A systematic review of the effectiveness of health education interventions on breast cancer literacy, screening uptake, and health beliefs in Africa

Breast cancer remains the most commonly diagnosed cancer among women in Africa and contributes substantially to cancer-related mortality. Late diagnosis and poor survival outcomes have been linked to limited awareness of breast cancer risk factors, symptoms, and screening practices, alongside broader health system barriers. Various educational and community-based interventions have been implemented to improve breast cancer literacy, screening uptake, and health beliefs; however, evidence regarding their effectiveness remains fragmented. This study systematically reviews evidence from interventions aimed at improving breast cancer literacy, screening uptake, and health beliefs among women in African countries. Following PRISMA guidelines, electronic databases (CINAHL, PubMed, PsycInfo, and Scopus) were systematically searched for eligible studies. Inclusion criteria were peer-reviewed publications conducted in African countries, involving women participants, using experimental or quasi-experimental designs, and measuring outcomes related to breast cancer knowledge, screening uptake, or health beliefs. Data extraction and thematic synthesis were conducted. Twenty-two studies met the inclusion criteria. Interventions included community-based education, facility-based awareness campaigns, multimedia approaches, and integrated screening services. Most interventions significantly improved breast cancer literacy. Screening uptake was enhanced, particularly when education was combined with immediate access to screening services. Health beliefs, particularly perceived susceptibility and benefits, also improved after exposure to health education interventions. Health education interventions enhance breast cancer knowledge and positively impact screening behaviours and health beliefs among women in Africa. Further high-quality research, including long-term follow-up and cost-effectiveness analyses, is needed to strengthen the evidence base and guide policy for breast cancer control across the sub-region. Registration https://doi.org/10.17605/OSF.IO/XWKU9