Where governments fear to tread, meso level interventions could be the solution to India’s rising breast cancer epidemic.

A mobile health intervention could help turn the tide of a rise in breast cancer in women as young as 30 in India. October is breast cancer awareness month, an annual intervention campaign to educate people about breast cancer, the most prevalent form of cancer globally. This disease has become a major problem in India. Breast cancer accounts for 25% to 31% of all cancers, with a significant shift from 50 – 70 years to younger aged women 30 – 50 years developing the disease.

From 2017- 2020 I carried out field research (1) in New Delhi, India to scope the challenges and opportunities for social marketing. I uncovered the reason for such appalling statistics is at the micro level women lack of awareness about the early warning signs of breast cancer. They are operant and operand resource poor. Macro environmental forces including weak political will to fund and resource women’s health, combine with socio-cultural protocols which render discussion a taboo and stigmatise those who suffer from cancer.

As a researcher of women’s health and wellbeing interventions in India, I thought it would be useful in Breast Cancer Awareness month to examine how the Covid-19 pandemic has affected the ensuing breast cancer epidemic in India. Tragically, the intense focus of the health service resources on Covid-19 patients, means late diagnosis at an advanced stage still remains the main challenge in the war against breast cancer. With no apparent government intervention on the horizon could a solution be found with a meso level intervention?

India has emerged as a hub central to the development of new technology. The rate of technological innovation and demand in India for mobile devices offer fresh possibilities for the health and wellbeing of the world’s largest democracy. Smart technology such as mobile phones are a promising tool for disease control interventions in emerging economies and in India the dominant focus has so far concentrated on HIV/AIDS and diabetes education. My recent research reveals mobile health technology (2) (mhealth) as an intervention opportunity to improve cancer healthcare knowledge for women in India.

We found the way forward is to equip and train Accredited Social Health Activists, known as ASHAs, to operate a mhealth technology device in their daily work.

Mhealth technology operated by ASHAs in the community to raise breast cancer awareness through the act in India (Source: Author)

We identified ASHAs as central to the breast cancer intervention. Accepted by the community, they overcome socio-cultural barriers and they encourage vulnerable target groups to understand the value of undertaking regular self- breast examinations.

Using a bespoke app (operated on a digital tablet with culturally-specific images) ASHAs are able to educate and demonstrate to women breast self-examination techniques which can help identify the early warning signs of cancer. The technology can be operated quickly in times of crisis (such as a global pandemic) therefore, it might be beneficial for the India health service to invest in innovative mobile technology to combat the rise in breast cancer statistics. These community workers operating m-health technology therefore present a as frontline solution to the breast cancer crisis exacerbated by Covid-19.

Dr Judith Fletcher-Brown

University of Portsmouth


(1) Fletcher-Brown, J., Pereira, V., &; Nyadzayo, M. W. (2018). Health marketing in an emerging market: The critical role of signaling theory in breast cancer awareness. Journal of Business Research86, 416-434.

(2) Fletcher-Brown, J., Carter, D., Pereira, V., &; Chandwani, R. (2020). Mobile technology to give a resource-based knowledge management advantage to community health nurses in an emerging economies context. Journal of Knowledge Management. 25(3),525-544