THE EFFECT OF TRAINING ON THE KNOWLEDGE, ATTITUDE AND PRACTICE OF BREAST SELF-EXAMINATION AMONG FEMALE COMMUNITY HEALTH EXTENSION WORKERS (CHEWs) IN SAGAMU LGA, OGUN STATE

Abstract

Background: Breast cancer (BC) is the most common form of malignant disease in women. In Nigeria, two thirds of cases present with advanced stages where little or no benefit can be derived from any form of treatment due majorly to lack of knowledge about the disease, even among healthcare workers.
Therefore, to function as effective promoter of breast cancer prevention and control, health workers must possess the relevant knowledge, appropriate attitude and belief concerning the disease and its early detection. Female healthcare workers particularly have been found to have greater influence on women’s positive perception of breast cancer and motivation to practice screening methods for early detection of the disease.
This study therefore set out to assess the effect of training on the Knowledge, Attitude and Practice of BSE among Female Community Health Extension Workers (CHEWs) in Sagamu LGA, Ogun State, South West Nigeria.
Methods: It was a community based nonrandomised interventional study involving a total of 117 CHEWs from two LGAs within Ogun State, with 62 from Sagamu LGA and 55 from Odogbolu LGA, serving as interventional and control group respectively.
The study, was conducted in three phases: A pre- interventional phase cross sectional assessment of the baseline BSE-related knowledge, attitude and practice (KAP) of the CHEWs in both groups using semi-structured, self-administered, pre-tested and validated questionnaire; An interventional phase involving the training of the CHEWs in the interventional group only, with a placebo equivalent in cervical cancer given to their counterparts in the control group. This was followed up with an immediate post interventional cross sectional assessment of their KAP which was also repeated three months later.
Analysis of data was performed using the Statistical package for social sciences (SPSS) software version 15; Pearson’s Chi-square and the independent t-test were used to test for significant changes resulting from the intervention in the two groups.
Results: Prior to the training, over 60 percent of the respondents in both groups (67.7% interventional and 61.8% control) had good overall BSE-related knowledge (X2=0.449, p=0.563) and positive attitudes (63.2% interventional and 66.4% control). Their BSE practice was however low (50.9% interventional and 46.8% control group respectively).
Following the training however, there was significant improvement in the BSE-related knowledge and attitude immediately (96.8% and 80.6%) as well as three months later (89.7% and 96.6%) with significant improvement in the three months post-training BSE practice (87.9%) among the respondents in the interventional group. There was no such significant improvement in these three outcome variables among the control group.
Conclusion: The training significantly influenced the knowledge, attitude and practice of BSE of the female CHEWs in the interventional group who were exposed to the training, but not on those of the control group who were not exposed.
Recommendation: It is thus recommended that the authorities of the various Schools or Colleges of Health Technology in Nigeria should include BSE-related training courses as a major component of the educational curricula programme of the CHEWs; The CHEWs in all the Primary Health Centres in the country should be made to undergo compulsory BSE training by their respective Local Government Authorities, with regular follow up update courses using self-explanatory instructional materials as well as breast models such as mammacare models; The CHEWs, so empowered with such training should be encouraged and supervised by their superiors especially the Medical Officer or Medical Officer of Health, to teach their clients at every opportunity

THE EFFECT OF TRAINING ON THE KNOWLEDGE, ATTITUDE AND PRACTICE OF BREAST SELF-EXAMINATION AMONG FEMALE COMMUNITY HEALTH EXTENSION WORKERS (CHEWs) IN SAGAMU LGA, OGUN STATE