Effectiveness of health education interventions on breast cancer literacy and breast screening uptake in sub-Saharan Africa: a systematic review protocol

BACKGROUND: The extant literature identifies low breast cancer literacy as a major reason for the low uptake of breast cancer screening among women in sub-Saharan Africa (SSA). Recognizing the potential of health education interventions to improve breast cancer literacy, researchers in SSA have implemented varied interventions. However, evidence on the effectiveness of these interventions in SSA is limited and fragmented, with variations in educational strategies, delivery methods, and cultural contexts. A systematic review is needed to synthesize existing evidence, assess the effectiveness of health education interventions in improving breast cancer literacy and screening uptake, and guide the development of culturally appropriate interventions aimed at improving breast cancer outcomes in SSA. OBJECTIVES: The aim of the study is to review empirical evidence on the effectiveness of health education interventions on breast cancer literacy and breast screening uptake in SSA. Specifically, the review seeks to identify the methods of delivering breast cancer education in SSA, determine the effectiveness of educational interventions on breast cancer literacy, and assess the effectiveness of educational interventions on breast cancer screening uptake. METHODS: This systematic review will include randomized controlled trials and quasi-experimental studies conducted among women aged 15 years and older in sub-Saharan Africa. Studies evaluating health education interventions designed to improve breast cancer literacy, awareness, or screening uptake will be eligible. Searches will be conducted in PubMed, Web of Science, Scopus, CINAHL, PsychInfo, and selected grey literature sources. Two reviewers will independently screen studies, assess eligibility, extract data, and evaluate methodological quality using the Cochrane Risk of Bias Tool (RoB 2) and the Joanna Briggs Institute Critical Appraisal Checklist, as appropriate. Findings will be synthesized narratively and, where sufficient methodological homogeneity exists, pooled using random-effects meta-analysis. DISCUSSION: It is envisioned that this study will provide evidence of the various health education interventions implemented across SSA to improve breast cancer literacy and screening uptake. It is also anticipated that the study will provide a means of comparing the effectiveness of the different interventions to inform policy and intervention scaling funds decisions in SSA. SYSTEMATIC REVIEW REGISTRATION: The protocol is prospectively registered in Open Science Framework (https://doi.org/10.17605/OSF.IO/XWKU9).