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尼日利亚拉各斯资源匮乏地区女性宫颈癌筛查项目的障碍和建议:一项定性研究。

Barriers and recommendations for a cervical cancer screening program among women in low-resource settings in Lagos Nigeria: a qualitative study.

机构信息

Department of Community Health and Primary Care, Lagos University Teaching Hospital, Surulere, Lagos, Nigeria.

Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria.

出版信息

BMC Public Health. 2022 Oct 12;22(1):1906. doi: 10.1186/s12889-022-14314-2.

Abstract

BACKGROUND

Cervical cancer is the fourth most common cancer in women globally despite being a largely treatable and preventable malignancy. Developing countries account for over 80% of all new cases. Women residing in low-resource settings such as those residing in slums have a higher risk of cervical cancer, and lower uptake of cervical cancer screening. Diverse barriers influence the uptake of cervical cancer screening among women in low-resource settings.

OBJECTIVES

This qualitative study was done prior to the introduction of a cervical cancer screening program in two slum areas in Lagos Nigeria and explored women's knowledge about cervical cancer, and their perceived barriers and recommendations for the program.

METHOD

Four focus group discussions(FGD) were conducted among 35 women between the ages of 21-65 years residing in two urban slums in Lagos, Nigeria from February to April 2019. Each FGD was limited to 8-10 participants of women of similar ages. Voice recordings were transcribed verbatim and thematic analysis was done.

RESULTS

Most of the women were not aware of cervical cancer and none knew the symptoms or risk factors of cervical cancer. The participants felt that the cervical cancer screening program would be well accepted in the community, however, expressed concerns about the cost of the screening test and the sex of the person performing the test. The recommendations proffered for a successful cervical cancer screening program include; reducing the cost of the test or providing the test free of charge, having people that speak the local language as part of the team, using female health care providers, using a private location within the community or nearby primary health center, and publicizing the program with the use of SMS, phone calls, town crier, and health talks. It was recommended that organizing health education sessions would help improve women's poorly perceived susceptibility to cervical cancer.

CONCLUSION

Interventions to increase uptake of cervical cancer screening among women in low resource settings need to improve knowledge of cervical cancer and address barriers to cervical cancer screening such as cost, distance, and as much as possible, sex of the healthcare provider should be considered.

摘要

背景

尽管宫颈癌在很大程度上是一种可治疗和可预防的恶性肿瘤,但它仍是全球女性中第四大常见癌症。发展中国家占所有新发病例的 80%以上。居住在资源匮乏环境中的女性,如贫民窟中的女性,患宫颈癌的风险更高,且接受宫颈癌筛查的比例更低。多种障碍影响了资源匮乏环境中女性接受宫颈癌筛查的情况。

目的

本研究是在尼日利亚拉各斯两个贫民窟引入宫颈癌筛查项目之前进行的,旨在探讨女性对宫颈癌的认知,以及她们对该项目的感知障碍和建议。

方法

2019 年 2 月至 4 月,在尼日利亚拉各斯的两个城市贫民窟中,对 35 名年龄在 21-65 岁之间的女性进行了 4 次焦点小组讨论(FGD)。每次 FGD 参与者限制在 8-10 名年龄相近的女性。对录音进行逐字转录并进行主题分析。

结果

大多数女性不了解宫颈癌,也不知道宫颈癌的症状或危险因素。参与者认为该宫颈癌筛查项目将在社区中得到很好的接受,但对筛查测试的费用和执行测试的人员的性别表示担忧。提出的成功开展宫颈癌筛查项目的建议包括:降低测试费用或免费提供测试、团队中配备讲当地语言的人员、使用女性医疗保健提供者、在社区内或附近的初级保健中心设立私人场所、利用短信、电话、城镇公告员和健康讲座来宣传该项目。建议组织健康教育课程将有助于提高女性对宫颈癌的认知,改善她们对宫颈癌的感知易感性。

结论

在资源匮乏环境中提高女性接受宫颈癌筛查的干预措施需要提高对宫颈癌的认知,并解决宫颈癌筛查的障碍,如费用、距离,并且尽可能地考虑医疗保健提供者的性别。

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