Qualitative Assessment of Breast Cancer Early Detection Services Provided through Well Woman Clinics in the District of Gampaha in Sri Lanka

Abstract

<b>Background:</b> Breast cancer is the most common cancer diagnosed among women in Sri Lanka. Early detectioncan lead to reduction in morbidity and mortality. The objective here was to identify perceptions of public healthmidwives (PHMs) on the importance of early detection of breast cancer and deficiencies of and suggestions onimproving existing breast cancer early detection services provided through Well Woman Clinics. Materials and<br/><b>Methods</b>: A qualitative study using four focus group discussions (FGDs) were conducted among 38 PHMs in theGampaha district in Sri Lanka and the meetings were audio-recorded, transcribed and analyzed using constantcomparison and identifying themes and categories. <br/><b>Results</b>: All the PHMs had a firm realization on the need ofbreast cancer early detection. The four FGDs among PHMs revealed non-availability of guidelines, inadequacyof training, lack of skills and material to provide health education, inability to provide privacy during clinicalexamination, shortage of stationery, lack of community awareness and motivation. The suggestions for theimprovements of the programme identified in FGDs were capacity building of PHMs, making availability ofguidelines, rescheduling clinics, improving the supervision, strengthening the monitoring, improving coordinationbetween clinical and preventive sectors, and improving community awareness. <br/><b>Conclusions</b>: Results of the FGDscan provide useful information on components to be improved in breast cancer early detection services. Studyrecommendations were training programmes at basic and post basic levels on a regular basis and supervisionfor the sustainance of the breast cancer early detection program.