FACTORS ASSOCIATED WITH HEALTH-SEEKING DELAYS AMONG WOMEN DIAGNOSED WITH BREAST CANCER IN TWO SELECTED TERTIARY HOSPITALS IN JOS, PLATEAU STATE, NIGERIA

TOPIC: FACTORS ASSOCIATED WITH HEALTH-SEEKING DELAYS AMONG WOMEN DIAGNOSED WITH BREAST CANCER IN TWO SELECTED TERTIARY HOSPITALS IN JOS, PLATEAU STATE, NIGERIA

TOPIC IS SUITABLE FOR:
1. Department of Nursing Science
2. Department of Public Health
3. Department of Community Health
This research material contains:
1-Chapter One to Five
2-Recent References/Citations
3-Tables in Chapter Four
4-Accurate Data Analysis
5-Table of Contents
6-Questionnaire

ABSTRACT 
This study was carried out to examine the factors associated with health-seeking delays among women diagnosed with breast cancer in two selected tertiary hospitals in Jos, Plateau State, Nigeria. The study was specifically carried out to determine the prevalence of health-seeking delays among women diagnosed with breast cancer in the two selected tertiary hospitals in Jos, Plateau State, examine the influence of socioeconomic factors on health-seeking delays among women diagnosed with breast cancer in the two selected tertiary hospitals in Jos, Plateau State, determine the influence of sociocultural factors on health-seeking delays among women diagnosed with breast cancer in Jos, Plateau State and evaluate the influence of healthcare system factors on health-seeking delays among women diagnosed with breast cancer in the selected tertiary hospitals. The study employed the descriptive research design. A total population of 286 women diagnosed with breast cancer was used for the study, comprising 168 women from Jos University Teaching Hospital and 118 women from Plateau State Specialist Hospital. Hence, the questionnaire was used for data collection, while the data collected were analyzed using frequency tables and percentages. A total of 167 respondents were selected as sample size using multi-stage sampling technique involving stratified and convenience sampling methods, while 152 validated copies of questionnaire were used for final analysis. From the responses obtained and analyzed, the findings revealed that health-seeking delays among women diagnosed with breast cancer were highly prevalent, with 30.3% of respondents rating the delay as significant and 24.3% rating it as very significant. The study also showed that socioeconomic factors significantly influenced health-seeking delays, as 48.0% of respondents had no health insurance coverage, while 32.2% reported that their economic situation had high impact on healthcare utilization. Likewise, the study further revealed that sociocultural factors influenced health-seeking delays, as 30.9% of respondents indicated that fear of social stigma affected healthcare decisions to a great extent, while 29.6% described community attitudes as unsupportive. The study further revealed that healthcare system factors contributed to health-seeking delays, as 31.6% of respondents rated healthcare responsiveness as poorly responsive, while 32.2% rated waiting time for consultation as long. The study therefore recommends that government and healthcare stakeholders should improve access to affordable breast cancer care, strengthen awareness programmes, address sociocultural barriers and improve healthcare service delivery.
Keywords: Health-Seeking Delays, Breast Cancer, Socioeconomic Factors, Sociocultural Factors, Healthcare System Factors.

CHAPTER ONE
INTRODUCTION (Preview)
1.1 Background of the Study
Health is an integral part of human development, and it is a critical determinant of social and economic productivity among populations. The dynamics of maintaining health and wellbeing are starting to be recognised as dependent on both access to medical interventions, and the decisions made about when and how to access health care. Current public health approaches focus on the fact that socioeconomic determinants influence health service use, which is an interplay of demographic characteristics, social organization and institutional settings. Bayable et al. (2023) argue that the health-seeking behaviour is one of the key behavioural factors affecting health outcomes for people with chronic diseases, and they discuss the timing of health-seeking. Likewise, Janatolmakan et al. (2026) reported that factors determining health seeking behaviour are interwoven between personal and environmental factors and these factors are heterogeneous among populations and disease conditions. This has led to a focus on the study of healthcare utilisation as an important and growing interest in population health research.
The importance of health seeking behaviour is underscored in the context of cancer, one of the top-ranking causes of morbidity and mortality worldwide. Cancer management involves a series of activities that start with recognition of the symptoms, span through diagnosis, treatment and survivorship care. In this continuum, choices about health care use have a significant impact on disease course and health care experiences. Hoveling et al. (2025) noted that the in-between phase from the time a symptom is identified to the time the cancer is seen in a health facility is a crucial step in cancer care pathways. Cakmak et al. (2025) also noted a multitude of behavioural and structural factors that affect access to health-related evaluation and treatment among cancer patients. This link between health care use and cancer management has sparked a rising body of academic research on the behavioural factors linked to cancer care pathways.
Breast cancer has a large socio-epidemiological burden and a wide impact on physical, psychological and social health and wellbeing, and is a particularly prominent form of cancer in women. The clinical presentation of breast cancer is diverse and the support required for the patient starts from the initial diagnosis, continues through treatment and cure and extends beyond.The clinical picture of breast cancer is heterogeneous and the support needed for the breast cancer patient begins at diagnosis and continues through treatment and cure and beyond. Darré et al. (2023) report on the diverse patterns of health care use among women with breast cancer, which are influenced by their socioeconomic status and lifestyle. Likewise, Swinny et al. (2021) found that women's breast cancer health seeking behaviors were linked to symptom experience, social support systems and health care experiences. Other research has shown that SE factors, cultural orientations, and characteristics of the healthcare system are factors that help explain the differences in healthcare use among women who are diagnosed with breast cancer (Al-Shiekh et al., 2022; Abdulkareem et al., 2023).
This has led to greater interest in specific investigations of the interplay between socioeconomic, sociocultural, and healthcare system elements, in lower and middle income countries, where breast cancer is diagnosed in women. The use of health care services among women who have breast cancer often mirrors wider social and institutional settings where health care is being decided (Sakafu et al., 2022). Similarly, Fayehun et al. (2025) suggested that the timing before healthcare presentation is frequently linked to disparities in economic resources, education, cultural orientations, and healthcare experiences. Similarly, Dedey et al., (2024) found in Ghana that individual and systemic conditions affect the seeking of healthcare among women diagnosed with breast cancer. In Nigeria and especially in the two selected tertiary hospitals in Jos, Plateau State these multidimensional influences offer a valuable framework for the analysis of the prevalence of health seeking delays and the socioeconomic, sociocultural and health system determinants of health seeking delays to women diagnosed with breast cancer.

1.2 Statement of the Problem
Delay in seeking health care after a breast cancer diagnosis has become a major public health problem, as the interval between first noticing a symptom of breast cancer and seeking treatment at a health care facility can have a substantial impact on the diagnosis and treatment process. Previous studies suggest that significant numbers of women with breast cancer do not promptly seek medical care when they discover breast changes. Abdulkareem et al. (2023) reported that delayed presentation is still prevalent among women with breast cancer and is influenced by a variety of factors relating to the individual and the environment. Mohammednoor et al. (2024) noted that for many women with breast cancer the delay in diagnosis has persisted. The problem persists, as Hoveling et al. (2025) also pointed out that delay in accessing care is a common theme in the breast cancer care pathways of many LMICs.
There are numerous socio-economic factors that have been linked to health seeking delays. Educational attainment, income status, occupational engagement, and financial capacity have previously been found to be factors affecting the utilization of health services among women with breast cancer (Dedey et al., 2024; Fayehun et al, 2025). In addition, socio-cultural factors like belief in sickness, family influence, social norms and understanding of breast symptoms have been associated with differences in health seeking behaviors among affected women (Al-Shiekh et al., 2022; Sakafu et al., 2022). Accessibility of services to the healthcare system, availability of specialized personnel, the efficiency of referral processes, and healthcare facility experiences have also been identified as factors contributing to delays in healthcare presentation and diagnosis (Cakmak et al., 2025; Khan et al., 2025). These factors have been described in various settings but the expression of these factors is determined by local contexts and so needs local investigation.
Despite being a growing public health concern in Nigeria, there is limited empirical evidence on the prevalence of health seeking delays and the proportionate roles of socioeconomic, sociocultural and healthcare system factors in three subnational contexts. Previous research has predominantly focused on the general cancer care journey, but has limited investigation into the multi-faceted aspects of delayed health care seeking by women diagnosed with breast cancer. (Fayehun et al., 2025) Therefore, few data are available on the magnitude of health seeking delays experienced by women seeking care in the two selected tertiary hospitals in Jos, Plateau State and insufficient information is available on the impact of socioeconomic condition, sociocultural orientation and characteristics of the health system on the health seeking delay. This study is thus required to offer empirical data on the prevalence and the determinants of the delay in seeking care by women diagnosed with breast cancer in the selected hospitals and to produce findings that can inform evidence-based planning and interventions to enhance timely health care utilization among affected women.
1.3 Objective of the Study
The sole purpose of this study is to examine the factors associated with health-seeking delays among women diagnosed with breast cancer in two selected tertiary hospitals in Jos, Plateau State, Nigeria
The specific objectives are:
1.Determine the prevalence of health seeking delays among women diagnosed with breast cancer in the two selected tertiary hospitals in Jos, Plateau State.
2.Examine the influence of socioeconomic factors on health seeking delays among women diagnosed with breast cancer in the two selected tertiary hospitals in Jos, Plateau State.
3.Determine the influence of sociocultural factors on health seeking delays among women diagnosed with breast cancer in Jos, Plateau State.
4.Evaluate the influence of healthcare system factors on health seeking delays among women diagnosed with breast cancer in the selected tertiary hospitals.
OTHER PARTS OF CHAPTER ONE INCLUDE:
1.4 Research Questions
1.5 Significance of the Study
1.6 Scope of the Study
1.7 Operational Definition of Terms

CHAPTER TWO
REVIEW OF LITERATURE (Preview)
This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps. This chapter, therefore, focuses on the concept of breast cancer, the concept of health-seeking behaviour, the concept of health-seeking delays, prevalence and causes of health-seeking delays among women diagnosed with breast cancer, factors associated with health-seeking delays, and the consequences of delayed health-seeking etc. The chapter is sub-grouped into the following major headings:
2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review
2.4 Summary of Literature Review

CHAPTER THREE
METHODOLOGY (Preview)
Presented below is a snapshot of key areas of the study methodology, the full and detail chapter three methodology is contained in the instant download document.

Research Design: The study adopted a descriptive research design.
Population of the Study: The population of the study comprised all women diagnosed with breast cancer who received treatment or medical care at Jos University Teaching Hospital (JUTH) and Plateau State Specialist Hospital (PSSH) in Jos, Plateau State, Nigeria.
Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 167 participants.
Sampling Technique: The study employed a multi-stage sampling technique involving stratified and convenience sampling techniques to select the individual respondents from the two selected tertiary hospitals.
Research Instrument: The study utilized a structured questionnaire titled “Factors Associated with Health-Seeking Delays Among Women Diagnosed with Breast Cancer in Two Selected Tertiary Hospitals in Jos, Plateau State, Nigeria” as the instrument for data collection.
Methods of Data Analysis: The collected data were analyzed using frequencies and percentages to summarize and present the demographic characteristics of the respondents and their opinions. The data were analyzed with the aid of the Statistical Package for the Social Sciences (SPSS) and presented in tables, charts, and graphs.
Full outline for chapter three:
3.1 Research Design
3.2 Research Setting
3.3 Target Population
3.4 Sample Size
3.5 Sampling Technique
3.6 Instruments For Data Collection
3.7 Validity and Reliability of Instrument
3.8 Pilot Study
3.9 Method of Data Collection
3.10 Method Of Data Analysis
3.11 Ethical considerations

CHAPTER FOUR; DATA PRESENTATION AND ANALYSIS
MAJOR FINDINGS (Preview)
The analysis results were presented in tables. Based on the results obtained from the analysis, the following findings are made: 

i. The study found that health-seeking delays among women diagnosed with breast cancer in the two selected tertiary hospitals in Jos, Plateau State, were prevalent, as evidenced by the responses showing that 41 respondents (27.0%) waited 4–6 months before seeking medical attention, while 47 respondents (30.9%) eventually presented at an advanced stage. The findings further revealed that 46 respondents (30.3%) rated the delay between symptom detection and seeking healthcare as significant.

ii. The study found that socioeconomic factors influenced health-seeking delays among women diagnosed with breast cancer, as evidenced by 46 respondents (30.3%) reporting that medical consultation was expensive, 48 respondents (31.6%) indicating that monthly income affected their decision to seek treatment to a great extent, and 73 respondents (48.0%) having no health insurance coverage when symptoms appeared. Furthermore, 49 respondents (32.2%) reported that their economic situation had a high impact on healthcare utilization.

iii. The study found that sociocultural factors influenced health-seeking delays among women diagnosed with breast cancer, as evidenced by 46 respondents (30.3%) indicating that their spouse's opinion influenced their decision to seek hospital care, while 48 respondents (31.6%) reported that cultural beliefs often influenced their response to breast symptoms. Furthermore, 47 respondents (30.9%) indicated that fear of social stigma affected their healthcare decisions to a great extent, while 46 respondents (30.3%) reported that religious beliefs strongly influenced their health-seeking actions.

iv. The study found that healthcare system factors influenced health-seeking delays among women diagnosed with breast cancer in the selected tertiary hospitals, as evidenced by 49 respondents (32.2%) rating the waiting time for medical consultation as long, while 47 respondents (30.9%) indicated that breast cancer screening and diagnostic services were rarely available when needed. Furthermore, 46 respondents (30.3%) described the hospital appointment process as inconvenient, while 48 respondents (31.6%) rated the healthcare system's responsiveness to their breast health concerns as poorly responsive.

CHAPTER FIVE: DISCUSSION OF FINDINGS
This chapter covers the following outline:
5.1 Discussion of Findings   
5.2 Implications of the findings
5.3 Limitations of the Study
5.4 Summary
5.5 Conclusion
5.6 Recommendations
5.7 Suggestions for Further Studies
Reference
Appendix

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