Improving community health volunteers’ knowledge on cervical cancer using dialogue-based training in rural Kisumu County

Edwin Onyango Ochomo, David Masinde, Collins Ouma
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Abstract

Abstract Background The global burden of cervical cancer continue to rise with the low- and middle-income countries bearing the greatest burden. East Africa recorded about 54560 cases and 36497 deaths attributed to cervical cancer in 2020 with 5236 cases and 3211 deaths being reported annually. This high burden can be attributed to low screening rates and late diagnosis, which lead to undesirable outcomes. Kenya still has low screening rates with only 16.4% of the eligible women screened against the WHO target of 70% by 2030. Kisumu has a lower screening rate of about 5.7% according to KHIS 2019 data. This low screening rate is due to lack of proper community health education. We evaluated the effectiveness of dialogue-based training in improving community health volunteers’ (CHV) knowledge on cervical cancer in Nyando. Methods The study adopted a pre-and-post, longitudinal study design. The CHVs knowledge was assessed before and after the training. We calculated the proportion net change in the number of CHVs with improved knowledge after the intervention. Statistical significance was assessed at p ≤ 0.05. Results The pre-test mean score was 30.1%, this improved to 53.4% at post-test following the dialogue-based training of the CHVs. The knowledge on the various aspects: risk factors ( p < 0.0001), signs and symptoms ( p < 0.0001) and screening ( p < 0.0001) significantly improved at the post-test following the dialogue-based training. The overall score also significantly improved (p < 0.0001) following the training among the CHVs. Occupation ( p < 0.0001) was found to be significantly associated with knowledge on cervical cancer. Conclusion The CHVs’ knowledge was inadequate but significantly improved following the dialogue-based training.
在基苏木县农村开展以对话为基础的培训,提高社区卫生志愿者对宫颈癌的认识
全球宫颈癌负担持续上升,中低收入国家负担最重。2020年,东非录得约54560例宫颈癌病例和36497例死亡,每年报告5236例病例和3211例死亡。这种高负担可归因于低筛查率和晚期诊断,从而导致不良后果。肯尼亚的筛查率仍然很低,只有16.4%的合格妇女接受了筛查,而世卫组织的目标是到2030年达到70%。根据KHIS 2019年的数据,基苏木的筛查率较低,约为5.7%。这种低筛查率是由于缺乏适当的社区卫生教育。我们评估了以对话为基础的培训在提高尼扬多社区卫生志愿者(CHV)对宫颈癌知识方面的有效性。方法采用前后、纵向研究设计。在培训前后对chv知识进行评估。我们计算了干预后知识水平提高的chv人数的净变化比例。p≤0.05,差异有统计学意义。结果测试前平均得分为30.1%,在基于对话的chv培训后提高到53.4%。各方面的知识:风险因素(p <0.0001),体征和症状(p <0.0001)和筛选(p <0.0001)在基于对话的训练之后的后测试中显著提高。总体得分也显著提高(p <0.0001)。职业(p <0.0001)与对子宫颈癌的了解程度显著相关。结论在对话培训后,chv的知识水平有了明显提高。
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