Health workers' and women's perspectives on barriers to cervical cancer screening and treatment uptake in North-Central Nigeria.

Abstract

e17508 Background: Cervical cancer is a significant public health problem globally, particularly in sub-Saharan Africa (SSA), with an estimated 35 new cases per100,000 women and 23 deaths per 100,000 women occurring annually, where poor uptake of screening and late-stage presentation contributes to the disease's rising burden. This study examines barriers to cervical cancer screening and early treatment uptake in Lafia, Nasarawa State, Nigeria and explores the perspectives of health workers and women presenting at the primary health centres. Methods: In this qualitative study, in-depth interviews (IDIs) were conducted with seven primary health care providers (doctors, nurses, and community health extension workers) and 17 women aged 25–65 attending two clinics in Lafia, North Central Nigeria. Health facilities and participants were selected using convenience sampling techniques. Semi-structured interviews were conducted in English and in the local language-Hausa. These were transcribed into English and thematically analyzed using Dedoose software. Inductive and deductive approaches were used to identify key patterns and themes related to barriers to cervical cancer screening and early treatment. Results: Our findings showed that women demonstrated poor knowledge and low awareness of cervical cancer and its screening but expressed willingness to undergo screening if it was provided and accessible. Health workers identified several barriers, including the absence of routine screening programs, inadequate training, insufficient trained personnel, limited equipment and the preference for female providers. Women mentioned additional challenges such as spousal influence, fear of the procedure, costs, transportation difficulties, long waiting times, stigma, as well as cultural and religious beliefs. Both groups advocated for targeted awareness campaigns, improved accessibility and affordability of screening services, better staffing, training, provision of essential equipment, and provision of self-sampling options or private spaces for screening. Conclusions: Addressing the identified barriers to cervical cancer screening and treatment in Nigeria requires targeted interventions and policy reforms, with a focus to improve access, affordability, and awareness.