Evidence brief: Negotiating illness through faith: Religious narratives of cancer etiology among patients and caregivers in Addis Ababa, Ethiopia

Abstract

Cancer has become a major global public health threat, and individuals diagnosed with cancer and their family caregivers often seek to understand their illness experiences. Religious, spiritual, and sociocultural beliefs play a central role in shaping illness interpretations and care-seeking behaviors. However, in Ethiopia, limited attention has been paid to how these frameworks influence cancer experiences. This study explored religious narratives and interpretations of illness etiology among individuals diagnosed with cancer and their family caregivers and examined their influence on illness experiences and health-seeking practices. An interpretive phenomenological approach was employed using semi-structured, in-depth interviews with 41 participants, including individuals with cancer, family caregivers, and religious leaders. Data were transcribed, translated, and thematically analyzed to examine the processes of meaning-making. The findings showed that participants commonly conceptualized addiction as spiritually mediated rather than merely biologically determined. Illness was frequently interpreted as having a divine or supernatural origin, including punishment, a test of faith, God’s will, or spiritual affliction. These interpretations were dynamic and shaped by religious teachings, sociocultural contexts and personal reflections. Religious frameworks influence emotional responses, coping strategies, and health-seeking behaviors, providing comfort and resilience while shaping treatment decisions. They functioned not only as explanatory frameworks for illness but also as practical resources that structured participants’ responses to and negotiations with uncertainty, suffering, and responsibility. Religious meaning-making plays a central role in illness interpretations and overall experiences in cancer trajectories. Recognizing and engaging with these spiritual frameworks may enhance culturally responsive and patient-centered cancer care. Integrating spiritual sensitivity into clinical practice and collaborating with religious leaders may improve communication, trust, and psychosocial support for patients and their families.

Introduction

The rapid increase in cancer incidence is receiving global attention as a major public health threat and an increasing socioeconomic burden of the 21st century. In 2022, the World Health Organization (WHO) reported an estimated 20 million new cancer cases and 9.7 million cancer-related deaths [1,2]. In many low- and middle-income countries (LMICs), cancer is not only increasing rapidly but is also imposing a double burden on already fragile healthcare systems [3,4]. Although cancer incidence is lower in LMICs than in high-income countries (HICs), these regions experience a disproportionately high mortality rate compared to HICs [5]. This is due largely to late diagnosis, limited access to diagnostic and treatment services, and fragile health system capacity [1,4].

In the African Region, more than 900 000 new cancer cases and over 580 000 deaths were recorded in 2022, demonstrating the growing public health impact of the disease [5]. Ethiopia is also experiencing a rapid increase in cancer cases and mortality [5–7].‌‌ The WHO report showed that in 2022, an estimated 80,334 new cancer cases and 54,698 deaths occurred [8]. The national healthcare system is weak in effectively responding to this rapidly growing burden due to limited infrastructure, a shortage of trained personnel, and limited access to essential cancer services [9,10]. In addition, insufficient public awareness, sociocultural interpretations of illness, and unfavorable socioeconomic conditions influence care-seeking pathways [9,11,12].