Assessment of the Quality of Cervical Cancer Prevention Services in Southwest Nigeria: A Cross-Sectional Study Using Donabedian’s Quality Framework
Introduction
Cervical Cancer (CC) is the second leading cause of cancer-related deaths among women in Nigeria, after breast cancer. However, there is a significant gap in evaluating prevention services due to the absence of organized and sustained programs. Immediate action is essential to address this critical issue.
Objective
The study assessed the quality of CC prevention services (CCPS) in selected Southwest Nigerian states using Donabedian’s quality framework.
Methods
The study employed a cross-sectional descriptive research design, selecting 24 Secondary Health Facilities (SHFs) and 72 reproductive-aged women (aged 30-49) from two states to evaluate the quality of CCPS. Based on the median score and interquartile range, the Donabedian quality framework categorizes CCPS as high, moderate, or poor. A paired independent t-test was conducted to compare the quality of existing CCPS in the two states.
Results
The study found that 42% of selected healthcare facilities in Osun State and 34% in Lagos State offer CCPS. The facilities have basic screening materials, with Visual Inspection with Acetic Acid (VIA) being the most used. The availability of materials resources in facilities varied based on the type of CCPS. The median score ranged from 124 to 185, with 54% of facilities rated good quality, 8.3% moderate, and 37.5% poor. However, there was no significant difference in CCPS quality between the two states at t = −1.96, P = 0.062.
Conclusion
Quality assessment of CCPS is crucial for providing effective and equitable healthcare. Donabedian’s framework enables systematic evaluation of the services’ structural, procedural, and outcome aspects. Addressing gaps and enhancing the quality of CCPS can effectively reduce the burden of CC.