Factors associated with health seeking delay in the screening of cervical cancer among women in Imo state, south Eastern Nigeria.

BACKGROUND TO THE STUDY: Cervical cancer is a curable disease if diagnosed early. The mortality rate due to cervical cancer is high worldwide, mainly because of the absence of a functioning screening process and the advanced stage of the disease at diagnosis. The aim of this study was to assess the factors associated with health-seeking delay in the screening of cervical cancer among women in Owerri Municipal LGA, Imo State. METHODS: A descriptive cross-sectional research design was employed in this study on factors associated with health-seeking delay in the screening of cervical cancer among women in Owerri Municipal LGA. A semi-structured questionnaire was used for the study, and Statistical Package for the Social Sciences (SPSS) version 20 was used in the analysis of the data gotten from the study. A probability-based multi-stage sampling method was adopted for the study in recruiting 432 women who participated in it. RESULT: Results from the study showed that most of the women, 117 (27.1 %), were between the ages of 22 and 27. The study found that a high percentage of the respondents, 350 (81.0 %), had heard about cervical cancer screening, and when they were asked who they thought should be screened for cervical cancer, 154 (35.6 %) said women between the ages of 15 and 40. Further findings revealed that, 420 (97.2 %) said they had not been screened for cervical cancer. The study also demonstrated that 260 (60.2 %) believe long distance has an impact on your access to health care. The findings of this study revealed that age (P = 0.0247), educational level of women (P = 0.0214), and monthly income of the women (P = 0.0062) were all significantly associated with health-seeking delay in cervical screening. CONCLUSION: The study concluded that there is no limited knowledge about cervical cancer among women in Owerri Municipal. Long distance to screening facilities, educational background, and monthly income are significantly associated with the delay in seeking health services for cervical screening. RECOMMENDATION: The study recommended that there should be massive awareness and participation in the screening program across the state.

Stakeholders' hopes and concerns about the COVID-19 vaccines in Southeastern Nigeria: a qualitative study.

BACKGROUND: Equitable access and high uptake of safe and effective vaccines is critical to ending the COVID-19 pandemic. To ensure the success of these vaccines, particularly in many developing and under-developed parts of the world, the concerns of local communities including fears, potency, and levels of acceptance should be addressed. This study assessed community stakeholders' perceptions in parts of Southeastern Nigeria about COVID-19 vaccine, towards engaging them effectively to ensure the success of the vaccination campaigns. METHODS: A qualitative study was conducted involving fourteen stakeholders from the Southeastern geo-political zone of Nigeria selected using purposive sampling. In-depth semi-structured individual interviews lasting about 30 min were used to collect data. Data analysis was informed by a general inductive approach. RESULTS: Stakeholders hoped that the development and roll out of the vaccines will bring COVID -19 to an end, will help to maintain good health and allow people get back to normal life. On the other hand, stakeholders expressed their concerns and worries about the "speed" with which the vaccines are being produced, possibility of future adverse effects from vaccination, misinformation, and level of preparedness in the health system to implement the vaccine campaign. CONCLUSIONS: This study identified that more needs to be done to improve perceptions of those who influence health decisions in communities towards COVID-19 vaccines. This includes firstly, the involvement of the community and religious leaders in vaccine promotion. Secondly, it is imperative to develop and disseminate persuasive messaging on vaccine effectiveness and safety targeted at both health professionals, policymakers, and the community which are culturally sensitive and address identified concerns among health workers. Thirdly, the health systems should be strengthened and system-level interventions that directly target one or more of the WHO's six health system building blocks: service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership/governance.

Determinants of cervical cancer screening uptake among female undergraduates in a tertiary institution in south eastern Nigeria: a cross sectional study.

INTRODUCTION: Cancer of the cervix is the second most common cancer among women worldwide and is the major cause of cancer deaths in developing countries. Screening is among the common cost-effective control methods for the disease. This study ascertained the determinants of cervical cancer screening uptake among female undergraduates in a tertiary institution in south eastern Nigeria. METHODS: This cross-sectional study was conducted using a stratified sampling technique among 375 respondents. A pretested semi structured questionnaire was used for data collection and SPSS version 21 was used in data analysis in which the association between qualitative variables was ascertained using Chi-square test at P < 0.05 probability level. RESULTS: The result revealed that majority of 321 (85.6%) were aware of CC as a disease and 202 (53.9%) of the respondents were aware of cervical cancer screening test. The study revealed that the uptake of cervical cancer screening was low among the female undergraduates. Only few 27 (7.2%) of the respondents have been previously screened for cervical cancer. High cost of screening 128 (31.2%) was the major reason for not undergoing screening. Significant association existed between socio-demographic variables (age, level of study, marital status and monthly allowance) and uptake of cervical cancer. Most of the respondents 10 (17.2%) that had been screened for cervical cancer were within the age bracket of 25-29 years and were in 500 level 21(19.4%). Cervical cancer uptake was higher 9 (29%) in married females compared to single females 18 (5.2%). It was also indicated that all the participants who have been screened were screened at a cost of ₦ 1,001 - ₦ 2,000. Majority of them 11 (25.6%) earned monthly allowance of ₦ 23,001 - ₦ 30,000. Strong association were also found between awareness of cervical cancer (X² = 4.89, P = 0.027), availability of screening center (X² = 37.433, P ≤ 0.001), cost of screening (X² = 100,793, P ≤ 0.001) and uptake of screening. CONCLUSIONS: The study revealed that the uptake of cervical cancer screening was low among the female undergraduates. In order to enhance screening uptake among female undergraduates, there is an urgent need to review the cost of screening especially in the school's health center and other hospitals/clinics within the school environment.

Knowledge, attitude and perception on cervical cancer screening among women attending ante-natal clinic in Owerri west L.G.A, South-Eastern Nigeria: A cross-sectional study.

BACKGROUND: Cancer of the cervix is the second most common cancer in women globally, and it is a major cause of morbidity and mortality among women in developing countries such as Nigeria. The study assessed the knowledge, attitude and perception on cervical cancer screening among women attending ante-natal clinic in Owerri West, south eastern Nigeria. METHOD: This cross-sectional study was conducted using a random sampling technique among 231 respondents attending ante-natal clinic in a cluster of 4 selected public primary healthcare centres. A structured questionnaire was used for data collection, and data obtained was analysed using a descriptive technique, while the chi-square test was used to test for the influence of age and education level on cervical cancer screening. RESULTS: The result showed that there was a high level of awareness (68.8%) of cervical cancer screening. The majority of women (122 (52.8%)) received this information from friends. Although the majority of the participants had heard about the screening, few of them had basic information on the cause of the disease 44 (19%), prevention 32 (13.9%), risk factors 48 (20.8%) and treatment (23.4%) of the disease. Of the 231 women, 59 (25.5%) strongly agreed they were too young to have cervical cancer and hence there was no need for the screening, while a greater proportion (53 (22.9%)) agreed that the screening is only meant for older women (30-45 years). Expensive cost of screening (68 (29.4%)) and invasion of privacy by male doctors (34.6%) were also strong reasons for avoiding screening. The study revealed strong influence of age (χ2 = 104.37; DF = 10; P<0.001) and level of education (χ2=31.63; DF = 6; P<0.001) on awareness of cervical cancer screening. Moreover, educational status had a significant positive influence (χ2= 54.71; P<0.001) on the cause of cervical cancer, with a higher proportion of participants with post-secondary education. CONCLUSION: Awareness of cervical cancer is high, but the perception that it can be treated is quite low, along with fear of the screening outcome. Age and level of education are significant factors of screening for cervical cancer. Educational programmes encouraging participation in cervical cancer screening should consider involving the use of close peers and friends to educate the women on the importance of screening program.