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Perception and management of cancer among the Yoruba in Ibadan, Nigeria.

Prevalence and mortality rates of cancer are on the increase worldwide. Its management is blurred by misconception in Nigeria particularly. This study therefore examines the Yoruba perception and management of cancer using health belief model as the theoretical framework. The study utilised both qualitative and quantitative approaches. It was carried out in Ibadan metropolis in Nigeria. For the qualitative data a total of 19 Focus group discussions (190 people) among people aged 20 years above 45 in-depth interviews and structured observation were held. For quantitative data, a simple random sampling technique was employed in selecting 450 people at the household level while non-probability sampling was used for the 45 people living with cancer (PLWC) and 75 health care providers. The result showed that cancer is perceived as a major health problem. It is commonly called "Jejere" literally meaning a devouring disease. Cancer is associated with natural causes due to unhealthy life styles such as nutritional pattern and indiscriminate use of both orthodox and traditional drugs. Socio-economic factors of the people determine management of cancer (43.4% and 33.0% for money and occupation respectively).Result showed that (60%) preferred and use the orthodox medical care for various reasons such as precison about treatment positive outcome of care among others. Utilization of modern healthcare however was associated with high cost. Education and occupation have significant relationship with perceived cause of cancer p < 0.05, respectively. Variables like sex, age, and religion were not significant to perceived causes (p > 0.05) of cancer. The perceived cause of cancer does not have any relationship with the choice of cancer care p > 0.05. The available health care is significant to the choice of cancer care p < 0.05. The choice of cancer care depends on variables like sex, age, education and occupation p < 0.05, while religion is insignificant to the choice of cancer care p > 0.05. The problems encountered at the health care institutions were not significant to their utilization pattern p > 0.05, in order words, the benefits derived out-weighs the problems. Perception of cancer was not tied to the usual Yoruba perception of diseases. Cancer care depends largely on economic factors and facilities for cure rather than cultural factors. It is recommended that the government should focus on the following for effective management of cancer: encourage mass literacy of the people and the indigenous practitioners; provide social support; and fund cancer research.