Date of Award

January 2021

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Kaveh Khoshnood


Background: Somali women face exceptionally high mortality and incidence rates from both breast and cervical cancer. They experience an age-standardized breast cancer mortality rate of 29.1 per 100,000 women, the highest in all of Africa, and an age-standardized breast cancer incidence rate of 41.7 per 100,000 women. Somalia’s second-highest cancer-related mortality and incidence rates are due to cervical cancer, both behind breast cancer. It is critical to identify the underlying factors that may influence healthcare workers’ management of both cancers. At present, there is no consensus regarding providers’ knowledge of different cancers and screening.Methods: A cross-sectional questionnaire was administered with a purposive sampling strategy to 469 healthcare professionals and students and was completed by 405 (86%). Healthcare workers were recruited from Mogadishu-based hospitals. Results: 197 healthcare professionals and 207 students completed the survey and were included in the analysis. 89% and 73% of respondents demonstrated good knowledge of breast and cervical cancer, respectively. Only 46% knew that a vaccine could prevent cervical cancer, and 89% of healthcare professionals disagreed that HPV vaccines were available to their patients. Attitudes towards cancer screening, in addition to breast self-examination, were overwhelmingly positive. For both breast and cervical cancer, 24% reported having treated a patient and 30% reported having conducted a screen for either disease. Conclusion: Overall, while knowledge of both diseases and screening was good, there remain areas for clear educational targeting such as HPV vaccine availability and breast cancer preventability. Attitudes to screening for both diseases were exceedingly positive, but, with the exception of breast self-examination, failed to translate into practice due to inadequate resources and patient refusal. Future investments into Somalia’s chronic care management should prioritize technology necessary to conduct screenings for both diseases, expanding HPV vaccine access, and understanding patients’ potential motivations for refusing screening at the current moment. Key Words: Breast Cancer, Cervical Cancer, Human Papillomavirus, HPV Vaccine, Cancer, Somalia, Epidemiology of Microbial Diseases


This is an Open Access Thesis.

Open Access

This Article is Open Access