Health facility readiness for provision of cervical cancer screening in Kinondoni Municipal Dar es salaam

Abstract

ABSTRACT Background Cervical cancer is the second most common cancer among women worldwide. About 83% of the cases occur in developing countries, representing 15% of female cancers. Cervical cancer ranks as the most frequent cancer among women in Tanzania, and the most frequent cancer among women between 15 and 44 years of age with age specific incidence rate of 34 per 100,000.Inspite of the fact that the government of Tanzania is undertaking program for prevention and management of cervical cancer, the prevalence remains high compared to other developing countries. This study aimed to assess the facility readiness for cervical cancer screening, and provider’s knowledge on cervical cancer screening in Kinondoni Municipal Objectives To assess public health facilities readiness on provision of cervical cancer screening services as part of comprehensive cervical cancer prevention and treatment in Kinondoni municipality. Methodology A descriptive cross-sectional study was conducted in Kinondoni municipality from August 2017 to October 2017 whereby a total of 14 public health facilities were surveyed. It included 2 public hospitals, 2 health centers and 10 dispensaries that were expected to be providing cervical cancer screening services. Information on facility readiness on cervical cancer screening, referral modalities, healthcare providers knowledge on cancer screening services and availability of equipment and supplies for screening was collected using a structured researcher administered questionnaire and a checklist. Data were analyzed using SPSS version 23.0 computer program whereby Categorical variables were analyzed and compared using the chi square test and continuous variables were analyzed as mean, standard deviation and compared using student’s t-test. In any comparison a p-value of less than 0.05 was interpreted as statistical significant. Facility readiness was assessed based on the presence of all basic items in the Tanzania National Guideline that include Infrastructure, equipment, Consumables and trained personnel, and working referral system. Knowledge was assessed using a Universal grading system. Results Thirteen (92.8%) out of fourteen health facillities had cervical cancer sreening services which was Visual Inspection with Acetic Acid (VIA). Out of these only three (21.4%) facility had all the readiness components fulfilled. A total of 105 health personel from 14 public health facilities were recruited in this study and majority of the participants were nurses 79 (75.2%), followed by Doctors21 (20%). Only18(17.14%) of the interviewed staff had attended cervical cancer screening training. Of all the staff, sufficient knowlege on Cervical cancer was documented in (63.8%) with significantly higher proportion among doctors (95.2%) compared to nurses (55.7%), p<0.004.

Conclusion Facility readiness for comprehensive cervical cancer screening and treatment is low among public health facilities in Dar es Salaaam. Moreover, inspite of higher knowledge on Cervical Cancer screeningamong staff the great majority were lacking training on Cervical cancer screening.