Communities’ perceptions towards cervical cancer and its screening in Wolaita zone, southern Ethiopia: A qualitative study

Background Cervical cancer is a malignant neoplasm from cells originating in the cervix uteri. Any woman who is sexually active is at risk of getting HPV. Women in sub-Saharan Africa region have higher chance of developing the disease. There are nearly 26 million Ethiopian women who are over the age of 15 and believed to be at risk of getting HPV. Regrettably, Ethiopian women typically present for cervical cancer care at a late stage in the disease, where treatment is most ineffective. Objectives To explore communities’ perceptions of cervical cancer and screening among women in Wolaita zone, southern Ethiopia. Methods A qualitative research using focused group discussions and in-depth interviews was used to explore communities’ perceptions of cervical cancer and screening among women in Wolaita zone, southern Ethiopia from March 2018-November 2019. The study participants were men, women and communities who were residents of the study settings and were not health professionals. All focused group discussions (FGDs) and key informant interviews were transcribed and entered into Microsoft Word and thematic content analysis was done. Results A total of fifty-nine participants participated in both FGD (three with men and six with women) and in-depth interviews (IDIs). Most participants have not heard about cervical cancer but know cancer in general. Participants mentioned that the disease usually relates to many births and unprotected sexual intercourse but none mentioned HPV infection. Most of the participants perceive that cervical cancer is incurable and assume that it could be prevented but they think they are not vulnerable to the disease and screening is not necessary. Conclusion This study indicates that rural communities in the zone had limited knowledge about cervical cancer and even less about risk factors, screening, treatment and prevention. There is a great need for cancer education and prevention in Ethiopia.

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Barriers to husbands’ involvement in maternal health care in Sidama zone, Southern Ethiopia: a qualitative study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2697-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Wondwosen Teklesilasie ◽

Wakgari Deressa

Keyword(s):

Health Care ◽

Maternal Health ◽

Maternal Health Care ◽

Southern Ethiopia ◽

Group Discussions ◽

Health Care Need ◽

Female Partners ◽

Pregnancy And Childbirth ◽

Interview Guide ◽

Depth Interviews

Abstract Background Husbands’ involvement in maternal care is considered as a crucial step in scaling up women’s utilization of the services. However, the factors related with how husband’s involvement in maternal health care have hardly been studied to date in the study areas. Therefore, this study aimed to explore barriers to husbands’ involvement in maternal health care, in Sidama zone, Southern Ethiopia. Methods The study employed a qualitative method. A pre-tested interview guide questions that prepared in English and translated in to Amharic language were used for data collection. The data were collected using focus group discussions, in-depth interviews and key-informants’ interview in April and May 2015. The data were analyzed thematically. Results The study identified a range of factors that-deterred husbands to involve in their female partners’ maternal health care. These are childbirth is a natural process, pregnancy and childbirth are women’s business, preference for TBAs’ care and husband’s involvement in pregnancy and birth care is a new idea were identified as barriers for husbands’ involvement in maternal health care, in this study. Conclusions A range of factors related with clients’ and service delivery factors’ were identified as barriers to husbands’ involvement in maternal health care. Based on the study findings we recommend a contextual based awareness creation programs about husbands’ involvement in maternal health care need to be established.

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KNOWLEDGE, ATTITUDE AND PRACTICES RELATED TO CERVICAL CANCER.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i4.179 ◽

2019 ◽

Vol 3 (4) ◽

Author(s):

Kavita Agarwal ◽

Saroj Paliwal

Keyword(s):

Cervical Cancer ◽

Screening Program ◽

Malignant Neoplasm ◽

Cross Sectional Study ◽

Reproductive Age ◽

Cervix Uteri ◽

Cancer Awareness ◽

Cross Sectional ◽

Cancer Risk Factors ◽

Cervical Cancer Risk

Background: Cervical cancer is a malignant neoplasm arising from cells originating in cervix uteri. It may be completely asymptomatic in early stages. Material and Methods: A facility based cross sectional study was done 200 women of reproductive age group (15-45 years) who present to out-patient department in gynecology. Results: A total of 200 women are approached for interview, in which 182(91.00%) had not heard about cervical cancer, only 9.00% women had knowledge about cervical cancer. About 82.00% women had positive attitude about cervical cancer screening & it’s vaccine. Conclusions: Women need more information about cervical cancer risk factors, symptoms and screening program. Keywords: Cervical cancer, awareness, screening.

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Challenges and opportunities to reduce the burden of cervical cancer in a low income, high HIV prevalence context

10.21203/rs.2.20620/v1 ◽

2020 ◽

Author(s):

Adebola Alade Adedimeji ◽

Rogers Ajeh ◽

Amanda Pierz ◽

Relindis Nkeng ◽

Jackson Jr. Nde ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Focus Group ◽

Cancer Prevention ◽

Cervical Cancer Screening ◽

Hiv Prevalence ◽

Structural Factors ◽

Focus Group Discussions ◽

Group Discussions ◽

Depth Interviews

Abstract BackgroundCervical cancer is a leading cause of death among Cameroon women. The burden of cervical cancer is in part traceable to the inadequate understanding of contextual determinants of access to expanding screening and prevention opportunities. We explored multilevel individual, community and structural factors that facilitate or inhibit cervical cancer prevention in women at risk in a high HIV prevalence context. MethodsWe utilized an exploratory qualitative approach to obtain data through focus group discussions and in-depth interviews. A two-stage sampling strategy was used to select 80 women and 20 men who participated in 8 focus group discussions and 8 in-depth interviews. The socio-ecological model guided the analysis of data to identify micro, meso and macro level determinants of cervical cancer screening. ResultsMicro-level factors-low level of awareness and knowledge about cervical cancer, lack of access to information about screening, low risk perceptions, poor health seeking behaviors and excessive cost of cervical cancer screening were major barriers for women seeking cervical cancer screening. Meso-level factors, such as social networks, socio-cultural norms, perceptions of the role of men and HIV-related stigma when screening is integrated into HIV care, also engender negative attitudes and behaviors. Poorly equipped health facilities and a lack of national cancer prevention policies and programs were among macro-level barriers limiting access to cervical cancer screening. ConclusionThe success of efforts to reduce the burden of cervical cancer in Cameroon rests on eliminating the myriad individual, familial, community and structural factors that limit access to screening among women in the study communities.

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Barriers and opportunities for management of shared sanitation facilities in low-income settlements in Kenya

10.21203/rs.2.20081/v2 ◽

2020 ◽

Author(s):

Sheillah Simiyu ◽

Raphael M. Kweyu ◽

Prince Antwi-Agyei ◽

Kwaku A. Adjei

Keyword(s):

Low Income ◽

Monitoring Program ◽

Sub Saharan Africa ◽

Group Discussions ◽

Social Challenges ◽

Risk Of Disease ◽

Joint Monitoring ◽

Sub Saharan ◽

Barriers And Opportunities ◽

Depth Interviews

Abstract Background: Sharing of sanitation is commonly being practiced in low income areas in Sub Saharan Africa. However, the Joint Monitoring Program (JMP) categorizes shared sanitation as a limited sanitation service. These shared facilities are often the only option available for most of the residents in low income settlements, and improving their management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved management of shared sanitation in low income settlements of Kisumu in Kenya. Methods: Thirty-nine In-depth interviews and 11 focus group discussions were held with residents, who mainly included tenants and landlords. Analysis followed a thematic approach to define the problem, specify the target behaviour and define what needs to change. Results: Pit latrines were commonly shared among landlords and tenants. Shared sanitation facilities were unclean due to poor use and lack of cleaning. Participants identified behavioural challenges such as poor use of the shared toilets, and social challenges such as lack of cooperation in cleaning. These results led to identification of opportunities for improvement such as instituting clear cleaning plans, communication among users, and problem solving mechanisms between landlords and tenants. These approaches could form the basis for designing intervention strategies for improving the management of shared sanitation. Conclusion: The results highlight the need to focus on social aspects for improvement of shared sanitation management in low income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to afford the millions of low income dwellers an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the JMP’s recommendation for high quality shared facilities.

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Barriers and opportunities for management of shared sanitation facilities in low-income settlements in Kenya

10.21203/rs.2.20081/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Sheillah Simiyu ◽

Raphael M. Kweyu ◽

Prince Antwi-Agyei ◽

Kwaku A. Adjei

Keyword(s):

Low Income ◽

Sub Saharan Africa ◽

Group Discussions ◽

Open Defecation ◽

Key Stakeholders ◽

Social Opportunities ◽

Risk Of Disease ◽

Sub Saharan ◽

Barriers And Opportunities ◽

Depth Interviews

Abstract Background Sharing of sanitation is commonly being practiced in low income areas in Sub Saharan Africa. However, the JMP categorizes shared sanitation as a limited sanitation service due to concerns of cleanliness and safety. The shared facilities are often the only option available for most of the residents in low income settlements, and improving the management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved management of shared sanitation in low income settlements of Kisumu in Kenya.Methods Thirty nine In-depth interviews and 11 Focus group discussions were held with residents, including tenants and landlords. Analysis followed a thematic approach to define the problem, specify the target behaviour and define what needs to change.Results Pit latrines were commonly shared among landlords and tenants. Shared sanitation facilities were unclean due to poor use and lack of cleaning. As respondents specified attributes of clean and useable shared toilets, they also identified behavioural, physical, social and motivational opportunities for improvement, and the key stakeholders that should be involved in shared sanitation interventions. Social opportunities such as clear cleaning plans, communication, and problem solving mechanisms between landlords and tenants were most commonly reported.Conclusion The results highlight the need to focus on social aspects for improvement of shared sanitation management in low income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to afford the millions of low income dwellers an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the JMP’s recommendation for well managed shared facilities.

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Barriers and opportunities for cleanliness of shared sanitation facilities in low-income settlements in Kenya

BMC Public Health ◽

10.1186/s12889-020-09768-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Sheillah N. Simiyu ◽

Raphael M. Kweyu ◽

Prince Antwi-Agyei ◽

Kwaku A. Adjei

Keyword(s):

Low Income ◽

Sub Saharan Africa ◽

World Health ◽

Group Discussions ◽

Kisumu City ◽

Risk Of Disease ◽

Joint Monitoring ◽

Sub Saharan ◽

Barriers And Opportunities ◽

Depth Interviews

Abstract Background The sharing of sanitation facilities is a common practice in low-income areas in sub-Saharan Africa. However, shared sanitation is currently categorized as a limited sanitation service, and may therefore not count towards meeting the global goals. These shared facilities are often the only option available for most residents in low-income settlements, and improving their cleanliness and overall management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved cleanliness of shared sanitation facilities in low-income settlements of Kisumu city, Kenya. Methods Thirty-nine in-depth interviews and 11 focus group discussions were held with residents – mainly tenants and landlords – of a low-income settlement in Kisumu. Analysis followed a thematic approach to define the problem, specify the target behaviour and identify the changes needed. Results Sanitation facilities were mainly pit latrines, typically shared among landlords and tenants. Participants singled out behavioural (poor use of the shared toilets) and social (lack of cooperation in cleaning) challenges that led to unclean shared toilets. Available opportunities for improvement included instituting clear cleaning plans, improving communication among users, and enhanced problem-solving mechanisms between landlords and tenants. These approaches could form the basis for designing intervention strategies for improving the cleanliness of shared sanitation facilities. Conclusion The results highlight the need to focus on social aspects for improvement of cleanliness in shared sanitation facilities in low-income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to provide the millions of low-income residents in Kenya an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the World Health Organization’s (WHO) Joint Monitoring Program’s (JMP) recommendation for high quality shared facilities.

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Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context

BMC Women s Health ◽

10.1186/s12905-021-01211-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Adebola Adedimeji ◽

Rogers Ajeh ◽

Amanda Pierz ◽

Relindis Nkeng ◽

Jackson Ndenkeh ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Focus Group ◽

Cancer Prevention ◽

Cervical Cancer Screening ◽

Low Income ◽

Focus Group Discussions ◽

Group Discussions ◽

Challenges And Opportunities ◽

Depth Interviews

Abstract Background Cervical cancer is a leading cause of death among Cameroon women. The burden of cervical cancer is in part traceable to the inadequate understanding of socio-contextual determinants of access to screening and prevention opportunities. We explored multilevel individual, community and structural factors that facilitate or inhibit cervical cancer prevention in women at risk in a low-income, high HIV prevalence context. Methods We utilized an exploratory qualitative approach to obtain data through focus group discussions and in-depth interviews from May to August, 2018. A two-stage purposive sampling strategy was used to select 80 women and 20 men who participated in 8 focus group discussions and 8 in-depth interviews. The socio-ecological model guided data analyses to identify micro-, meso-, and macro-level determinants of cervical cancer screening. Results Micro-level factors including lack of awareness and knowledge about cervical cancer, lack of access to information, excessive cost of cervical cancer screening, low risk perceptions, and poor health seeking behaviors were major barriers for women seeking cervical cancer screening. Meso-level factors, such as social networks, socio-cultural norms, perceptions of the role of men and HIV-related stigma when screening is integrated into HIV care, also engender negative attitudes and behaviors. Macro-level barriers to cervical cancer screening included poorly equipped health facilities and a lack of national cancer prevention policies and programs. Conclusion In the context of the call for elimination of cervical cancer as a public health problem, our findings highlight challenges and opportunities that should be considered when implementing interventions to increase uptake of cervical cancer screening in low-middle income settings.

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A novel external beam radiotherapy method for cervical cancer patients using virtual straight or bending boost areas; an in-silico feasibility study

Radiation Oncology ◽

10.1186/s13014-021-01838-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Luca Cozzi ◽

Sushil Beriwal ◽

Esa Kuusela ◽

Supriya Chopra ◽

Hester Burger ◽

...

Keyword(s):

Cervical Cancer ◽

At Risk ◽

Organs At Risk ◽

External Beam Radiotherapy ◽

Locally Advanced ◽

Target Volume ◽

Cervix Uteri ◽

External Beam ◽

Dose Volume Histograms ◽

Variable Position

Abstract Aim To investigate the potential role of a novel spatially fractionated radiation therapy (SFRT) method where heterogeneous dose patterns are created in target areas with virtual rods, straight or curving, of variable position, diameter, separation and alignment personalised to a patient’s anatomy. The images chosen for this study were CT scans acquired for the external beam part of radiotherapy. Methods Ten patients with locally advanced cervical cancer were retrospectively investigated with SFRT. The dose prescription was 30 Gy in 5 fractions to 90% target volume coverage. Peak-and-valley (SFRT_1) and peak-only (SFRT_2) strategies were applied to generate the heterogeneous dose distributions. The planning objectives for the target (CTV) were D90% ≥ 30 Gy, V45Gy ≥ 50–55% and V60Gy ≥ 30%. The planning objectives for the organs at risk (OAR) were: D2cm3 ≤ 23.75 Gy, 17.0 Gy, 19.5 Gy, 17.0 Gy for the bladder, rectum, sigmoid and bowel, respectively. The plan comparison was performed employing the quantitative analysis of the dose-volume histograms. Results The D2cm3 was 22.4 ± 2.0 (22.6 ± 2.1) and 13.9 ± 2.9 (13.2 ± 3.0) for the bladder and the rectum for SFRT_1 (SFRT_2). The results for the sigmoid and the bowel were 2.6 ± 3.1 (2.8 ± 3.0) and 9.1 ± 5.9 (9.7 ± 7.3), respectively. The hotspots in the target volume were V45Gy = 43.1 ± 7.5% (56.6 ± 5.6%) and V60Gy = 15.4 ± 5.6% (26.8 ± 6.6%) for SFRT_1 (SFRT_2). To account for potential uncertainties in the positioning, the dose prescription could be escalated to D90% = 33–35 Gy to the CTV without compromising any constraints to the OARs Conclusion In this dosimetric study, the proposed novel planning technique for boosting the cervix uteri was associated with high-quality plans, respecting constraints for the organs at risk and approaching the level of dose heterogeneity achieved with routine brachytherapy. Based on a sample of 10 patients, the results are promising and might lead to a phase I clinical trial.

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Challenges and opportunities associated with cervical cancer screening programs in a low income, high HIV prevalence context

10.21203/rs.2.20620/v3 ◽

2021 ◽

Author(s):

Adebola Alade Adedimeji ◽

Rogers Ajeh ◽

Amanda Pierz ◽

Relindis Nkeng ◽

Jackson Jr. Nde ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Focus Group ◽

Cancer Prevention ◽

Cervical Cancer Screening ◽

Hiv Prevalence ◽

Focus Group Discussions ◽

Group Discussions ◽

Challenges And Opportunities ◽

Depth Interviews

Abstract Background Cervical cancer is a leading cause of death among Cameroon women. The burden of cervical cancer is in part traceable to the inadequate understanding of contextual determinants of access to expanding screening and prevention opportunities. We explored multilevel individual, community and structural factors that facilitate or inhibit cervical cancer prevention in women at risk in a high HIV prevalence context. Methods We utilized an exploratory qualitative approach to obtain data through focus group discussions and in-depth interviews from May to August, 2018. A two-stage systematic sampling strategy was used to select 80 women and 20 men who participated in 8 focus group discussions and 8 in-depth interviews. The socio-ecological model guided data analyses to identify micro-, meso-, and macro-level determinants of cervical cancer screening. Results Micro-level factors including lack of awareness and knowledge about cervical cancer, lack of access to information on and excessive costs for cervical cancer screening, low risk perceptions, and poor health seeking behaviors were major barriers for women seeking cervical cancer screening. Meso-level factors, such as social networks, socio-cultural norms, perceptions of the role of men and HIV-related stigma when screening is integrated into HIV care, also engender negative attitudes and behaviors. Macro-level barriers to cervical cancer screening included poorly equipped health facilities and a lack of national cancer prevention policies and programs. Conclusion In the context of the call for elimination of cervical cancer as a public health problem, our findings highlight challenges and opportunities that should be considered when implementing interventions to increase uptake of cervical cancer screening in low-middle income settings.

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Comprehensive Knowledge towards Cervical Cancer and Associated Factors among Women in Durame Town, Southern Ethiopia

Journal of Cancer Epidemiology ◽

10.1155/2020/4263439 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Biruktawit F. Woldu ◽

Lidiya G. Lemu ◽

Debiso E. Mandaro

Keyword(s):

Cervical Cancer ◽

Health Professionals ◽

Associated Factors ◽

Multiple Logistic Regression Analysis ◽

Reproductive Age ◽

Sub Saharan Africa ◽

Good Knowledge ◽

Outcome Variable ◽

Southern Ethiopia ◽

Comprehensive Knowledge

Low awareness about cervical cancer and poor screening practice are some of the contributing factors for the high burden of cervical cancer in sub-Saharan Africa. The aim of this study was to assess comprehensive knowledge towards cervical cancer and associated factors among reproductive age women visiting Durame General Hospital. Institution-based cross-sectional study was conducted in April 2019. Systematic random sampling technique was employed to select study participants. Pretested interviewer administered questionnaire was used for data collection. Binary and multiple logistic regression analysis was done. Adjusted odds ratio with a 95% CI was used to determine the presence and strength of associations between independent and outcome variable. Variables with p value less than 0.05 were considered as statistically significant. Among the 237 women enrolled, more than half (55.7%) have ever heard about cervical cancer. Health professionals were major source of information. Half of respondents (51.5%) had good knowledge towards cervical cancer. Urban residence ( AOR = 2.28 , 95% CI (1.19-4.35)), having formal employment ( AOR = 2.92 , 95% CI (1.53-5.59)), and knowing someone with cervical cancer ( AOR = 5.21 , 95% CI (2.32-11.71)) were found to have significant association with good knowledge towards cervical cancer. The comprehensive knowledge of women towards cervical cancer was found to be insufficient. Provision of community-based health education with health professionals needs to be emphasized.

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