceptions and responses of traditional healers to CC. The findings in this article highlight the importance of traditional healers in rural communities and the strategies traditional healers utilise in their communities when dealing with CC, such as involving the whole family in the healing process of the women and incorporating their traditions, spirituality and cultures when working with the women and their families.