Selmouni Farida, Sauvaget Catherine, Zidouh Ahmed, Plaza Consuelo Alvarez, Muwonge Richard, Rhazi Karima El, Basu Partha, Sankaranarayanan Rengaswamy
International Agency for Research on Cancer, Lyon, France E-mail :
Asian Pac J Cancer Prev. 2016;17(9):4313-4318.
This study documented the performance of providers of visual inspection with acetic acid (VIA) at primary health centers, assessing their compliance with the VIA skills checklist and determinants of non-compliance, and exploring their perceptions of VIA training sessions.
A cross- sectional study was conducted among VIA providers in the Meknes-Tafilalet region of Morocco. Structured observation of their performance was conducted through supervisory visits and multiple focus group discussions (FGDs).
Performance of all the recommended steps for effective communication was observed in a low proportion of procedures (36.4%). Midwives/nurses had higher compliance than general practitioners (GPs) (p<0.001). All recommended steps for VIA examination were performed for a high proportion of procedures (82.5%). Compliance was higher among midwives/nurses than among GPs (p<0.001) and among providers in rural areas than those in urban areas (p<0.001). For pre-VIA counselling, all recommended steps were performed for only 36.8% of procedures. For post-VIA counseling, all recommended steps were performed in a high proportion (85.5% for VIA-negative and 85.1% for VIA-positive women). Midwives/nurses had higher compliance than GPs when advising VIA-positive women (p=0.009). All infection prevention practices were followed for only 14.2% of procedures, and compliance was higher among providers in rural areas than those in urban areas (p<0.001). Most FGD participants were satisfied with the content of VIA training sessions. However, they suggested periodic refresher training and supportive supervision.
Quality assurance of a cervical cancer screening program is a key element to ensure that the providers perform VIA correctly and confidently.
本研究记录了初级卫生中心醋酸肉眼检查（VIA）提供者的表现，评估他们对VIA技能清单的遵守情况以及不遵守的决定因素，并探索他们对VIA培训课程的看法。
在摩洛哥梅克内斯-塔菲拉勒特地区的VIA提供者中进行了一项横断面研究。通过监督访问和多次焦点小组讨论（FGD）对他们的表现进行结构化观察。
在低比例的检查程序（36.4%）中观察到了有效沟通所有推荐步骤的执行情况。助产士/护士的遵守情况高于全科医生（GP）（p<0.001）。VIA检查的所有推荐步骤在高比例的检查程序（82.5%）中得到执行。助产士/护士的遵守情况高于全科医生（p<0.001），农村地区提供者的遵守情况高于城市地区提供者（p<0.001）。对于VIA前咨询，所有推荐步骤仅在36.8%的检查程序中得到执行。对于VIA后咨询，所有推荐步骤在高比例中得到执行（VIA阴性女性为85.5%，VIA阳性女性为85.1%）。在为VIA阳性女性提供建议时，助产士/护士的遵守情况高于全科医生（p=0.009）。仅14.2%的检查程序遵循了所有感染预防措施，农村地区提供者的遵守情况高于城市地区提供者（p<0.001）。大多数FGD参与者对VIA培训课程的内容感到满意。然而，他们建议定期进行复习培训和提供支持性监督。
宫颈癌筛查项目的质量保证是确保提供者正确且自信地进行VIA检查的关键要素。
