A Culture-Centred Approach to Breast Cancer Communication Among Black Women in KwaZulu-Natal, South Africa
DOI:
https://doi.org/10.25159/2957-3645/20454Keywords:
communication, breast cancer, culture-centred, Zulu, Black womenAbstract
Breast cancer is a significant global health concern. Women in low-income settings, such as South Africa, are increasingly being diagnosed with this illness and often face poorer survival outcomes. The existing body of research on this topic highlights the need for new culturally informed studies. Such research is expected to support the development of culturally appropriate communication strategies that promote early cancer detection and treatment. This study therefore investigates the awareness and communicative practices of selected Zulu women concerning breast cancer. Thirty semi-structured interviews were conducted with women with breast cancer from KwaZulu-Natal in South Africa. Analysed using the culture-centred approach and thematic analysis, their accounts indicate that current communication approaches do not align well with the Zulu context. Unequal power dynamics between patients and healthcare providers, geographic seclusion and a pro-literacy bias are significant barriers to effective breast cancer communication. The findings of this study highlight the importance of enhancing cultural sensitivity within healthcare systems to strengthen breast cancer awareness and communication in KwaZulu-Natal.
References
Albrecht, G. L. (2006). “The sociology of health and illness.” In C. Calhoun, C. Rojek & B. Turner (Eds.), The Sage handbook of sociology, Sage. https://doi.org/10.4135/9781848608115.n16 DOI: https://doi.org/10.4135/9781848608115.n16
Arnold, M., Morgan, E., Rumgay, H., Mafra, A., Singh, D., Laversanne, M., Vignata, J., Gralowb, J. R., Cardosoc, F., Siesling, S., & Soerjomataram, I. (2022). Current and future burden of breast cancer: Global statistics for 2020 and 2040. The Breast, 66, 15–23. https://doi.org/10.1016/j.breast.2022.08.010 DOI: https://doi.org/10.1016/j.breast.2022.08.010
Apffelstaedt, J. P., Hattingh, R., Baatjes, K., & Wessels, N. (2014). Results of a pilot programme of mammographic breast cancer screening in the Western Cape. South African Medical Journal, 104(4), 297–298. https://www.ajol.info/index.php/samj/article/view/102676 DOI: https://doi.org/10.7196/SAMJ.7242
Bateman, C. (2013). PinkDrive intervention ‘over-rated’ – experts. South African Medical Journal, 103(3), 136–137. https://doi.org/10.7196/samj.6753 DOI: https://doi.org/10.7196/SAMJ.6753
Braun, V., Clarke, V., Hayfield, N., & Terry, G. (2019). Thematic analysis. In P. Liamputtong (Ed.), Handbook of research methods in health social sciences (843–860). Springer. https://doi.org/10.1007/978-981-10-5251-4_103 DOI: https://doi.org/10.1007/978-981-10-5251-4_103
Bright, D., McKay, A., & Firth, K. (2024). How to be reflexive: Foucault, ethics and writing qualitative research as a technology of the self. International Journal of Research & Method in Education, 47(4), 408–420. https://doi.org/10.1080/1743727X.2023.2290185 DOI: https://doi.org/10.1080/1743727X.2023.2290185
Brown, O., Goliath, V., Van Rooyen, D. R., Aldous, C., & Marais, L. C. (2018). Cultural factors that influence the treatment of osteosarcoma in Zulu patients: Healthcare professionals’ perspectives and strategies. Health SA Gesondheid, 23. https://doi.org/10.4102/hsag.v23i0.1095 DOI: https://doi.org/10.4102/hsag.v23i0.1095
Buys, T., Casteleijn, D., Heyns, T., & Untiedt, H. (2022). A reflexive lens on preparing and conducting semi-structured interviews with academic colleagues. Qualitative Health Research, 32(13), 2030–2039. https://doi.org/10.1177/10497323221130832 DOI: https://doi.org/10.1177/10497323221130832
Clarke, V., & Braun, V. (2017). Thematic analysis. Journal of Positive Psychology, 12(3), 297–298. https://doi.org/10.1080/17439760.2016.1262613 DOI: https://doi.org/10.1080/17439760.2016.1262613
CANSA. (2024). CANSA awarded outstanding breast cancer campaign by UICC. https://cansa.org.za/cansa-awarded-outstanding-breast-cancer-awareness-campaign-award-by-uicc/
Challand, C. (2024). An analysis of the social construction of breast cancer awareness in media and cause-related marketing. Motley Undergraduate Journal, 2(1), 26–36. https://doi.org/10.55016/ojs/muj.v2i1.78775 DOI: https://doi.org/10.55016/ojs/muj.v2i1.78775
Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods Approaches. Sage.
Das, M., Angeli, F., & Van Schayck, O. C. P. (2020). Understanding self‐construction of health among the slum dwellers of India: A culture‐centred approach. Sociology of Health & Illness, 42(5), 1001–1023. https://doi.org/10.1111/1467-9566.13075 DOI: https://doi.org/10.1111/1467-9566.13075
Davis, K. (2022). “Look at me!” Post-mastectomy transformative politics. European Journal of Women’s Studies, 29(4), 506–522. https://doi.org/10.1177/13505068221100053 DOI: https://doi.org/10.1177/13505068221100053
Dlamini, Z., Molefi, T., Khanyile, R., Mkhabele, M., Damane, B., Kokoua, A., Bida, M., Saini, K. S., Chauke-Malinga, N., Luvhengo, T. E., & Hull, R. (2024). From incidence to intervention: A comprehensive look at breast cancer in South Africa. Oncology and Therapy, 12(1), 1–11. https://doi.org/10.1007/s40487-023-00248-1 DOI: https://doi.org/10.1007/s40487-023-00248-1
Dutta, M. (2008). Communicating health: A culture-centred approach. Polity.
Dutta-Bergman, M. J. (2005). Theory and practice in health communication campaigns: A critical interrogation. Health Communication, 18(2), 103–122. https://doi.org/10.1207/s15327027hc1802_1 DOI: https://doi.org/10.1207/s15327027hc1802_1
Hammarberg, K., Kirkman, M., & De Lacey, S. (2016). Qualitative research methods: When to use them and how to judge them. Human Reproduction, 31(3), 498–501. https://doi.org/10.1093/humrep/dev334 DOI: https://doi.org/10.1093/humrep/dev334
Jacobs, I., Taljaard-Krugell, C., Wicks, M., Cubasch, H., Joffe, M., Laubscher, R., Romieu, I., Biessy, C., Gunter, M. J., Huybrechts, I., and Rinaldi, S. (2022). Adherence to cancer prevention recommendations is associated with a lower breast cancer risk in black urban South African women. British Journal of Nutrition, 127(6), 927–938. https://doi.org/10.1017/S0007114521001598 DOI: https://doi.org/10.1017/S0007114521001598
Kumar, R., Mardones, M., Costa, L., Saini, S., Villarreal-Garza, C., Martinez-Cannon, B. A., Manjunath, G., Sinha, S., Han, Z., Arora, A., Ferreira, A. M., Larsen, L., Hairabedian, S., Curry, T., Borge, H., Amorim, G., Shimizu, C., Zamre, V., Toi, T., & Warner, E. (2023). Beyond October, beyond pink: A year-round revelation for women’s breast health. Journal of Women’s Health, 32(11), 1143–1146. https://doi.org/10.1089/jwh.2023.0663 DOI: https://doi.org/10.1089/jwh.2023.0663
Leclerc‐Madlala, S. (2001). Virginity testing: Managing sexuality in a maturing HIV/AIDS epidemic. Medical Anthropology Quarterly, 15(4), 533–552. https://doi.org/10.1525/maq.2001.15.4.533 DOI: https://doi.org/10.1525/maq.2001.15.4.533
Makhetha, M., Chabilal, N., & Aldous, C. (2024). Recent trends in hereditary breast cancer incidence by race and age in KwaZulu‐Natal, South Africa: An 11‐year single‐centre retrospective study (2011–2021). International Journal of Cancer, 154(1), 65–70. https://doi.org/10.1002/ijc.34687 DOI: https://doi.org/10.1002/ijc.34687
Malele, N. (2021). English-IsiNdebele glossary of medical terms. https://hdl.handle.net/20.500.12185/547
Melkote, S. R., & Steeves, H. L. (2001). Communication for development in the third world: Theory and practice for empowerment (2nd ed.). Sage. https://doi.org/10.4135/9788132113751 DOI: https://doi.org/10.4135/9788132113751
Moodley, J., Constant, D., Mwaka, A. D., Scott, S. E., & Walter, F. M. (2021). Anticipated help seeking behaviour and barriers to seeking care for possible breast and cervical cancer symptoms in Uganda and South Africa. ecancer, 15, 1171. https://doi.org/10.3332/ecancer.2021.1171 DOI: https://doi.org/10.3332/ecancer.2021.1171
Naidu, M. (2009). “Topless” tradition for tourists: Young Zulu girls in tourism. Agenda, 79, 38–48. http://www.jstor.org/stable/27868946
Ramathuba, D. U., Ratshirumbi, C. T., & Mashamba, T. M. (2015). Knowledge, attitudes and practices toward breast cancer screening in a rural South African community. Curationis, 38(1), 1–8. https://doi.org/10.4102/curationis.v38i1.1172 DOI: https://doi.org/10.4102/curationis.v38i1.1172
Rayne, S., Schnippel, K., Benn, C., Kruger, D., Wright, K., & Firnhaber, C. (2018). The effect of access to information on beliefs surrounding breast cancer in South Africa. Journal of Cancer Education, 33(4), 806–813. https://doi.org/10.1007/s13187-017-1234-3 DOI: https://doi.org/10.1007/s13187-017-1234-3
Remennick, L. (2006). The challenge of early breast cancer detection among immigrant and minority women in multicultural societies. Breast Journal, 12, S103–S110. https://doi.org/10.1111/j.1075-122X.2006.00204.x DOI: https://doi.org/10.1111/j.1075-122X.2006.00204.x
Sarmah, N., Sibiya, M. N., & Khoza, T. E. (2023). The sociocultural influences on breast cancer screening among rural African women in South Africa. International Journal of Environmental Research and Public Health, 20(21), 7005. https://doi.org/10.3390/ijerph20217005 DOI: https://doi.org/10.3390/ijerph20217005
Sarmah, N., Sibiya, M. N., & Khoza, T. E. (2025). A model for promoting breast self-examination among rural South African women in KwaZulu-Natal. Health SA Gesondheid, 30, 1–8. https://doi.org/10.4102/hsag.v30i0.2777 DOI: https://doi.org/10.4102/hsag.v30i0.2777
Sastry, S., & Basu, A. (2020). How to have (critical) method in a pandemic: Outlining a culture-centered approach to health discourse analysis. Frontiers in Communication, 5, 585954. https://doi.org/10.3389/fcomm.2020.585954 DOI: https://doi.org/10.3389/fcomm.2020.585954
Van Oers, H., & Schlebusch, L. (2020). Indicators of psychological distress and body image disorders in female patients with breast cancer. Journal of Mind and Medical Sciences, 7(2), 179–187. https://doi.org/10.22543/7674.72.P179187 DOI: https://doi.org/10.22543/7674.72.P179187
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Unisa PressAccepted 2026-03-24
Published 2026-07-14