Phinda G Khumalo

Cervical cancer screening-related knowledge among community health workers in Eswatini: a cross-sectional survey

Summary Eswatini has the highest age-standardized incidence and second highest mortality rate related to cervical cancer globally. In Eswatini, community health workers educate communities about cervical cancer screening. They need to have accurate knowledge about cervical cancer and screening to do this effectively. Therefore, the current study aimed to assess knowledge regarding cervical cancer screening among community health workers in Eswatini. A telephone survey of 172 community health workers from eight selected constituencies was conducted. Descriptive analyses were performed to assess participants’ socio-demographic and service-related characteristics. Linear regression was applied to investigate factors associated with cervical cancer screening-related knowledge. One hundred and seven (62%) participants answered at least 80% of the questions correctly. However, knowledge regarding cervical cancer risk factors, the meaning of screening results and Eswatini cervical cancer screening guidelines was suboptimal. Community health workers aged 46–55 were more likely (β = 1.27, 95% confidence interval [CI]: 0.39–2.15, p < 0.01) to have a higher cervical cancer screening knowledge score than those aged 30–45 years. Community health workers from Lubombo were marginally less likely (β = −0.83, 95% CI: −1.80 to −0.04, p = 0.05) to have a higher knowledge score than those from Hhohho. This study suggests knowledge deficits amongst community health workers in Eswatini. Knowledge deficits may result in inaccurate information being communicated to clients. While increasing knowledge of these vital health workers may not be sufficient to increase cervical cancer screening rates in Eswatini, it is an essential first step that should be the focus of future educational efforts.

Cervical cancer screening knowledge and associated factors among Eswatini women: A cross-sectional study

Background Over recent years, cervical cancer incidence and related mortality have steadily increased in Eswatini. Low cervical cancer screening uptake partly explains the situation. Cervical cancer screening-related knowledge is positively associated with screening uptake. Little is known about women’s cervical cancer screening-related knowledge in Eswatini. Objective This study aimed to assess cervical cancer screening knowledge and associated factors among Eswatini women eligible for screening. Methods A cross-sectional study involving three hundred and seventy-seven women aged 25 to 59 selected from four primary healthcare clinics in Eswatini was conducted. A paper and pen survey assessed knowledge about cervical cancer risk factors, benefits of screening, the meaning of screening results, recommended screening intervals, and socio-demographics. Descriptive analyses were performed to assess participants’ sociodemographic characteristics. Linear regression was applied to examine associations between cervical cancer screening-related knowledge and participants’ sociodemographic characteristics. Results Two hundred and twenty-nine (61%) participants answered 80% or more knowledge questions correctly. Compared to HIV-positive participants, HIV-negative participants had 0.61 times lower cervical cancer screening knowledge scores (β = -0.39, 95% CI: -0.56, -0.19, p = 0.03). Participants who travelled more than 30 minutes to the clinic had 0.3 times lower cervical cancer screening knowledge scores (β = -0.70, 95% CI: -1.15, -0.25, p < 0.01) compared to participants who travelled less than 30 minutes to the clinic. Conclusions Relatively high overall cervical cancer screening knowledge levels were observed among the study participants. Findings from the current study may inform future educational programs to create and sustain an accurate understanding of cervical cancer screening in Eswatini communities.

Attitudes and barriers to intervention research targeted at improving cervical cancer screening uptake in Sub-Saharan Africa: A survey of researchers’ perspectives

Cervical cancer remains a major public health crisis in Sub-Saharan Africa, partly due to low screening rates. Despite the need for intervention research to inform strategies to increase screening participation, limited research has explored the specific challenges faced by researchers conducting intervention research on cervical cancer screening in this region. This study examined researchers' attitudes and perceived barriers to conducting intervention research aimed at enhancing cervical cancer screening uptake in the region. The study also identified factors associated with endorsing a higher number of barriers. An online survey was conducted among researchers who had published studies on cervical cancer screening in Sub-Saharan Africa between 2010 and 2020. Data on attitudes, perceived barriers, sociodemographic and research experience characteristics were collected. Descriptive statistics and linear regression analysis were used to analyse data. One hundred and fifty-seven researchers from 17 sub-Saharan African countries completed the survey (response rate: 26.5 %). Most participants acknowledged the necessity of increasing intervention research to improve screening uptake. Common perceived barriers included insufficient funding (89 %), slow ethical and regulatory approvals (61 %), and challenges in measuring screening uptake (57 %). Less experienced researchers were more likely to endorse a greater number of barriers. Researchers recognised the importance of intervention research to improve cervical cancer screening uptake in Sub-Saharan Africa. However, they faced significant barriers, particularly relating to funding, regulatory processes, and measurement challenges. Researchers with less experience in research perceived more barriers, indicating a need for targeted support. A coordinated response is required to address these barriers. Priorities include investing in context-specific research, streamlining ethics and regulatory processes, enhancing early-career researcher training, and establishing dedicated funding for intervention studies. Future efforts should focus on country-specific research, regional ethics harmonisation, and sustainable capacity-building initiatives.