Knowledge, Attitudes and Practices Regarding Cervical Cancer Screening Among Village Health Volunteers

Abstract

Background: In the years 2014, coverage rates of cervical cancer screening in Nakornnayok province accounted to 76.5%. This was lower than the government's specified goal of 80%. Community health volunteers are members of a Thai healthcare alliance established to help promoting healthcare service communication and collaboration at the primary level. Such village health volunteers (VHVs) are established in most villages. Objective: To assess the knowledge and attitudes of cervical cancer screening among VHVs. Materials and Methods: The subjects were 128 VHVs from four Nakornnayok sub-districts; namely KlongYai, Chomphol, Buangsan and Suksara, Thailand. The study was conducted from December 2014 to January 2015. The questionnaire was designed to assess the knowledge and attitude of cervical cancer screening provided by the VHVs. In addition, cervical cancer screening coverage rates of each area were collected. The demographic data, scores of knowledge, attitudes, practices and the cervical cancer screening coverage rates were analyzed by one-way ANOVA. Results: The questionnaire reliability was assessed as 0.81. The total knowledge and attitude scores were 10 and 15 points. The mean knowledge scores of KlongYai, Chomphol, Buangsan and Suksara were 6.8, 7.0, 6.5 and 9.0 points, respectively. The VHVs had a high level of overall knowledge about cervical cancer screening. The mean attitude scores were 12.4, 13.2, 13.4 and 13.1 points. VHVs had a positive attitude to the promotion of cervical cancer screening at the overall level. The percentages of VHVs promoting cervical cancer information in respective districts were 72.2, 94.3, 94.9 and 50.0. However, the cervical cancer screening coverage rates were 62.4%, 34.7%, 80.3% and 47.3% respectively. Conclusions: The knowledge, attitudes and percentages of promoting information of cervical cancer screening among VHVs in the four sub-districts were high but did not correlate with the cervical screening coverage rates for each area. VHVs needed to understand socio-cultural beliefs of the women in the target population and design suitable strategies to encourage higher cervical screening coverage.

The role of community health workers in cervical cancer screening in low-income and middle-income countries: a systematic scoping review of the literature

“…At the end of the screening process, 15 peer-reviewed studies remained for inclusion in the final review, of which one originated from snowball sampling, and one from the grey literature 5 22–35…”

“…Different modalities of screening were used across the 15 studies. Pap smears were the most common modality offered (n=6),5 24–27 34 followed by dual or mixed screening modalities (using a combination of Pap smears, VIA or HPV-DNA) (n=5),23 29 32 33 35 HPV-DNA sampling only (n=3),22 30 31 and VIA only (n=1) 28…”

“…The most common role for CHWs was to carry out education, outreach, or awareness raising activities (n=14) 5 22 24–35. Home-based community outreach programmes were described in studies in El Salvador and Iran 22 25.…”

“…In five studies, CHWs played a role in the actual cervical screening process, either through performing cervical screening or in assisting specialist medical staff 5 23 32 34 35. In Nigeria, CHWs were trained to carry out screening using VIA under supervision, and link positive cases for cryotherapy 23.…”

“…These methods included HPV testing and visual inspection of the cervix by trained health workers. This policy has been adopted by some LMICs, for example in Thailand, where the Thai Ministry of Public Health recommend that women aged between 30 and 60 should be screened every 5 years by any available method 5…”