Saaka Sulemana Ansumah, Antabe Roger, Amoak Daniel, Molle Mildred Naamwintome, Adeetuk Lina
Department of Geography and Environment, Faculty of Social Science, University of Western Ontario, Canada.
Department of Health and Society, University of Toronto Scarborough, Toronto, Canada.
J Cancer Policy. 2025 Jun 30;45:100611. doi: 10.1016/j.jcpo.2025.100611.
Breast Cancer (BC) is a leading cause of cancer-related deaths among women, yet the uptake of BC screening exercises remains low, particularly in patriarchal settings of Sub-Saharan Africa (SSA), including Ghana, where women report lower decision-making autonomy regarding their own health. Despite the urgency of this issue, there is a notable lack of research in the Ghanaian context on how women's autonomy affects their engagement in BC screening.
Utilizing data from the 2022 Ghana Demographic and Health Survey (GDHS) (N = 15,014 women), and employing logistic regression models, this study fills the scholarly gap and contributes to the existing literature by examining the association between women's decision-making autonomy and the uptake of BC screening in Ghana.
Women with greater decision-making autonomy (OR=1.169; p < 0.001), the employed (OR=1.186; p < 0.001), owners of valid health insurance cards (OR=1.185; p < 0.01), those who had proximity to health facilities (OR=1.170; p < 0.01), visited health facility in the preceding 12 months (OR=1.351; p < 0.001), and listened to radio at least once in a week (OR=1.486, p < 0.001), were all significantly more associated with BC screening. On the contrary, rural residents (OR=0.874; p < 0.05), traditional religious believers (OR=0.538; p < 0.05), all significantly reported lower odds of BC screening. More so, education, age, ethnicity, household wealth, and region of residence significantly predicted BC screening in the study context.
Preventive healthcare policies like BC screening must pay critical attention to women with less educational attainment or from poor socio-economic backgrounds who may lack autonomy regarding their own health.
乳腺癌是女性癌症相关死亡的主要原因之一，但乳腺癌筛查活动的参与率仍然很低，特别是在撒哈拉以南非洲（SSA）的父权制环境中，包括加纳，在那里女性在自身健康问题上的决策自主权较低。尽管这个问题很紧迫，但在加纳背景下，关于女性自主权如何影响她们参与乳腺癌筛查的研究明显不足。
本研究利用2022年加纳人口与健康调查（GDHS）的数据（N = 15,014名女性），并采用逻辑回归模型，通过研究加纳女性的决策自主权与乳腺癌筛查参与率之间的关联，填补了学术空白并为现有文献做出了贡献。
决策自主权较高的女性（OR = 1.169；p < 0.001）、就业女性（OR = 1.186；p < 0.001）、持有有效健康保险卡的女性（OR = 1.185；p < 0.01）、居住在靠近医疗机构地区的女性（OR = 1.170；p < 0.01）、在过去12个月内去过医疗机构的女性（OR = 1.351；p < 0.001）以及每周至少听一次广播的女性（OR = 1.486，p < 0.001），都与乳腺癌筛查显著相关。相反，农村居民（OR = 0.874；p < 0.05）、传统宗教信徒（OR = 0.538；p < 0.05）报告的乳腺癌筛查几率显著较低。此外，在本研究背景下，教育程度、年龄、种族、家庭财富和居住地区对乳腺癌筛查有显著预测作用。
像乳腺癌筛查这样的预防性医疗政策必须高度关注教育程度较低或社会经济背景较差、在自身健康方面可能缺乏自主权的女性。
