Effectiveness of an Educational Intervention among Public Health Midwives on Breast Cancer Early Detection in the District of Gampaha, Sri Lanka


Background: Breast cancer is the commonest cancer among Sri Lankan females, accounting for 26% of thecancer incidence in women. Early detection of breast cancer is conducted by public health midwives (PHMs)in the Well Woman Clinics. The aim of the present study was to determine the effectiveness of an educationalintervention on improving knowledge, attitudes and practices (KAP) on breast cancer screening among PHMs inthe district of Gampaha. Materials and
Methods: Two Medical Officer of Health (MOH) areas in Gampaha districtwere selected using random sampling as intervention (IG) and control (CG) groups. All the PHMs in the twoMOH areas participated in the study, with totals of 38 in IG and 47 in CG. They were exposed to an educationalintervention with the objective of using them to subsequently conduct the same among 35-59 year women inthe community. Following the intervention, post-intervention assessments were conducted at one month and sixmonths to assess the effectiveness of the intervention.
Results: The overall median scores for KAP among PHMsrespectively were as follows. Pre-intervention: IG:58%(IQR: 53- 69%), 90%(IQR: 70-100%) and 62%(IQR:57-70%). CG: 64%(IQR: 56-69%), 90%(IQR: 70-90%) and 62%( IQR: 50-77%). Post-intervention: one month,IG:96%(IQR: 93-96%), 100%(IQR: 100-100%), and 85%(IQR: 81-89%). CG:67%(IQR: 60- 73%), 90%(IQR:80-100%) and 65%(IQR: 50-73%). Post-intervention: six months, IG: 93% (IQR: 91-93%), 100%(IQR: 90-100%), and 81%(IQR: 77-89%). CG: 67%(IQR: 58- 71%), 90%(IQR: 90-100%), and 62%( IQR: 58-73%). Allthe above post-intervention scores of PHMs in the IG were significantly higher in comparison to CG (p<0.001).
Conclusions: This planned educational intervention had a significant impact on improving KAP of PHMs forearly detection of breast cancer in the Gampaha district.