Background:
The WHO supported a study of the effectiveness and acceptability of VIA and Cryotherapy in six African countries including Nigeria. The Nigerian project site was based in Ogun State.
Aim:
To evaluate the impact of the adoption of Visual Inspection with Acetic Acid (VIA) and Cryotherapy and identify the characteristics for effective implementation of cervical cancer screening programme in Nigeria
Method:
2000 women and 31 trained health workers in cervical screening were interviewed using self-validated questionnaires; 10 cervical screening centres were also assessed using standard check lists
Results:
Awareness of cervical cancer and screening are very low (6.5% and 4.8% respectively). Only 2.3% could identify a virus as the cause of cervical cancer while 4.1% identified cervical screening as a way to prevent cervical cancer. 97.7% and 97.9% had no or poor knowledge of risk factors and knowledge of symptoms of cervical cancer. 90.5% identified lack of awareness as the barrier to uptake of cervical screening. 1.4% of the women have had cervical screening done. 96% of the women would like to have cervical screening done. 74.2% of health workers had a good understanding of VIA and 70.7% of them knew what to do with a positive screening result. 48.4% of trained health workers were no longer involved with cervical screening. 87.1% of the health workers lacked access to adequate support. Cost is not a determinant of number of patients accessing VIA services at the facilities (P=0.38).
Conclusions:
Awareness and knowledge of cervical cancer is very poor. Uptake of cervical screening is even poorer. Most women desire cervical screening. Health workers have good understanding of cervical screening and the health facilities are adequately equipped for cervical screening. The major barriers to uptake of screening services are low level of awareness, lack of support by local and state government and huge health staff turnover.