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

Abstract

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

Awareness and Utilization of Cervical Cancer Screening Among Primary Health Care Workers in Ilesa, Osun State

“…The findings of the study revealed that the level of utilization of cervical cancer screening services was moderate Ifemelumma, et al (2019) however noted that the uptake of cancer of the cervix screening services was poor with only 20.6% having been screened. Okolie, et al (2021) revealed that CCS uptake was poor with common barriers being the cost of screening, fear of positive results, lack of test awareness, reluctance to screen, low-risk perception, and lack of time.…”

Addressing missed opportunities for cervical cancer screening in Nigeria: a nursing workforce approach

“…Nigeria’s weak health system and lack of a cervical cancer control policy that facilitates a roadmap for the country’s fight against cervical cancer are considered principal problems [ 13 , 14 ]. Similarly, factors such as poor awareness, low-risk perception, poverty, lack of female providers, fear of positive screening result and sociocultural norms contribute immensely to poor uptake of CCS services among Nigerian women [ 15 , 20 ].…”

“…The role of health workers, especially female nurses, in tackling Nigeria’s rising cervical cancer burden has been a vital part of ongoing calls to maximise opportunistic screening activities [ 15 , 16 ]. Traditionally, female nurses, including midwives, play a critical role in the delivery of reproductive health services, including CCS services, to eligible women [ 26 – 28 ].…”

“…Previous cervical cancer-related studies with a focus on nurses mostly explored knowledge, attitude and screening practices without assessing their involvement in CCS service delivery [ 29 – 31 ]. Surprisingly, in a systematic review by Okolie et al [ 15 ], Nigerian female health workers, including nurses, were reported to have poor screening practices as those who have never screened ranged from 45.9% to 97%. This abysmal screening rate among health workers, especially nurses who are expected to be role models in screening uptake, portends danger in reversing the disease trend.…”

“…This target serves as a rallying call for countries to fully vaccinate 90% of girls against HPV, screen 70% of women by 35 years and again by 45 years of age and 90% of women with precancer or invasive cervical cancer treatment [ 1 ]. Meeting these targets in Nigeria will rely on a concerted health system policy and programme that are driven by a strong political commitment [ 14 , 15 ]. Therefore, this article explores a nursing workforce approach towards tackling missed opportunities for CCS and reducing the burden of the disease in Nigeria.…”