Breast ironing in Africa: a scoping review protocol

BACKGROUND: Breast ironing is a harmful cultural practice reported in some African communities and, although often culturally justified, it is increasingly recognised as a violation of the rights of affected girls. This review aims to answer: (1) What is the prevalence of breast ironing? (2) What motivations are reported? (3) What are its health and social impacts?

OBJECTIVE: The objective of this scoping review is to map evidence on prevalence, drivers, consequences, and interventions related to breast ironing.

METHOD AND ANALYSIS: Searches will be conducted in MEDLINE (PubMed), CINAHL (EBSCOhost), Scopus, and Web of Science, with grey literature identified through Google Scholar and institutional repositories, including African Journals Online (AJOL). The review will follow the Joanna Briggs Institute (JBI) scoping review methodology, and study selection will be reported in accordance with PRISMA-ScR guidelines. Two reviewers will independently screen titles/abstracts and full texts, while two reviewers will extract data. Findings will be synthesised using a descriptive analytical approach and presented as a structured narrative summary.

DISCUSSION: This review will strengthen the existing evidence base on the impact of breast ironing across Africa. Across studies, common motivations are expected to centre on perceived protection from sexual attention, early pregnancy, sexual violence, or forced marriage, while consistently reporting substantial physical harms-such as pain and tissue damage-and psychological consequences, including fear, shame, trauma, and loss of bodily autonomy. Recognising the practice within gender-based violence legislation may enhance legal accountability and protection for girls, while targeted training for healthcare providers and community-based education initiatives may support efforts to prevent the practice and mitigate its health and social consequences.