Knowledge, attitude and practice of breast cancer treatment among health care providers and traditional healers in Tanzania: A crosssectional study

Introduction: Healthcare providers (HCPs) and traditional healers (THs) play a pivotal role in the breast cancer treatment pathway and can impact access to timely and effective healthcare. This study aimed to assess the knowledge, attitudes, and practices regarding breast cancer treatment among HCPs and THs in Northern Tanzania. Methods: Employing a cross-sectional design, data were collected among 528 respondents (308 HCPs and 220 THs), using a validated questionnaire. Modified Poisson regression analysis was performed to determine the knowledge and attitudinal factors associated with referral status. Results: Overall, referrals to health care facilities were 49.8% (263/528); for HCPs, 55.8% (172/308) and THs, 41.4% (91/220). Multivariable analysis revealed that HCPs who believed that cancer patients face administrative discrimination (aRR: 1.53; 95%CI: 1.25, 1.87), that a patient is responsible for their own disease (aRR: 1.26; 95%CI: 1.00, 1.60), and don’t disclose patient information to others (aRR: 1.24; 95%CI: 1.01, 1.52) were more likely to refer patients. THs who hesitated to speak with cancer patients (aRR; 0.42; 95%CI: 0.19, 0.97), thought that cancer patients are socially marginalized (aRR; 0.30; 95%CI: 0.15, 0.59), that cancer patients are avoided by friends (aRR: 0.62; 95%CI: 0.45, 0.86) and that a patient is responsible for their own disease (aRR: 0.45; 95%CI: 0.33, 0.62) were less likely to refer patients. Conclusion: The findings underscore the need for targeted educational programs to address the knowledge gaps and attitudes regarding breast cancer among THs, which could enhance their understanding and improve their referral practices. Bridging the knowledge gaps between HCPs and THs is crucial for improving cancer treatment and referrals in Northern Tanzania.