Primary health care workers’ understanding and skills related to cervical cancer prevention in Sango PHC centre in south-western Nigeria: a qualitative study

Abstract

Aim: The study explored the knowledge and service delivery skills of primary health care (PHC) workers to conduct cervical cancer screening programmes in Sango primary health centre in Sango town, Ado-Odo Ota, Ogun State in Nigeria. Background: Cervical cancer is the second most common cancer affecting women. The prevention and control services in Nigeria are provided mainly at post-primary health facilities. Authorities have advocated the integration of cervical cancer prevention into reproductive health services provided at PHC centres. The service delivery capabilities of PHC workers are critical for successful implementation of screening programmes. Method: Exploratory qualitative research design was used. Data were collected among 10 PHC workers who were purposively sampled at Sango PHC. Semi-structured interview guide with broad items and a checklist were used to assess participants’ cervical cancer screening knowledge and service delivery skills using visual inspection screening methods. Data were analysed thematically and triangulated. Findings: A range of roles were represented in the interviews of the health care workers at the PHC studied. They had poor knowledge and skills about cervical cancer screening using visual inspection with acetic acid and visual inspection with Lugol’s iodine. Study participants perceived nurses as most equipped PHC workers to conduct screening at PHC level, followed by the community health officers. Participants reported no cervical cancer services at the centre and community. The findings provided useful insight that guided the training of primary health workers and the development of a community-based cervical cancer screening model for women in rural communities. Conclusion: Nurses and other PHC workers should be trained on visual inspection screening method. This low-cost but effective methodology could be incorporated into their training curricula as a strategy for scaling up cervical cancer prevention programmes across Nigeria.

Visual Inspection with Acetic Acid (VIA) Positivity Among Female Sex Workers: a Cross-sectional Study Highlighting One-year Experiences in Early Detection of Pre-cancerous and Cancerous Cervical Lesions in Kampala, Uganda

“…More than half (55%) reported their rst sexual intercourse between the age of 15-19 years and the median age 16 years (IQR, [15][16][17][18]. Regarding age at rst pregnancy, the median was 17 years (IQR, [16][17][18][19] and more than half (55%) had their rst pregnancy at < 18 years.…”

“…However, the health providers' VIA screening skills have been shown to improve signi cantly over time with continuous exposure and practice (15). For example in Ghana, the health care providers who had been trained up to seven years with regular supervision maintained high visual inspection performance (16).…”

Registered nurses' perspectives on barriers of cervical cancer screening in Swaziland: a qualitative study

“…However, even with the simplest methods in place, health care providers still face challenges in service provision due to various factors. The factors that hinder screening have been classified into: the health care system and health care provider related [ 7 - 9 ]. According to two studies, inaccessibility to health care centres and the unavailability of quality services are hindrances to cervical cancer screening [ 8 , 10 ].…”

“…Several studies showed that health care providers identified the following barriers in offering cervical cancer screening: insufficient screening centre/space and equipment at their working places, financial barriers for clients in those health care centres where screening is charged [ 7 , 8 , 12 , 15 - 17 ]. Furthermore, two studies conducted in Zimbabwe showed that lack of time dedicated to counselling and educating women on cervical cancer and staff shortages served as deterrents to screening [ 8 , 9 ].…”

“…Furthermore, two studies conducted in Zimbabwe showed that lack of time dedicated to counselling and educating women on cervical cancer and staff shortages served as deterrents to screening [ 8 , 9 ]. The health care provider related factors encompassed insufficient training or the limited number of trained staff, resulting in them being less confident and reluctant to recommend the PAP smear test for women [ 7 , 10 ]. Work overload was also a factor causing health care providers not to discuss with every patient about the screening [ 10 , 15 ].…”