scholarly journals Patient Preferences and Willingness to Pay for Cervical Cancer Prevention in Zambia: Protocol for a Multi-Cohort Discrete Choice Experiment (Preprint)

2018 ◽  
Author(s):  
Sujha Subramanian ◽  
Yevgeniya Kaganova ◽  
Yuying Zhang ◽  
Sonja Hoover ◽  
Namakau Nyambe ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Willingness To Pay ◽  
Cervical Cancer Screening ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Sub Saharan Africa ◽  
Screening Programs ◽  
Sub Saharan

BACKGROUND Although most countries in southern Africa have cervical cancer screening programs, these programs generally fail to reach a significant majority of women because they are often implemented as pilot or research projects, and this limits their scope and ability to scale up screening. Some countries have planned larger-scale programs, but these have either never been implemented or have not been successfully scaled up. Most of the global burden of cervical cancer is experienced in countries with limited resources, and mortality from cervical cancer is the most common cause of cancer-related deaths among women in Sub-Saharan Africa. OBJECTIVE The purpose of this study is to learn about preferences for cervical cancer screening in Zambia, to identify barriers and facilitators for screening uptake, and to evaluate willingness to pay for screening services to support the scaling up of cervical cancer screening programs. METHODS We will conduct a discrete choice experiment by interviewing women and men and asking them to choose among constructed scenarios with varying combinations of attributes relevant to cervical cancer screening. To inform the discrete choice experiment, we will conduct focus groups and interviews about general knowledge and attitudes about cervical screening, perception about the availability of screening, stigma associated with cancer and HIV, and payment for health care services. For the discrete choice experiment, we will have a maximum design of 120 choice sets divided into 15 sets of 8 tasks each with a sample size of 320-400 respondents. We will use a hierarchical Bayesian estimation procedure to assess attributes at the following two levels: group and individual levels. RESULTS The model will generate preferences for attributes to assess the most important features and allow for the assessment of differences among cohorts. We will conduct policy simulations reflecting potential changes in the attributes of the screening facilities and calculate the projected changes in preference for choosing to undergo cervical cancer screening. The findings from the discrete choice experiment will be supplemented with interviews, focus groups, and patient surveys to ensure a comprehensive and context-based interpretation of the results. CONCLUSIONS Because willingness to pay for cervical cancer screening has not been previously assessed, this will be a unique and important contribution to the literature. This study will take into account the high HIV prevalence in Sub-Saharan Africa and prevailing gender attitudes to identify an optimal package of interventions to reduce cervical cancer incidence. This simulation of women’s decisions (and men’s support) to undergo screening will lay the foundation for understanding the stated preferences and willingness to pay to help design future screening programs. REGISTERED REPORT IDENTIFIER RR1-10.2196/10429

Systematic review of cervical cancer prevalence and determinants of early detection in Sub-Saharan Africa

2018 ◽  
Vol 1 (1) ◽  
pp. 32-36
Author(s):  
Eleazar Ndabarora ◽  
Dariya Mukamusoni ◽  
Clarte Ndikumasabo ◽  
Védaste Ngirinshuti
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Cervical Cancer Screening ◽  
Sub Saharan Africa ◽  
Extensive Literature ◽  
Early Management ◽  
Screening Programs ◽  
Mesh Terms ◽  
Sub Saharan

Cervical cancer is one of the leading causes of morbidity and mortality globally and in Sub-Saharan Africa in particular. There is evidence that early detection and early management of cases are the best strategies to prevent and control this health threat, since treatment of the later stages of the diseases are very expensive. The objectives of the review were: (1) to identify and review studies on the prevalence of cervical cancer and determinants of early detection in Sub-Saharan Africa, and (2) to recommend further studies and interventions based on the findings of this review. Extensive literature search was conducted using the MeSH terms. Articles on cervical cancer and/or determinants of early detection which fulfilled inclusion criteria were reviewed independently by three reviewers. The prevalence of cervical cancer in Sub-Saharan Africa is increasing. Although there are evidences that cervical cancer screening programs are practical and feasible even in resource-limited settings in Sub-Saharan Africa, there is a very low uptake of cervical cancer screening and there are key factors that need to be addressed in order to make these programs established and effective.

scholarly journals Cervical cancer screening uptake in Sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Nigus Bililign Yimer ◽  
Mohammed Akibu Mohammed ◽  
Kalkidan Solomon ◽  
Mesfin Tadese ◽  
Stephanie Grutzmacher ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Meta Analysis ◽  
Cervical Screening ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Screening Uptake ◽  
Analytic Review ◽  
Sub Saharan

AbstractBackgroundCervical cancer screening and prevention programs have been given considerable attention in high-income countries, while only receiving minimal effort in many African countries. This meta-analytic review aimed to estimate the pooled uptake of cervical cancer screening uptake and identify its predictors in Sub-Saharan Africa.MethodsPubMed, EMBASE, CINAHL, African Journals Online, Web of Science and SCOPUS electronic databases were searched. All observational studies conducted in Sub-Saharan Africa and published in English language from January 2000 to 2019 were included. The Newcastle-Ottawa Scale was applied to examine methodological quality of the studies. Inverse variance-weighted random-effects model meta-analysis was done to estimate the pooled uptake and odds ratio of predictors with 95% confidence interval. I2 test statistic was used to check between-study heterogeneity, and funnel plot and Egger’s regression statistical test were used to check publication bias. To examine the source of heterogeneity, subgroup analysis based on sample size, publication year and geographic distribution of the studies was carried out.ResultsOf 3,537 studies identified, 29 studies were included with 36,374 women. The uptake of cervical cancer screening in Sub-Saharan Africa was 12.87% (95% CI: 10.20, 15.54; I2= 98.5%). Meta-analysis of seven studies showed that knowledge about cervical cancer increased screening uptake by nearly 5-folds (OR: 4.81; 95% CI: 3.06, 7.54). Other predictors include educational status, age, HIV status, contraceptive use, perceived susceptibility, and awareness about screening locations.ConclusionCervical screening uptake is low in Sub-Saharan Africa and influenced by several factors. Health outreach and promotion targeting identified predictors are needed to increase uptake of screening service in the region.sProtocol registrationCRD42017079375

scholarly journals P824 Accuracy of cervical cancer screening using a self-collected vial for HPV DNA testing among adult women in sub-saharan africa

2019 ◽  
Author(s):  
Zita Aleyo Nodjikouambaye ◽  
Damtheou Sadjoli ◽  
Ralph Sydney Mboumba Bouassa ◽  
Hélène Péré ◽  
David Veyer ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Sub Saharan Africa ◽  
Adult Women ◽  
Dna Testing ◽  
Hpv Dna ◽  
Hpv Dna Testing ◽  
Sub Saharan

Cervical cancer screening in sub-Saharan Africa: A randomized trial of VIA versus cytology for triage of HPV-positive women

2014 ◽  
Vol 137 (1) ◽  
pp. 127-134 ◽  
Author(s):  
Jérôme Bigoni ◽  
Mélissa Gundar ◽  
Pierre-Marie Tebeu ◽  
Adamo Bongoe ◽  
Sonja Schäfer ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Randomized Trial ◽  
Cervical Cancer Screening ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Awareness and Attitude of Women towards Cervical Cancer Screening in Abakaliki, South East Nigeria

2021 ◽  
Vol 13 (4) ◽  
pp. 115
Author(s):  
J. O. Egede ◽  
L. O. Ajah ◽  
U. M. Agwu ◽  
M. I. Ajah ◽  
F. O. Edegbe ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Willingness To Pay ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
High Risk Population ◽  
Cross Sectional ◽  
Screening Services

INTRODUCTION: Cervical cancer screening has significantly contributed to the detection of premalignant and malignant lesions of the cervix and prevention of the morbidity and mortality associated with the disease. In the developing countries, especially sub-Saharan Africa where the burden of cervical cancer is highest, the high-risk population may not know the screening schedules or be able to pay for the services, and so fail to benefit. OBJECTIVE: To determine the level of awareness of cervical cancer screening schedule and willingness to pay for cervical screening services among women in Abakaliki, southeast Nigeria. METHOD: The study design was a descriptive cross-sectional questionnaire-based and the population comprised 800 participants who came for free cervical cancer screening at well women centre, Alex Ekwueme Federal University Teaching Hospital, Abakaliki between January and December 2017. Data were analyzed using the Statistical Package for Sciences version 20.0. RESULT: Of the 756 (94.5%) questionnaires analyzed, the mean age was 41.4 years, modal parity 4; 83.6% had prior knowledge of cervical cancer while 81.0% knew that cervical cancer screening is a diagnostic tool. Surprisingly, only 32% of those aware of cervical cancer had previously done cervical cancer screening, while 10.8% knew the interval for cervical cancer screening. On screening for cervical cancer in future, 89.2% of the respondents were willing to repeat the test while 54.2% would be willing to pay for the screening services. Being 40 years of age or less, married, educated, of high socio-economic class and having first sexual intercourse at 18 years or less were associated with willingness to pay for screening. CONCLUSION: Although the knowledge of cervical cancer is high, cervical cancer screening uptake is low, many women are aware of the interval for cervical cancer screening, and many will not be willing to pay for cervical cancer screening out of their pockets. 

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