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INFLUENCE OF CERVICAL CANCER CAMPAIGNS ON THE KNOWLEDGE, ATTITUDE AND BEHAVIOUR OF WOMEN OF SOUTH-EAST NIGERIA
Abstract
Cervical cancer is one of the commonest cancer among women globally . It is the leading cause of cancer among women and kills almost on daily basis. Annually, about 14,550 are diagnosed with cervical cancer and many of them die of the disease. Studies revealed that it is due to late detection/diagnosis, poor knowledge of cancer, its preventive measures and screening techniques. Consequently, campaign managers have resorted to aggressive awareness and sensitization programmes aimed at increasing knowledge, changing attitudes and enhancing the practice of all necessary screening procedure; since success is highly dependent on the influence of these campaigns to increase knowledge; change unhealthy attitudes towards cervical cancer prevention, treatment and enhance practice of screening methods. Accordingly, this research examined the influence of cervical cancer campaigns on the Knowledge, Attitude and Practice (KAP) among women in South-East Nigeria. Using survey, the researcher employed convergent mixed method design. From the population of 8,210,604, a sample size of 413 was drawn using online sample size calculator advanced by Wimmer and Dominick, 2013. Evidence from the research shows that majority of women in the South-East are not exposed to cervical cancer campaigns and awareness level of the disease never changed their negative attitude on the disease. This led to poor practice among women in South-East Nigeria. It was suggested that government, as a matter of policy should create health-related (Public Health) course and incorporate same in the academic curricular of primary, post-primary and tertiary schools, so that life-threatening health issues can be inculcated into the students. It was also suggested that the government should embark on aggressive cervical cancer campaigns so as to ensure that the right information get to the needy vulnerable audience as timely as possible.
Table of Contents
Title page – – – – – – – – – – – i
Certification- – – – – – – – – – – ii
Dedication – – – – – – – – – – – iii
Acknowledgement – – – – – – – – – – iv
Abstract – – – – – – – – – – – v
Table of contents – – – – – – – – – – vi
CHAPTER ONE: INTRODUCTION
1.1 Background of the Study – – – – – – – – – 1
1.2 Statement of the Problem – – – – – – – – 4
1.3 Research Objectives – – – – – – – – – 4
1.4 Research Questions – – – – – – – – – 5
1.5 Significance of the Study – – – – – – – – 5
1.6 Definition of Terms – – – – – – – – – 6
1.7 References – – – – – – – – – – 7
CHAPTER TWO: REVIEW OF LITERATURE
2.1 Sources of Literature – – – – – – – – 8
2.2 Focus of Review – – – – – – – – – 8
2.3 Cancer – – – – – – – – – – 8
2.4 Cervical Cancer – – – – – – – — – 9
2.5 Mass Media and Exposure to Health Messages – – – – – – 12
2.6 Campaigns Against the Spread of Cervical Cancer – – – – – – 24
2.7 Awareness, Knowledge and Attitude of Women Towards Cervical Cancer. – 24
2.8 Challenges of early Detection, Prevention and Cure Among Women- – – 27
2.9 Theoretical Framework – – – – – – – – 28
2.10 Summary of Literature – – – – – – – – 34
2.11 References – – – – – – – – – – 35
CHAPTER THREE: RESEARCH METHODOLOGY
3.1 Research Design – – – – – – – – – – 38
3.2 Population of the Study – – – – – – – – 39
3.3 Sample Size – – – – – – – – – – 40
3.4 Sampling Techniques – – – – – – – – – 43
3.5 Sampling Techniques for Qualitative Analysis – – – – – – 46
3.6 Measuring Instruments – – – – – – – – – 46
3.7 Reliability and Validity of Measuring Instruments – – – – – 46
3.8 Method of Data Collection – – – – – – – – 48
3.9 Method of Data Analysis – – – – – – – – 48
3.10 References – – – – – – – – – – 49
CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS
4.1 Data Presentation and Analysis – – – – – – – – 51
4.2 Discussion of Findings – – – – – – – – – 80
4.3 References- – – – – – – – – – 85
CHAPTER FIVE: SUMMARY OF FINDINGS,CONCLUSION AND RECOMMENDATION.
5.1 Summary of Findings – – – – – – – – – 86
5.2 Conclusion – – – – – – – – – – 86
5.3 Recommendation- – – – – – – – – – 87
5.4 Contribution to Knowledge – – – – – – – – 89
Bibliography- – – – – – – – – – 90
Appendix
CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
The growing human susceptibility to deadly diseases has continued to be a public health concern all over the world. One of such killer diseases is cervical cancer. According to World Health Organization (WHO, 2014,p. 25) cervical cancer is the commonest cancer among women in 45 countries of the world, and it kills more women than any other form of cancer in 55 countries. These include many countries in sub-Saharan Africa (including Nigeria), many in Asia, and some Central and South American countries. In Nigeria, it is the second fiercest type of cancer among women after breast cancer. Current estimates indicate that every year, 14,550 women are diagnosed with cervical cancer and 9,659 die of this disease in Nigeria (WHO,2014). Unfortunately, over two million women are projected to die from this disease in 2015 World-Wide (ICO Information Centre on HPV and Cancer 2015,p.23).
Over the last 30 years, cervical cancer incidence and mortality rates have fallen in countries where social and economic status have improved. This is largely a result of the implementation of secondary prevention efforts, which include high awareness, effective screening, early diagnosis and treatment for pre-cancer and early cancer. However, in developing nations, including Nigeria, there is rising incidence of cervical cancer. For instance, in 2012, 528 000 new cases of cervical cancer were diagnosed worldwide; of this number, about 85 percent occurred in less developed regions of Africa and Asia. In the same year, 266, 000 women died of cervical cancer worldwide; almost 9 out of every 10 of these, or 231 000 women in total, lived and died in low- to middle income countries. In contrast, 35 000, or just 1 out of every 10 of these women, lived and died in high-income countries (WHO, 2014).
The main reason for these disparities is the relative lack of awareness, effective prevention and early detection and treatment programmes, as well as the lack of equal access to such programmes. Without these interventions, cervical cancer is usually only detected when it is already at an advanced stage so that it is too late for effective treatment, and therefore increased mortality.
According to The Committee Encouraging Corporate Philanthropy (CECP, 2015), most women are not aware of the need for cervical cancer screening; most have never had cervical cancer screening in their lifetime. As a result, cervical cancer kills about one woman every hour in Nigeria (about 9,000 every year). The rural Nigerian woman is worse off, because of the absence of adequate medical facilities for screening, diagnosis & follow-up. Medically, these statistics are made possible considering the fact that Nigeria is the most populous black nation in the world with very high incidence of poverty and poor access to medical facilities (Okafor, 2015). Cervical cancer is caused by Human Papilloma virus(HPV).
Factors contributing to the development of cervical cancer include immune suppression, cigarette smoking, long-term use of hormonal contraceptives, and co-infection with Chlamydia trachoma or Herpes simplex virus according to the World Health Organization reports. Many patients are asymptomatic as the cancer has been diagnosed as an incidental finding after a loop biopsy of the cervix for pre-invasive disease. This is not uncommon as microscopic cervical cancers are difficult to identify colpscopically and are only identified on subsequent histological examination. Most cervical cancers however are friable, vascular masses on the cervix and are likely to produce a number of complaints including post-coital bleeding, intermenstrual bleeding, post-menopausal bleeding and blood stained virginal discharge (Gynocology by Ten Teachers, p.130). Initial clinical assessment of patients may be unrevealing as the disease is often locally not visible, even in advanced disease (Okafor, 2015).
To combat this cervical cancer menace, Society for Family Health (SFH), in conjunction with Planned Parenthood Federation of Nigeria (PPFN) and Marie Nigeria, pioneered a mass cervical cancer screening campaign in Nigeria known as “Every Woman is at risk of cervical cancer”. The campaign is focused on the fact that women should go for screening to ascertain if they have cervical cancer. Blue star, a non governmental organization was in charge of the campaign. Posters with inscription “Everywoman is at risk of cervical cancer” were displayed as health workers sensitize women on the need to go for cervical screening. The campaign message was that cervical cancer is preventable if detected early. That is to say that it is important to go for cervical screening as many times as possible, as other cervical cancer cure such as surgery may be painful and could have side effects. The campaign was run between June and December 2010. .
Also, there was another campaign on cervical cancer tagged “All you need to know about cervical cancer”. The medium for the campaign was Health Centres. They pasted posters and distributed fliers during the campaign. Federal Ministry of Health, Planned Parenthood Federation of Nigeria and Marie SFOPES Nigeria sponsored the campaign .The campaign emphasizes the affordable, complete and effective treatment options for pre-cancer. This campaign was run between January and September, 2011. It was intended to make women gain knowledge on the best way to prevent cervical cancer.
1.2 Statement of the Problem
Despite various campaigns such as “Every woman is at risk of cervical cancer”, and “All you need to know about cervical cancer”; organized in the bid to fight cervical cancer, research has shown that it is still the commonest caused disease among women and kills more women in 55 countries including Nigeria,(WHO,2014,p.25).For this reason, we do not know whether to attribute this continuous infection to inefficiency in campaign messages delivered or wrong campaign strategies. Also, we do not know whether to blame it on audience members predispositions towards vital instructions and teachings adopted in cervical cancer campaigns. Some observers however, believe that any campaign aimed at fighting this deadly disease must reasonably increase knowledge, change attitude and promote practices among women.
In view of the above reality, the extent to which South-East women are exposed to cervical cancer campaigns remains a motivation for this study. Whether or not they know the factors that make them vulnerable to cervical cancer and how to prevent it will not only be X-rayed, but their attitude and practices towards campaign messages on prevention, early detection and treatment of the disease are the foundations of this research.
1.3 Research Objectives
The broad goal of this research was to evaluate women exposure to cervical cancer campaigns in South-East Nigeria. However, the following research objectives were raised for this study:
- To ascertain the extent to which women in South-East are exposed to cervical cancer campaigns.
- To find out the extent to which cervical cancer campaigns have increased the knowledge level of South-East women on the disease.
- To ascertain the influence of cervical cancer campaigns on the attitude of South-East women.
- To examine the extent to which the attitude of women on cervical cancer campaigns has influenced their practices of regular screening and clinical therapy.
1.4 Research Questions
The following research questions were advanced to guide this study:
1). To what extent do women in South-East expose themselves to cervical cancer campaigns?
- To what extent have cervical cancer campaigns increased the knowledge level of South-
East women on the disease?
- What is the influence of cervical cancer campaigns on the attitude of South-East women?
4, To what extent has the attitude of women on cervical cancer campaigns influenced their practices of regular screening and clinical therapy?
1.5 Significance of the Study
This study no doubt will help increase the knowledge about cervical cancer amongst women in the South-East region of Nigeria and beyond . It will determine the appropriate way to effectively reach out to the target vulnerable audience especially greater percentage of women in the rural areas; thereby increasing cervical screening and reducing mortality. Also, the outcome of this study will be valuable to the health sector, scholars and other health related sectors. Therefore, this study shall serve as a solid foundation for further studies . This study shall also contribute to the call for more interventions from the government and other health agencies regarding cervical cancer.
1.6 Definition of Terms
The following key terms are defined operationally for ease of understanding within the framework of this research.
Attitude: Yielding to the appeals of cervical cancer campaign.
Campaign: Series of action intended to influence attitude of women in the South-East towards cervical cancer.
Knowledge: The level of information that women of South-East have on cervical cancer campaign relative to preventions early detection and treatment.
Practice: All conscious efforts by women in South-East to fight cervical cancer through pap smear test as a result of their exposure to cervical cancer campaigns.
South-East Women: Women from Abia, Anambra, Enugu Ebonyi and Imo States.
REFERENCES
Center f or Disease Control, (2015). HPV fact sheet center for disease control. Retrieved from http://www.cdc.gov/std/hpv/stdfact-hpv-and-men.htm
ICO Information Centre on HPV and Cancer, (2015). Human papillomavirus and related diseases report. ICO
Okafor, N. (2015). 7 things you didn’t know about cancer in Nigeria. Pulse Nigeria.com http://pulse.ng/health/2015-world-cancer-day-7-things-you-didnt-know-about-cancer-in- nigeria-id3458129.html
Olusegun, K. A. & Adepiti, C. A. (2008). Knowledge of cervical cancer and utilization of pap smear among patients in a tertiary Centre in South West Nigeria. Ibom Medical Journal, 3(2), 56-61
The Committee Encouraging Corporate Philanthropy, ( 2015). Cervical cancer as an icon of hope and hopefulness. CECP.
World Health Organization, (2014). WHO cervical cancer report. WHO.
INFLUENCE OF CERVICAL CANCER CAMPAIGNS ON THE KNOWLEDGE, ATTITUDE AND BEHAVIOUR OF WOMEN OF SOUTH-EAST NIGERIA
