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首页> 外文期刊>Promotion & education >Breast cancer screening among women in Namibia: explaining the effect of health insurance coverage and access to information on screening behaviours
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Breast cancer screening among women in Namibia: explaining the effect of health insurance coverage and access to information on screening behaviours

机译：纳米比亚妇女中乳腺癌筛查：解释健康保险覆盖率的影响，并获取关于筛查行为的信息

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Objectives: Breast cancer contributes substantially to morbidity and mortality in Namibia as is the case in most countries in Sub-Saharan Africa (SSA). However, there is a dearth of nationally representative studies that examine the odds of screening for breast cancer in Namibia and SSA at large. This paper aims to fill this gap by examining the determinants of breast cancer screening guided by the Health Belief Model. Methods: We applied hierarchical binary logit regression models to explore the determinants of breast cancer screening using the 2013 Namibia Demography and Health Survey (NDHS). We accounted for the effect of unobserved heterogeneity that may affect breast cancer, testing behaviours among women cluster level. The NDHS is a nationally representative dataset that has recently started to collect information on cancer screening. Results: The results show that women who have health insurance coverage (odds ratio (OR) = 1.62, p = 0.01), maintain contact with health professionals (OR = 1.47, p = 0.01), and who have secondary (OR = 1.38, p = 0.01) and higher (OR = 1.77, p = 0.01) education were more likely to be screened for breast cancer. Factors that influence women's perception of their susceptibility to breast cancer such as birthing experience, age, region and place of residence were associated with screening in this context. Conclusions: Overall, the health belief model predicted women's testing behaviours and also revealed the absence of relevant risk factors in the NDHS data that might influence screening. Overall, our results show that strategies for early diagnosis of breast cancer should be given major priority by cancer control boards as well as ministries of health in SSA. These strategies should centre on early screening and may involve reducing or eliminating barriers to health care, access to relevant health information and encouraging breast self-examination.
机译：目的：乳腺癌的含量大大促成纳米比亚的发病率和死亡率，就像大多数国家都在撒哈拉以南非洲（SSA）的情况一样。然而，有一种缺乏的国家代表性研究，审查了纳米比亚和SSA的乳腺癌筛查的几率。本文旨在通过检查健康信仰模式指导的乳腺癌筛查的决定因素来填补这种差距。方法：我们应用分层二进制Logit回归模型，探讨使用2013年纳米比亚人口统计和健康调查（NDHS）探索乳腺癌筛查的决定因素。我们占可能影响乳腺癌的不可观察的异质性的影响，妇女聚类水平的测试行为。 NDHS是一个最近开始收集有关癌症筛查信息的国家代表性数据集。结果：结果表明，有健康保险覆盖的妇女（赔率比（或）= 1.62，P <= 0.01），保持与卫生专业人员（或= 1.47，P = 0.01）的接触，患者（或= 1.38乳腺癌更有可能筛选乳腺癌，p = 0.01）和更高（或= 1.77，p <= 0.01）教育。影响妇女对乳腺癌易感性感知的因素，例如分娩经验，年龄，地区和居住地与筛查有关。结论：总体而言，健康信仰模式预测妇女的检测行为，并揭示了可能影响筛查的NDHS数据中的相关风险因素。总体而言，我们的结果表明，癌症管制委员会以及SSA中的健康部门应优先考虑乳腺癌早期诊断策略。这些策略应该在早期筛查中，可能涉及减少或消除卫生保健的障碍，获取相关的健康信息并鼓励乳房自我检查。

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