Does introduction of user fees affect the utilization of cervical cancer screening services in Nigeria?

Nyengidiki, TK; Inimgba, N; Bassey, G; Ogu, Rosemary

doi:10.4103/njcp.njcp_257_18

Cited by 5 publications

(10 citation statements)

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“…This finding agrees with previous evidence highlighting the significant impact of socioeconomic status on the uptake of screening 63,64 . The cost of CCS which ranges from $25 to 30 (₦10 250–₦12 300) could be prohibitive as payment for the service is mostly reliant on out‐of‐pocket spending 30,65 . Considering that the cost of CCS could be up to 41% of the monthly minimum wage (₦30 000), inability to afford screening by FHWs may result from poor remuneration, competing needs, and/or poor coverage of existing health insurance schemes 50 .…”

Section: Discussionsupporting

confidence: 88%

“…63 , 64 The cost of CCS which ranges from $25 to 30 (₦10 250–₦12 300) could be prohibitive as payment for the service is mostly reliant on out‐of‐pocket spending. 30 , 65 Considering that the cost of CCS could be up to 41% of the monthly minimum wage (₦30 000), inability to afford screening by FHWs may result from poor remuneration, competing needs, and/or poor coverage of existing health insurance schemes. 50 Financial constraints may also reflect wider economic issues in a country where more than 50% of the population lives below $2 daily.…”

Section: Discussionmentioning

confidence: 99%

“…It becomes worrisome knowing that only 8.7% of all eligible women have been reached with opportunistic screening in Nigeria 26 . Such poor screening rate has been linked to a spectrum of factors; weak health system, poor awareness, low‐risk perception, sociocultural barriers, fear of positive result, poverty, and acceptability of available screening options 27–30 . Despite the emphasis on taking advantage of women's contact with the health system to provide CCS services, evidence indicates that such opportunities have been missed 28,31 …”

Section: Introductionmentioning

confidence: 99%

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Factors influencing cervical cancer screening practice among female health workers in Nigeria: A systematic review

et al. 2021

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Background: Cervical cancer is the most prevalent gynaecologic cancer in Nigeria.Despite being largely preventable through screening, cervical cancer is the second leading cause of cancer morbidity and mortality in Nigeria. To reduce the burden of cervical cancer in Nigeria, female health workers (FHWs) are expected to play an influential role in leading screening uptake and promoting access to cervical cancer education and screening. Aim: The aim of this systematic review is to assess the factors influencing cervical cancer screening (CCS) practice among FHWs in Nigeria. Methods: We conducted a systematic literature search across six (6) electronic databases namely MEDLINE, Embase, Scopus, African Index Medicus, CINAHL, and Web of Science between May 2020 and October 2020. Reference list and grey literature search were conducted to complement database search. Four reviewers screened 3171 citations against the inclusion criteria and critically appraised the quality of eligible studies. Narrative synthesis was used in summarising data from included studies. Results: Overall, 15 studies met the inclusion criteria and were all quantitative crosssectional studies. Included studies sampled a total of 3392 FHWs in Nigeria. FHWs had a high level of knowledge and positive attitude towards CCS. However, CCS uptake was poor. Predominant barriers to CCS uptake were the cost of screening, fear of positive results, lack of test awareness, reluctance to screen, low-risk perception, and lack of time. In contrast, being married, increasing age, awareness of screening methods, and physician recommendation were the most documented facilitators. Conclusion: This study revealed that a complex interplay of socioeconomic, structural, and individual factors influences CCS among FHWs in Nigeria. Therefore, implementing holistic interventions targeting both health system factors such as cost of screening and infrastructure and individual factors such as low-risk perception and

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors influencing cervical cancer screening practice among female health workers in Nigeria: A systematic review

et al. 2021

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“…Despite the scale up of CC prevention, these findings inform future efforts in terms of strengthening CC screening services utilization by increasing mass awareness campaign in both periurban and rural settings. In fact, poor conditions in which populations are living impact the success of prevention strategies, as illustrated in Burkina Faso [21] and Nigeria [22]. Therefore, strategies aiming at bringing CC screening closer to women by mitigating geographic and financial barriers in LMICs should be encouraged.…”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators in cervical cancer screening uptake in Abidjan, Côte d'Ivoire in 2018: a cross-sectional study

Boni

Gnahatin²,

Comoé³

et al. 2021

BMC Cancer

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Backgrounds Cervical cancer (CC) incidence remains unacceptably high in Côte d’Ivoire. In an effort to prevent this malignant condition, a national CC screening program has been scaled up in the country. This study aimed at assessing CC screening uptake and its associated factors in Abidjan in 2018. Methods A cross-sectional survey was conducted from July to September 2018 in the main healthcare facilities of three randomly selected out of the eight health districts of Abidjan. During the study period, a standardized questionnaire was administrated by research assistants to all women aged 25 to 55 years old, attending the three participating facilities. Demographics, knowledge on CC, personal history of CC screening and reasons for not attending CC screening were collected. A logistic regression model was computed to document factors associated with reported CC screening uptake. Results A total of 1158 women with a median age of 32 years (IQR [27–36]), including 364 (31.4%) with no formal education were included. Of those participants, 786 (67.9%) had ever heard about CC. CC screening uptake at least once was reported by 7.5% [95% CI: 6.0–9.0] participants. In multivariable analysis, being ≥45 years (aOR: 6.2 [2.3–17.2]), having a university level (aOR: 2.8 [1.2–6.6]) (versus non formal education) and access to mass campaign information (aOR: 18.2 [8.5–39.1]) were associated with a reported CC screening uptake. The main reported barriers to CC screening were unawareness towards CC screening (75.5%), negligence (20.5%), fear of CC detection (3.9%) and fear of additional costs (3.3%). Conclusion CC screening uptake remains low despite current initiatives to support awareness and prevention in Abidjan. Awareness campaigns need to be massively increased with the adjunction of tailored messages based on the level of women’s education to enhance the CC screening coverage and reach the WHO goal of CC elimination by 2030.

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“…Cervical and ovarian malignancies are the commonly encountered genital tract malignancies in developing countries with cervical cancer being the most common in virtually all developing countries where organized screening programmes are lacking [2,[5][6][7]. A hospital-based study, showed that cervical cancer was the leading cause of death among gynecological cancer patients accounting for over 44% of gynecological mortality [8].…”

Section: Introductionmentioning

confidence: 99%

Case Fatality Rate and Review of Literature on Gnaecological Cancers Mortality at a Specialiazed Oncology Unit in Port Harcourt

Bassey

Nyengidiki

Kpurunee

2022

AJMAH

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Background: Gynecological cancer is a major public health problem and an important cause of morbidity and mortality in women worldwide. There are only few researches on the overall mortality attributed to gynecological cancers in Nigeria. Objectives: To determine the case fatality rate, prevalence and reason for mortality amongst gynecological oncology patients at the oncology unit of the University of Port Harcourt Teaching Hospital (UPTH). Study Design: This was a retrospective study of mortality from gynecological cancers in UPTH between 1st January, 2014 and 31st December, 2018. Case files of patients with mortality from genital tract malignancies were reviewed and relevant information extracted Results: A total of 2070 gynecological admissions were recorded out of which 399 were gynecological cancer patients, giving a 19.3% prevalence of gynecological cancer. Fifty-six gynecological cancer related deaths were reported within the study period with an overall cancer mortality rate of 14.0%. Ovarian cancer was responsible for the highest number of deaths 48.2% with a case-fatality rate of 18.6% while cervical cancer had a case fatality rate of 13.1%. Majority of the patients 96.6% presented at advanced stage of the disease. Those with financial constraints totaled 62.5% while 89.3% had challenges accessing specialized health care. Conclusion: The study shows that the case-fatality rate of mortalities from gynaecological cancers at UPTH is very high with ovarian malignancy accounting for most deaths. Late presentation, low socioeconomic status and delay in accessing specialized health care were the main factors responsible for these mortalities. Proper screening, early diagnosis. prompt treatment and improvement in the socioeconomic status of gynaecological cancer patients will improve the case fatality rate in UPTH.

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Does introduction of user fees affect the utilization of cervical cancer screening services in Nigeria?

Cited by 5 publications

References 0 publications

Factors influencing cervical cancer screening practice among female health workers in Nigeria: A systematic review

Factors influencing cervical cancer screening practice among female health workers in Nigeria: A systematic review

Barriers and facilitators in cervical cancer screening uptake in Abidjan, Côte d'Ivoire in 2018: a cross-sectional study

Case Fatality Rate and Review of Literature on Gnaecological Cancers Mortality at a Specialiazed Oncology Unit in Port Harcourt

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