Factors associated with breast self-examination practice among female medical students in selected universities in Borama, Somaliland

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Background Breast cancer remains a significant global health challenge, characterized by high morbidity and mortality rates, particularly in resource-limited settings where access to advanced diagnostic imaging is scarce. In Somaliland, early detection is critical to improving survival outcomes. Breast self-examination (BSE) serves as a vital, cost-effective, and non-invasive screening tool that empowers women to identify early pathological changes. This study investigated the prevalence of BSE practice and its associated sociodemographic, knowledge-based, and attitudinal factors among female medical students in Borama, Somaliland. Methods A university-based cross-sectional study was conducted among 202 female medical students in April–May 2024. Data were collected using a structured self-administered questionnaire through convenience sampling with proportional quotas across selected health science faculties. Data analysis included descriptive statistics and binary logistic regression to identify independent predictors of BSE practice, with statistical significance set at p < 0.05. Results The findings revealed a high level of knowledge (77.7%) and overall positive attitudes (80.2%) toward BSE. However, the actual prevalence of BSE practice was moderate, only 46.5% ( n = 94) of participants had ever performed BSE, and among these, only 51.1% practiced monthly as recommended. Multivariable logistic regression identified attitude as the strongest predictor of practice (OR = 3.251, 95% CI: 1.68–6.29, p < 0.001), followed by age (5.012, p < 0.001), indicating that older students and those with proactive health beliefs were significantly more likely to engage in BSE. Conclusion Despite high theoretical knowledge, a substantial “knowledge-practice gap” exists. Interventions should transition from purely factual education to attitude-focused behavioral training. Integrating practical BSE demonstrations into university curricula is essential to equip future healthcare professionals with the habits necessary to promote early detection in the wider community.

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