Olubodun Tope, Olaniran Abimbola, Awowole Ibraheem Olayemi, Ohazurike Ephraim, Soyannwo Tolulope, Adebisi Olusegun I, Adedayo Oludolamu Oluyemisi, Issa Kamarudeen Olaitan, Olorunfemi Solomon Olorunsaiye, Akinmolayan Omotola Omowunmi, Isarinde Olumide Ayodeji, Boladale Ibrahim Oladimeji, Ajewole Gbemiga Adekunle, Morhason-Bello Imran O
Department of Community Medicine and Primary Care, Federal Medical Center, Abeokuta, Ogun State, Nigeria.
KIT Royal Tropical Institute, Amsterdam, Netherlands.
PLoS One. 2025 Sep 11;20(9):e0316883. doi: 10.1371/journal.pone.0316883. eCollection 2025.
The burden of cervical cancer is highest in low- and middle-income countries. In Nigeria, where organized cervical cancer screening programs are lacking, opportunistic screening during maternal healthcare visits may enhance screening uptake. This study is aimed at understanding the practice of opportunistic cervical cancer screening and health education, and the barriers and facilitators experienced by health workers practicing in antenatal and postnatal clinics in Ogun State, Nigeria.
This is a qualitative cross-sectional study. In-depth interviews were conducted among 43 health workers - doctors, nurses and community health extension workers, working in antenatal and postnatal clinics in public primary, secondary and tertiary health facilities selected by quota sampling. A hybrid thematic data analysis approach, combining deductive and inductive methods was employed.
Health education on cervical cancer prevention was not done in most health facilities. Where cervical cancer health education was practiced, it was done mostly prior to family planning provision, and sometimes at antenatal, postnatal/infant immunization clinics. Facilities for cervical cancer screening was not available in most of the health facilities and patients had to travel long distances to tertiary facilities to have a Pap smear done. Barriers to cervical cancer screening and health education include, high cost of screening, manpower shortage, fear of positive result among patients, poor awareness among patients, and religious and cultural beliefs. The major facilitators to screening and health education mentioned were passion for their work and the desire that no woman should die from preventable cancers.
To address identified barriers, the government should enhance health worker training, ensure adequate staffing, improve the availability of screening equipment and reagents and make screening free/affordable. Community mobilization efforts should be intensified to increase awareness and promote accessibility. Integrating cervical cancer health education and screening into routine antenatal and postnatal care is essential for improving uptake.
宫颈癌负担在低收入和中等收入国家最为沉重。在尼日利亚，由于缺乏有组织的宫颈癌筛查项目，孕产妇保健就诊期间的机会性筛查可能会提高筛查的接受率。本研究旨在了解机会性宫颈癌筛查和健康教育的实施情况，以及在尼日利亚奥贡州产前和产后诊所工作的卫生工作者所经历的障碍和促进因素。
这是一项定性横断面研究。通过配额抽样，对在公立初级、二级和三级卫生设施的产前和产后诊所工作的43名卫生工作者（医生、护士和社区卫生推广工作者）进行了深入访谈。采用了一种结合演绎和归纳方法的混合主题数据分析方法。
大多数卫生机构未开展宫颈癌预防健康教育。在开展宫颈癌健康教育的地方，大多是在提供计划生育服务之前进行，有时也在产前、产后/婴儿免疫诊所进行。大多数卫生机构没有宫颈癌筛查设施，患者不得不长途前往三级医疗机构进行巴氏涂片检查。宫颈癌筛查和健康教育的障碍包括筛查成本高、人力短缺、患者担心结果呈阳性、患者意识淡薄以及宗教和文化信仰。提到的筛查和健康教育的主要促进因素是对工作的热情以及希望没有女性死于可预防的癌症。
为解决已确定的障碍，政府应加强卫生工作者培训，确保人员配备充足，提高筛查设备和试剂的可及性，并使筛查免费/负担得起。应加强社区动员努力，以提高认识并促进可及性。将宫颈癌健康教育和筛查纳入常规产前和产后护理对于提高接受率至关重要。
