Effect of a Community Health Worker Based Health Promotion Intervention on Uptake of Cervical Cancer Screening Services among Women of Reproductive Age in Kitui County, Kenya

Abstract

Introduction: Cervical cancer is a malignant neoplasm of the cervix uteri. It is the second most common cancer among women  worldwide, with an estimated 528,000 new cases and 266,000 deaths among women each year. Cervical cancer is associated with a
huge financial and social burden especially in the developing world. Diagnosing cervical cancer at an early stage and providing access to effective treatment is key to reducing its burden. In Kenya, cervical cancer screening is very low at 14%.The aim of this study was to assess the effect of a Community Health Worker (CHW) led health education intervention in promoting uptake of cervical cancer screening in Kitui County-Kenya.
Methods:  The study was carried out in Kitui County. This was a quasi-experiment with one pre-intervention and one post intervention survey conducted in both intervention and control sites. Kitui East and Mwingi West were intervention and control sites respectively. The intervention site received a Community Based Health Education (CBHE) intervention aimed at promoting awareness and screening of both breast and cervical cancer. A total sample size of 422 participants were identified in each survey based on Fisher et al (1998) formula. Purposive and simple random sampling methods were used in identifying study area and study participants respectively.
Results: The CHW led Health education intervention increased the proportion of women who sought cervical cancer screening services by 29.5% over the 8 months of the intervention period. The odds of seeking cervical cancer screening services were 10 times higher in the intervention site compared to control site respectively [(crude OR=4.051: 95%CI of OR=2.982-5.503, P<0.05) (Adjusted OR=10.307: 95%CI of OR=6.284- 16.904, P<0.05].
Conclusion and  Recommendation: The CHW led health education intervention was effective in increasing utilization of cervical cancer screening services in Kitui County. CHWs providing level one health services, therefore, need to integrate cervical cancer awareness and
screening messages in their service delivery. This will promote cervical cancer screening and trigger early treatment and management of cervical cancer, hence bringing down the burden of cancer in the country.

Keywords: Cervical cancer, Screening, Community Health Workers, Health Promotion