WILLINGNESS TO SCREEN FOR CERVICAL CANCER AND THE DETERMINANTS AMONG PRIMARY HEALTH CARE WORKERS IN IBADAN NORTH LOCAL GOVERNMENT AREA, NIGERIA

Abstract

Cervical cancer is the fourth most common cancer in women, with an estimated 528,000 new cases occurring globally. Cervical cancer screening has therefore been established as an effective instrument in early detection for cervical cancer. Health workers are often times looked upon as "role models" in health related issues such as the need for uptake of cervical cancer screening services. Their attitude to and practice relating to such issues might positively or negatively influence the decision made by the community members. This study therefore aimed to investigate the willingness to screen for cervical cancer and the determinants among primary health care workers in Ibadan North Local Government Area (INLG), Nigeria. This was a cross-sectional study which enrolled all 313 available and consenting female health workers at primary health care centers and private-owned health facilities in Ibadan North Local Government. Instrument used was a structured, pretested, self-administered questionnaire. Questionnaire inquired information on knowledge, utilization, and willingness to screen for cervical cancer. Data were reported using descriptive statistics, chi-square test and logistic regression analysis with significance at p ≤ 0.05. The mean age of the respondents was 33 ± 10 years. More than half of the respondents were married (55.3%) and were nurses (55%). Most of the respondents (89.8%) had a poor knowledge about cervical cancer. Less than one-third of the respondents (25.9%) and (20.4%) had done Pap smear and Visual inspection with acetic acid respectively. Also, only 15. 7% of the respondents had done cervical cytology and (13.4%) had done HPV test. Reasons given by respondents for non utilization of cervical cancer screening include; not at risk of cervical cancer (29.4%), lack of awareness of the tests (22.4%), lack of awareness of where the screening can be done (16%), lack of time for the screening (15. 7%), and financial constraint (14.4%). Those who were primiparous were 70% less likely to be willing to screen for cervical cancer relative to those who were nulliparous (OR=0.30, 95% CI = 0.13-0.71) and those who were grandmultiparous were 78% less likely to he willing to screen for cervical cancer relative to those who were nulliparous (OR=0.22, 95% CI= 0.07- 0.66). In addition, nurses/midwives were about 3 times more likely to be willing to screen for cervical cancer relative to doctors (OR= 2.82, 95% CI= 1.25-6.38). The level of knowledge of primary health care workers on cervical cancer screening methods and risk factors associated with cervical cancer was relatively low. Utilization of these screening methods was also low. A high percentage of the respondents were willing to screen for cervical cancer. It is therefore recommended that policies that encourage health workers to know and utilize cervical cancer screening methods should be introduced and education on cervical cancer and its awareness should to be properly disseminated so that the information delivered is complete.