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Background: Cervical cancer remains a leading cause of death among women in the developing world, with poor prognosis attributed to lack of awareness about the disease and its prevention. Hospital workers’ attitude and practice to such an issue might positively or negatively influence people they come into contact with. This study is to assess the determinants of cervical cancer screening via Pap smear among Female Staff in a Tertiary Hospital in Nigeria.Methods: A hospital-based cross-sectional study was conducted between September and November 2015. A structured self-administered questionnaire was used to collect data from 265 female hospital workers on socio-demographic characteristics (age, parity, educational level and occupational category) and awareness and utilization of Pap smear test. The data obtained were analyzed using SPSS version 20.0.Results: Of the 265 respondents, only 40 (15.1%) had Pap smear test done at least once previously. Bivariate analysis of socio-demographic factors and Pap smear test uptake among the respondents was statistically significant for younger maternal age ≤35 years, not being married, higher educational level, professional occupation category and awareness of Pap smear. However, only maternal age, marital status and awareness of Pap smear remain statistically significant after multivariate analysis.Conclusions: Uptake of Pap smear test as a screening test for cervical cancer is low among female hospital workers. Identified determinants of cervical cancer screening via Pap smear test were younger age ≤35 years, not being married, higher educational level, professional occupational category and awareness of Pap smear.
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PURPOSE: The purpose of this study was to conduct a cost effectiveness analysis of strategies designed to improve national cervical cancer screening rates, along with a distributional cost effectiveness analysis that considers regional disparities. MATERIALS AND METHODS: Cost effectiveness analysis was conducted using a Markov cohort simulation model, with quality adjusted life years as the unit of effectiveness. The strategies considered were current (biennial Papanicolaou smear cytology of females aged 20 or above), strong screening recommendation by mail to target regions (effect, 12% increase in screening uptake; cost, 1,000 Korean won per person), regular universal screening recommendation by mail (effect, 6% increase in screening uptake; cost, 500 Korean won per person), and strong universal screening recommendation by mail (effect, 12% increase in screening uptake; cost, 1,000 Korean won per person). Distributional cost effectiveness analysis was conducted by calculating the cost effectiveness of strategies using the Atkinson incremental cost effectiveness ratio. RESULTS: All strategies were under the threshold value, which was set as the Korean gross domestic product of $25,990. In particular, the ‘strong screening recommendation to target regions’ strategy was found to be the most cost effective (incremental cost effectiveness ratio, 7,361,145 Korean won). This was also true when societal inequality aversion increased in the distributional cost effectiveness analysis. CONCLUSION: The ‘strong screening recommendation to target regions’ strategy was the most cost effective approach, even when adjusting for inequality. As efficiency and equity are objectives concurrently sought in healthcare, these findings imply a need to develop appropriate economic evaluation methodologies to assess healthcare policies.