Multilevel analysis of undergoing clinical breast examination and its associated factors among mothers of reproductive age in Kenya: Kenyan Demographic and Health Survey 2022.

introductionBreast cancer is one of the most common public health concerns among women around the world. The incidence of breast cancer is increasing in all areas of the world. It is the first cause of death from malignant tumors. Breast cancer in Sub-Saharan African countries is the number one cancer and the leading cause of cancer mortality among women. In low-income countries like Kenya, early screening programs, including clinical breast examination by health professionals, can identify women's health status and risk of breast cancer. Therefore, this study was conducted to assess the uptake of clinical breast examination for cancer and to determine the associated factors among mothers of reproductive age.

methodsA total weighted sample of 10,267 mothers of reproductive age was included in this study. The data were taken from the recent Kenyan Demographic and Health Survey 2022. A multilevel multivariable logistic regression model was used to identify the associated factors associated with the uptake of clinical breast examination. In the multivariable multilevel analysis, the adjusted odds ratio (AOR) with a 95% CI was used to declare statistically significant associations with uptake among mothers of reproductive age in Kenya.

resultsIn Kenya, the overall prevalence of clinical breast examination uptake among mothers of reproductive age was 11.39%. In multilevel analysis, the significant factors associated with the uptake of clinical breast examination were the age of the mothers; age was significantly associated with the uptake of clinical breast examination; when compared with mothers aged 15-24 years, examination increased in those aged 25-34 years (AOR =  1.45; 95% CI (1.15-1.83)) and 34-49 years (AOR =  2.4; 95% CI (1.88-3.29)), when compared to no education, odds of examination increased in those with primary education (AOR =  2.0; 95% CI (1.19-3.37)) and secondary and higher (AOR =  2.67; 95% CI (1.56-4.57)), when compared to mothers who are unemployed, the odds of examination were higher among those who are employed (AOR =  1.42; 95% CI (1.16-1.74)), place of delivery; when compared to mothers who delivered at home, the odds of examination were higher among those who delivered at a health institution (AOR =  1.5; 95% CI (1.0-2.19)), when compared to those who are not exposed to television, odds of examination increased in those who were exposed to this form of media (AOR =  1.34; 95% CI (1.0-1.72)), when compared to those who travel on foot, odds of examination increased in those who used vehicles for transportation (AOR =  1.34; 95% CI (1.12-1.62)), and when compared to communities with a high level of literacy, the odds of examination increased in communities with a low level of literacy (AOR =  1.7; 95% CI (1.14-2.54)).

conclusionIn Kenya, the uptake of clinical breast examinations among mothers of reproductive age remains low. To address this, policymakers and stakeholders need to prioritize breast cancer screening programs to reduce mortality rates. The factors identified in this study are crucial for developing strategies to enhance clinical breast examination services, facilitating early detection and treatment of breast cancer.