Client perception of the quality of cervical cancer screening services at a centre in South-South Nigeria.
Zakaa Zawua1*, Nkencho Osegi1, Stephen Musa2, Peter Waripamo Oweisi1, Daniel Ugochukwu Obodo1
1Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.
2Department of Pathology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.
*Correspondence: Dr. Zakaa Zawua; +234 806 806 4981; firstname.lastname@example.org
Download full article in pdf format
Background: The burden of cervical cancer unevenly rests on the developing world. It is estimated that about 80% of the nearly 500,000 incident cases and 273,000 deaths occur in developing countries.
Approximately 5% of these deaths occur in Nigeria. This bleak picture is further worsened by the lack of population-wide screening services for premalignant lesions of the cervix, cost implications in a vastly uninsured population and the concurrent HIV/AIDS pandemic.
Patients’ perception of the quality of cervical cancer screening could be the link to the poor utilisation of these services in Nigeria and possibly the developing world.
Objective: The study objective was to critically evaluate patients’ perception of the quality of cervical cancer screening services and compare their perception to their socio-demographic characteristics.
Materials and Methods: This is a cross-sectional study. Clients who had Pap smear test between 2013 and 2018 were oﬀered a phone-based semi structured questionnaire evaluating their economic and demographic characteristics, and perception of the quality of the test.
Results: Of the 149 respondents 79.9% were married, 67.8% had a high socioeconomic status and 55.7% sought cervical screening as routine check-up. About 16% of respondents reported both ‘good’ and ‘very poor’ levels of satisfaction. 71.8%, 61.7% and 41.6% of respondents declared good level of satisfaction with doctors’, nurses’ and laboratory staﬀ’s attitude respectively. The odds of experiencing good satisfaction were increased among married respondents (OR = 2.30; 95% CI: 1.01 – 5.21; p -.046), in high SES (OR – 2.97; 95% CI:1.36 – 6.47; p – .006) and those seeking cervical screening on routine check (OR – 2.59; 95% CI:1.21 – 5.56; p – 0.015) or on doctor’s request (OR – 3.95; 95% CI:1.34 – 11.60; p – 0.013).
Conclusions: Poor uptake of cervical cancer screening is still a public health issue in most of the developing world. In this study, our model has shown that the perception of the quality of cervical cancer screening services amongst ﬁrst time clients need some improvement. We therefore recommend an improvement in the attitude of health care workers and a better overall explanation of screening processes.
Keywords: Cervical cancer, Developing world, Premalignant lesions, Screening.
Cite this article: Zauwa Z, Osegi N, Musa S, Oweisi PW, Obodo DU. Client perception of the quality of cervical cancer screening services at a centre in South-South Nigeria. Yen Med J. 2020;2(1):50-57.
- Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–2917.
- Bruni L, Albero G, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in Nigeria. Summary Report 17 June 2019. Available from: https://hpvcentre.net/statistics/reports/NGA.pdf. Accessed December 18, 2019.
- Okunowo AA, Daramola ES, Soibi-Harry AP, Ezenwankwo FC, Kuku JO, Okunade KS, et al. Women’s knowledge of cervical cancer and uptake of Pap smear testing and the factors influencing it in a Nigerian tertiary hospital. J Cancer Res Pract. 2018;5(3):105–111.
- Awosusi A, Folaranmi T, Yates R. Nigeria’s new government and public financing for universal health coverage. Lancet Glob Health. 2015;3(9):514–515.
- Clifford GM, de Vuyst H, Tenet V, Plummer M, Tully S, Franceschi S. Effect of HIV infection on human papillomavirus types causing invasive cervical cancer in Africa. J Acquir Immune Defic Syndr. 2016;73(3):332-338.
- Ghittoni R, Accardi R, Chiocca S, Tommasino M. Role of human papillomaviruses in carcinogenesis. Ecancermedicalscience. 2015;9:526. DOI:10.3332/ecancer.2015.526
- Crosbie EJ, Einstein MH, Franceschi S, Kitchener HC. Human papillomavirus and cervical cancer. Lancet. 2013;382(9895):889– 899.
- Kyrgiou M, Shafi MI. Colposcopy and cervical intraepithelial neoplasia. Obstet Gynaecol Reprod Med. 2014;24(7):204–214.
- Vilos GA. The history of the Papanicolaou smear and the odyssey of George and Andromache Papanicolaou. Obstet Gynecol. 1998;91(3):479–483.
- Catarino R, Petignat P, Dongui G, Vassilakos P. Cervical cancer screening in developing countries at a crossroad: Emerging technologies and policy choices. World J Clin Oncol. 2015;6(6):281-287.
- Ezem B U. Awareness and uptake of cervical cancer screening in Owerri, South-Eastern Nigeria. Ann Afr Med. 2007;6:94–98.
- Idowu A, Olowookere SA, Fagbemi AT, Ogunlaja OA. Determinants of cervical cancer screening uptake among women in Ilorin, North Central Nigeria: a community-based study. J Cancer Epidemiol. 2016;2016:Article ID 6469240. Available from: https://doi.org/10.1155/2016/6469240. Accessed December 18, 2019.
- Hyacinth HI, Adekeye OA, Ibeh JN, Osoba T (2012) Cervical Cancer and Pap Smear Awareness and Utilization of Pap Smear Test among Federal Civil Servants in North Central Nigeria. PLoS ONE. 7(10):e46583
- Benedet JL, Bender H, Jones III H, Ngan HYS, Pecorelli S. Staging classifications and clinical practice guidelines of gynaecologic cancers. Int J Gynecol Obstet. 2000;70:207–312.
- Ilioudi S, Lazakidou A, Tsironi M. Importance of patient satisfaction measurement and electronic surveys: methodology and potential benefits. Int J Health Res Innov. 2013;1(1):67–87.
- Lim JN, Ojo AA. Barriers to utilisation of cervical cancer screening in Sub Sahara Africa: a systematic review. Eur J Cancer Care. 2017;26(1):e12444.
- Oyedeji G, Socio-economic and cultural background of hospitalized children in Ilesha, Nig Med Pract. 1985;12:111–117.
- Anderson EW. Customer satisfaction and word of mouth. J Serv Res. 1998;1(1):5–17.
- Maseko FC, Chirwa ML, Muula AS. Client satisfaction with cervical cancer screening in Malawi. BMC Health Serv Res. 2014;14(1):420-426.
- Ngugi CW, Boga H, Muigai AW, Wanzala P, Mbithi JN. Factors affecting uptake of cervical cancer early detection measures among women in Thika, Kenya. Health Care Women Int. 2012;33(7):595–613.
- Ndikom CM, Ofi BA. Awareness, perception and factors affecting utilization of cervical cancer screening services among women in Ibadan, Nigeria: a qualitative study. Reprod 2012;9(1):11.
- Mutyaba T, Faxelid E, Mirembe F, Weiderpass E. Influences on uptake of reproductive health services in Nsangi community of Uganda and their implications for cervical cancer screening. Reprod Health. 2007;4(1):4.
- Gatune JW, Nyamongo IK. An ethnographic study of cervical cancer among women in rural Kenya: is there a folk causal model? Int J Gynecol Cancer. 2005;15(6):1049–1059.
- Fort VK, Makin MS, Siegler AJ, Ault K, Rochat R. Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study. Patient Prefer Adherence. 2011;5:125-131.
- William M, Kuffour G, Ekuadzi E, Yeboah M, El Duah M, Tuffour P. Assessment of psychological barriers to cervical cancer screening among women in Kumasi, Ghana using a mixed methods approach. Afr Health Sci. 2013;13(4):1054–1061.