Prostate cancer is the second most diagnosed cancer in men, disproportionately affects African populations with rural South Africa, especially the Eastern Cape, facing high prevalence due to healthcare inequalities, late diagnoses and limited resources. This study will play a role in aiding the responsiveness of the Eastern Cape Department of Health to deliver optimal cancer prevention and control for prostate cancer. Furthermore, it will highlight ways to destigmatise prostate cancer in African communities. Methods A multi-methods approach conducted in the OR Tambo district, Eastern Cape. Phase 1 involves a scoping review to explore prostate cancer prevention strategies in Africa. Phase 2 is a quantitative cross-sectional study analysing secondary data of prostate cancer survivors. Phase 3 and 4 include qualitative interviews to assess survivors’ perceptions and the general male population’s knowledge and attitudes towards prostate cancer care and attitudes towards prophylactic orchidectomy. Analysis Phase 1, narrative synthesis of articles, summarising findings with tables, a PRISMA diagram for article selection and exclusions. Phase 2; data will be analysed using descriptive statistics, T-tests, ANOVA, logistic regression and chi-square tests in STATA. Phase 3; thematic analysis of semi-structured interviews using NVIVO 14 using inductive coding and a six-step approach to identify key themes. Phase 4; analysed using NVIVO 14 to identify themes related to PC knowledge and health behaviours. Ethics and Dissemination This study received ethics approval from the Walter Sisulu University Health Sciences Research Ethics Committee with Ethics approval number WSUHREC014/2025 Informed written consent will be obtained for primary data, while secondary data will be anonymised. Findings will be shared through publications and conferences to advance prostate cancer prevention.

Background: Prostate cancer remains a significant public health burden globally, particularly in sub-Saharan Africa, where rising incidence rates are compounded by limited screening, late-stage diagnosis and disparities in healthcare access. In South Africa, the Eastern Cape Province reports high prostate cancer prevalence, with many patients presenting at advanced stages. Understanding the epidemiological profile of affected individuals is critical for developing targeted health strategies. Objectives: This sub-study aims to describe the epidemiological characteristics of patients diagnosed with prostate cancer, using secondary data from Nelson Mandela Academic Hospital (NMAH), focusing on patients seen between March 2020 and November 2021. Methods: A quantitative cross-sectional study design is employed. De-identified secondary data extracted from clinical records of male patients diagnosed with prostate cancer and managed at NMAH during the study period. Variables include demographic information, clinical characteristics, health service utilization indicators. Analysis: Data will be captured and coded in Microsoft excel 2013 (Microsoft corporation, Seattle, WA, USA). The data will then be exported to STATA 18 for analyses. Descriptive statistics will be used to summarize the data. Inferential analyses such as logistic regression and chi-square tests will be used to explore associations between variables and treatment outcomes. The study provides insights into the demographic and clinical profiles of prostate cancer patients in a high-burden setting. It is anticipated that findings will highlight the age distribution, stage at diagnosis, and treatment patterns among patients diagnosed with prostate cancer. This will inform future prevention and intervention strategies in the Eastern Cape Province. Conclusions: By mapping out the epidemiological patterns of prostate cancer in the Eastern Cape through this sub-study, the research contributes to evidence-based planning and resource allocation, ultimately supporting efforts to reduce prostate cancer morbidity and mortality in rural South Africa.

* Background Prostate cancer is one of the most prevalent cancers among men in South Africa, particularly affecting those in rural and underserved communities. Despite growing awareness, late presentation and poor health-seeking behaviour remain significant challenges. Understanding the sociocultural factors that shape men’s experiences and decision-making regarding prostate cancer is essential for improving early detection and care. Objective This study explores the perspectives of prostate cancer survivors and men in the general population on prostate cancer, its prevention, treatment and related health-seeking behaviour in rural South African context. Methods This study adopts a qualitative design. Semi-structured interviews conducted with two purposefully sampled groups: prostate cancer survivors (n=15) and men from the general population with no known diagnosis (n=15), in the OR Tambo District OF THE eastern Cape Province, South Africa. Interviews will be conducted in isiXhosa (the local language), audio recorded, transcribes and translated into English. Data will be analysed thematically using NVivo software. Ethical approval has been obtained from the Walter Sisulu University Human Research Ethics Committee (014/2025), with additional permissions granted by the Eastern Cape Provincial Department of health and Nelson Mandela Academic hospital. Conclusion the findings will contribute to a deeper understanding of individual and community-level factors influencing prostate cancer health-seeking behaviour. This study will generate context-specific qualitative evidence to guide public health policy and prostate cancer awareness campaigns in rural African settings, male-friendly community interventions to promote early detection in rural areas, with broader implications for addressing health inequities in non-communicable disease care.

Background/Objectives: Prostate cancer is a major public health concern and a leading cause of cancer-related morbidity and mortality among men worldwide, with disproportionately high mortality rates in sub-Saharan Africa. Late diagnosis, limited access to screening services, low health-seeking behaviour, and sociocultural barriers contribute to poor outcomes, particularly in rural settings. However, evidence on effective and context-appropriate strategies for prostate cancer prevention and early detection in African countries remains fragmented. Objective: This scoping review protocol aims to map and synthesize existing evidence on strategies implemented to reduce the burden of prostate cancer in Africa, with a focus on prevention, screening, community engagement approaches, and their acceptability. Methods: This scoping review protocol will be conducted in accordance with established methodological frameworks and reported following the PRISMA-ScR guidelines. A comprehensive search will be undertaken in PubMed (MEDLINE), EBSCOhost, ScienceDirect, CINAHL, and ProQuest. Studies conducted in African countries and published in English, French, or Portuguese will be included. Study selection and data extraction will be managed using Covidence, and findings will be summarized descriptively and thematically. Expected Results: This review is expected to identify and categorize existing prostate cancer prevention and early detection strategies implemented across African settings. Gaps in evidence, differences in implementation, and reported levels of acceptability among men are anticipated to be highlighted. Conclusions: The completed scoping review is expected to provide a comprehensive overview of prostate cancer prevention and early detection strategies implemented in Africa and to identify gaps in evidence. The evidence will inform the development of culturally responsive and context-specific interventions, with particular relevance for rural South African settings. This manuscript presents a protocol for a scoping review; no review findings are reported.

Background: Undernutrition among children under five years remains a major public health challenge, particularly in low- and middle-income countries and rural communities where poverty, food insecurity, and limited access to health services persist. Maternal and caregiver perceptions play a critical role in shaping feeding practices and health-seeking behaviours that influence child nutritional outcomes. Objective: This study explored mothers’ and caregivers’ perceptions of factors contributing to undernutrition among children under five years in a rural community of Ngqeleni, Eastern Cape, South Africa. Methods: A qualitative descriptive study was conducted at a primary healthcare clinic in the Ngqeleni sub-district. Purposive sampling was used to recruit mothers and caregivers of children under five years. Data were collected through seven in-depth interviews and three focus group discussions involving a total of 25 participants. Interviews were conducted using a semi-structured guide and analyzed thematically. Results: Five major themes emerged: caregivers’ perceptions of nutrition, household food insecurity and unemployment, limited dietary diversity, culturally influenced feeding practices, and gaps in practical nutrition knowledge. Caregivers demonstrated concern for child nutrition but described constrained feeding choices shaped by poverty, reliance on social grants, environmental challenges, and limited access to diverse foods. Environmental challenges such as drought and lack of piped water further limited food production. Limited nutrition knowledge and reliance on informal information sources contributed to suboptimal feeding practices. Conclusions: Undernutrition in this rural setting is shaped by a complex interaction of economic hardship, environmental constraints, and limited caregiver knowledge. Community-based nutrition education, strengthened primary healthcare counselling, and multisectoral interventions addressing poverty, water access, and food security are essential to improve child nutrition outcomes.

Background: Maternal healthcare access is a critical determinant of women’s and neonatal health, especially in rural areas of low- and middle-income countries. Despite high reported utilization in South Africa, rural communities continue to experience adverse childbirth outcomes. Objective: To evaluate the association between maternal healthcare access and childbirth outcomes in Ingquza Hill Local Municipality, Eastern Cape Province of South Africa. Methods: A cross-sectional study was conducted among 213 pregnant and postpartum women receiving maternal healthcare services at St Elizabeth Hospital, a regional referral hospital serving multiple primary healthcare clinics across the municipality. Data were collected using structured questionnaires and maternity access indicators (including ANC attendance, timing of first ANC visit, number of visits, physical accessibility, and place of delivery), and childbirth outcomes. Logic regression analyses were performed to identify associations between access indicators and unfavorable childbirth outcomes. Results: Utilization of maternal healthcare services was high, with 96% of participants reporting ANC attendance, 92% receiving skilled care during pregnancy, and 91% delivering in a health facility. Unfavorable childbirth outcomes were observed in 12% of participants. Conventional indicators of maternal healthcare access, including ANC attendance, number of visits, physical accessibility, and place of delivery, were not statistically associated with childbirth outcomes in regression analyses. However, initiation of antenatal care was notably delayed, with a mean gestational age at first ANC visit of 21.7 weeks. The limited number of adverse outcomes constrained statistical power to detect modest associations. Conclusions: High maternal healthcare utilization alone did not ensure improved childbirth outcomes in this rural setting. Delayed initiation of antenatal care emerged as a critical gap that may limit the effectiveness of subsequent care, highlighting the limitations of coverage-based access indicators. Strategies to improve maternal and neonatal outcomes should prioritize early antenatal engagement, quality and continuity of care, and move beyond utilization metrics toward measures of effective coverage in rural and resource-limited contexts.