The includes; individual/intrapersonal level, social networks/interpersonal level, organizational

The model dates backs
to 20th century from the writings of Lewin, Barker, and
Bronfernbrenner amid others who started understanding human behavior as an interaction
of an individual and the surrounding.

The ecological
model is defined as “a model of health that emphasizes the linkages and
relationships among multiple factors (or determinants) affecting health,”
Institute of Medicine, 2003. Many health related studies have adopted
extensively this model as the backbone of their study operations, execution and
results explanation. This model provides the foundation for understanding the many
factors affecting behavior and guides the development of initiatives held to influence
the social environment of the individual, social networks/interpersonal,
organizational, community and public policy on health behavior.  According to the works of McLeroy et al.
(1988), the model has two concepts, 1).Multiple level i.e. behavior affects and
is affected by multiple levels of influence; 2). Reciprocal causation i.e.
Individual behaviors shapes, and is shaped by, the social environment. This
model has five stages/levels which includes; individual/intrapersonal level,
social networks/interpersonal level, organizational level, community and public
policy on health behavior. 

The intrapersonal/individual level

The person’s
level of literacy on biological and personal history characteristics that make
her susceptible to breast or cervical cancer, increases her health literacy
about breast or cervical cancer disease. Some of these individual factors
includes age, level of education, occupation, income levels, substance use, and
history of cancer cases. At this level we are looking onto how individual women
understands and belief, and how they interpret the information given to them by
the health workers to date in regard to breast and cervical cancer diagnosis,
planned treatment and the educational needs.


The social
networks are the links an individual has in the society that may be of support
in addressing challenges of life. The social networks any person has may, may
increases her understanding and literacy. On this, we are looking on how social
systems may support the woman diagnosed with breast or cervical cancer in undergoing
all the intended treatment procedures, clinic follow ups and her social life. A
person who has had one of her family member diagnosed with breast or cervical
cancers may influence her screening and testing seeking health behavior for her
own and the diagnosis.


Organizational level

At this level we
are looking at the preventive, diagnostic, health literacy and treatment
activities implemented at organizational level addressing the breast and
cervical cancer. When we say organizational level we are referring to the
health facilities. The activities that are geared towards facilitating
individual behavioral change by influencing screening, diagnosis, treatment, referrals
and follow ups of the patients. Also the understanding of the clinician in
regards to cervical and breast cancer may assist the patient in requesting the
right diagnostic procedure and tests.

Community level

This level
explores the social cultural beliefs, norms and values that surround the
cervical and breast cancers diagnosis, treatment and literacy among the
community members. The social cultural norms and values can reflect on how persons
in a given society uptake any given health service as reported by Abdikarim K., Atieno M, & Habtu M. (2017). The study established that, cervical cancer screening uptake among young women was affected by the perception that it compromises the virginity which is valued most than testing for cervical cancer. For this study,
we are going to understand how the social cultural beliefs may affect the women
diagnosed with breast or cervical cancers in influencing diagnosis, treatment adherence
and social interactions in the society.

Public policy level

Policies and laws govern accessibility of
health care and universal health insurance cover frequently define access to
cervical cancer screening, diagnosis, treatment and adherence to intended
treatment. Cancer being a costly disease to treat and remedy; government
policies design and execution would influence the cancer screening and