评估埃塞俄比亚亚的斯亚贝巴公共卫生中心的卫生系统对获得宫颈癌预防、筛查和治疗服务的影响。

Assessing the influence of the health system on access to cervical cancer prevention, screening, and treatment services at public health centers in Addis Ababa, Ethiopia.

机构信息

Institute of Healthcare Management, Strathmore University, Nairobi, Kenya.

International Institute for Primary Healthcare - Ethiopia (IPHC-E), Addis Ababa, Ethiopia.

出版信息

PLoS One. 2024 May 31;19(5):e0300152. doi: 10.1371/journal.pone.0300152. eCollection 2024.

DOI:10.1371/journal.pone.0300152

PMID:38820249

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11142424/

Abstract

BACKGROUND

Cervical cancer is the second leading cause of cancer death among Ethiopian women. This study aimed to assess the influence of the health system on access to cervical cancer prevention, screening, and treatment services at public health centers in Addis Ababa, Ethiopia.

METHODS

This study used a cross-sectional survey design and collected data from 51 randomly selected public health centers in Addis Ababa. Open Data Kit was used to administer a semi-structured questionnaire on Android tablets, and SPSS version 26 was used to analyze the descriptive data.

RESULTS

In the study conducted at 51 health centers, cervical cancer prevention and control services achieved 61% HPV vaccination for girls, 79% for cervical cancer awareness messages, 80% for precancer lesion treatment, and 71% for cervical screening of women. All health centers were performing cervical screening mostly through visual inspection with acetic acid due to the inconsistent availability of HPV DNA tests and the lack of Pap smear tests. In 94% of health centers, adequate human resources were available. However, only 78% of nurses, 75% of midwives, 35% of health officers, and 49% of health extension workers received cervical cancer training in the 24 months preceding the study. Women had provider choices in only 65% of health centers, and 86% of the centers lacked electronic health records. In 41% of the health centers, the waiting time was 30 minutes or longer. About 88% and 90% of the facilities lacked audio and video cervical cancer messages, respectively.

CONCLUSION

This study revealed that the annual cervical cancer screening achievement was on track to fulfill the WHO's 90-70-90 targets by 2030. We recommend that decision-makers prioritize increasing HPV vaccination rates, enhancing messaging, reducing wait times, and implementing electronic health records to improve access to cervical cancer services in Addis Ababa.

摘要

背景

宫颈癌是埃塞俄比亚女性癌症死亡的第二大主要原因。本研究旨在评估卫生系统对埃塞俄比亚亚的斯亚贝巴市公立卫生中心提供宫颈癌预防、筛查和治疗服务的影响。

方法

本研究采用横断面调查设计，从亚的斯亚贝巴市随机选取的 51 个公立卫生中心收集数据。使用开放式数据套件（Open Data Kit）在安卓平板电脑上进行半结构化问卷的管理，使用 SPSS 版本 26 对描述性数据进行分析。

结果

在对 51 个卫生中心进行的研究中，宫颈癌预防和控制服务取得了以下成果：为女孩接种 HPV 疫苗的比例达到 61%，为宫颈癌防治意识宣传的比例达到 79%，癌前病变治疗的比例达到 80%，妇女宫颈癌筛查的比例达到 71%。所有卫生中心主要通过醋酸视觉检查进行宫颈癌筛查，因为 HPV DNA 检测和巴氏涂片检查的供应不一致。94%的卫生中心人力资源充足。然而，只有 78%的护士、75%的助产士、35%的卫生官员和 49%的卫生推广员在研究前 24 个月接受过宫颈癌培训。只有 65%的卫生中心允许妇女自行选择服务提供者，86%的中心缺乏电子健康记录。在 41%的卫生中心，等候时间为 30 分钟或更长。大约 88%和 90%的设施分别缺乏音频和视频宫颈癌信息。