What do healthcare providers know about human papillomavirus (HPV) and
                        cervical cancer? a cross-sectional knowledge assessment in Debre Markos,
                        Ethiopia

Raboteau, S.; Magan, Yimdriuska; Sisay, Abinet; Mahmoud, Eiman; Burrowes, Sahai

doi:10.1016/j.aogh.2016.04.041

Cited by 1 publication

(3 citation statements)

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“…Moreover, as other studies in low-income settings have found provider knowledge of cervical cancer screening and treatment best practice is patchy, particularly for mid-level providers [ 17 , 24 , 28 , 30 , 50 – 54 ]. For example, an internal evaluation in 2015 that we conducted at Debre Markos Referral Hospital (one of the facilities sampled in this study) found that knowledge of different screening and treatment procedures was inconsistent and varied significantly by profession with only 57% of respondents in able to identify cryotherapy as a treatment method, and only 48% of nurses able to identify VIA as a screening method, even though these are recommended practices in Ethiopia [ 29 ]. Almost 40% of nurses and midwives in that evaluation were not able to identify vaginal discharge as a symptom of cervical cancer; one-third could not identify abdominal pain, and almost 70% of all midlevel providers were not aware that cervical cancer could be asymptomatic [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…For example, an internal evaluation in 2015 that we conducted at Debre Markos Referral Hospital (one of the facilities sampled in this study) found that knowledge of different screening and treatment procedures was inconsistent and varied significantly by profession with only 57% of respondents in able to identify cryotherapy as a treatment method, and only 48% of nurses able to identify VIA as a screening method, even though these are recommended practices in Ethiopia [ 29 ]. Almost 40% of nurses and midwives in that evaluation were not able to identify vaginal discharge as a symptom of cervical cancer; one-third could not identify abdominal pain, and almost 70% of all midlevel providers were not aware that cervical cancer could be asymptomatic [ 29 ]. Providers’ poor knowledge of symptoms and lack of knowledge of appropriate protocols may explain why so many of the women in our sample were initially misdiagnosed.…”

Section: Discussionmentioning

confidence: 99%

“…Among Ethiopian health care workers, studies have found knowledge of cervical cancer to be high [ 24 , 28 ], and a strong belief that cervical cancer screening is an essential part of women’s health care [ 24 ]. However, this knowledge may still be patchy and unevenly distributed among health care providers, with nurses, midwives, and health officers having significantly lower cervical cancer knowledge than physicians [ 29 ]. Most health care workers lack training in the provision of cervical cancer care, and fewer still have provided screening [ 24 , 28 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

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Perceptions of cervical cancer care among Ethiopian women and their providers: a qualitative study

et al. 2022

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Background Cervical cancer is the second most commonly diagnosed cancer among Ethiopian women, killing an estimated 4700 women each year. As the government rolls out the country’s first national cancer control strategy, information on patient and provider experiences in receiving and providing cervical cancer screening, diagnosis, and treatment is critical. Methods This qualitative study aimed to assess the availability of cervical cancer care; explore care barriers and sources of delay; and describe women’s and providers’ perceptions and experiences of care. We analyzed data from 45 informants collected at 16 health centers, district hospitals and referral hospitals in East Gojjam Zone and a support center in Addis Ababa. Thirty providers and ten women receiving care were interviewed, and five women in treatment or post-treatment participated in a focus group discussion. Deductive and inductive codes were used to thematically analyze data. Results Providers lacked equipment and space to screen and treat patients and only 16% had received in-service cervical cancer training. Consequently, few facilities provided screening or preventative treatment. Patients reported low perceptions of risk, high stigma, a lack of knowledge about cervical cancer, and delayed care initiation. All but one patient sought care only when she became symptomatic, and, pre-diagnosis, only half of the patients knew about cervical cancer. Even among those aware of cervical cancer, many assumed they were not at risk because they were not sexually active. Misdiagnosis was another common source of delay experienced by half of the patients. Once diagnosed, women faced multiple-month waits for referrals, and, once in treatment, broken equipment and shortages of hospital beds resulted in additional delays. Barriers to therapeutic treatment included a lack of housing and travel funds. Patient-provider communication of cancer diagnosis was often lacking. Conclusions In-service provider training should be intensified and should include discussions of cervical cancer symptoms. Better distribution of screening and diagnostic supplies to lower-level facilities and better maintenance of treatment equipment at tertiary facilities are also a priority. Expanded cervical cancer health education should focus on stigma reduction and emphasize a broad, wide-spread risk of cervical cancer.

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