EFFECT OF HEALTH EDUCATION ON KNOWLEDGE AND UPTAKE OF CERVICAL SCREENING SERVICE AMONG PRISON OFFICERS’ WIVES IN IKOYI BARRACKS, LAGOS

Abstract

Introduction: Cervical cancer is the second most common female cancer worldwide according to the World Health Organization. In Nigeria, it is the commonest gynecological cancer among Nigerian women. Although cervical cancer is preventable, about half a million new cases and a quarter of a million deaths were recorded globally in 2008. Furthermore, about 80% of these deaths occurred in low income countries, where women present very late and only 5% of the global cancer resources are available. Early detection of cervical cancer precursors through cervical screening using the Visual inspection with acetic-acid method, a credible alternative to Papanicolaou’s (PAP) smear can be life saving. The prison health centre does not offer cervical screening service even though the officers’ wives are at risk of this fatal disease. The aim of this study was to assess the effect of health education and provision of free cervical screening service on the knowledge and uptake of service among prison officers’ wives in Ikoyi prison barracks, Lagos.
Method: Two medium security prison barracks in Lagos where chosen for study because they were far apart and similar. One was designated intervention while the other was the control group. A comprehensive list containing the names of all the prison officers’ wives, their addresses and phone numbers obtained from the chairpersons of the prison officers’ wives of the various barracks was used to identify 135 and 108 eligible respondents in the intervention and control group respectively. A baseline survey on the knowledge of cervical cancer and screening practices was carried out in both populations with the aid of a semi-structured, pre-tested and interviewer-administered questionnaire. Thereafter, respondents in the intervention group received health education sessions on cervical cancer and its’ prevention. A free cervical screening service was made available during the study at the intervention site. Respondents in the control group received health education sessions on personal hygiene and environmental sanitation. Subsequently, participants in both groups were re-assessed to evaluate the effect of the health education intervention and uptake of the screening service.
Results: Awareness of cervical cancer was low among the intervention and control group prior to intervention. At baseline, only 17.8% and 18.5% of participants in the intervention and control group respectively were aware of cervical cancer. About 79.2% and 70.0% of those who were aware of cervical cancer in intervention and control group respectively had poor knowledge of cervical cancer at baseline. Furthermore only 23.7 % and 25.0 % of participants in the intervention and control group respectively had ever heard of cervical screening. Eighty-seven percent (intervention) and 92.6% (control) had poor knowledge of cervical screening. The uptake of cervical screening at baseline was 5.9% and 9.3% in the intervention and control group respectively. At post intervention, knowledge of cervical cancer and cervical screening in the intervention group increased by 40.7% and 46.6% respectively. A percentage difference of 57.1 was for cervical cancer screening. Minimal, insignificant changes were observed in the control group for most parameters analyzed post-intervention.
Conclusion: Simple, organized health education and a cheap cervical screening test like Visual inspection with acetic-acid can improve knowledge and increase screening rates rapidly among women at risk of cervical cancer.

Recommendation: Cervical screening should be integrated into the services offered in the prison health clinic

EFFECT OF HEALTH EDUCATION ON KNOWLEDGE AND UPTAKE OF CERVICAL SCREENING SERVICE AMONG PRISON OFFICERS’ WIVES IN IKOYI BARRACKS, LAGOS