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Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon

OBJECTIVES: The World Health Organization’s (WHO) global strategy for cervical cancer elimination has set the target of 70% of women screened in all countries by 2030. Community sensitization through media is often used, but community health workers’ (CHW) involvement may contribute to improving scr...

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Autores principales: Pham, Marie-Anne, Benkortbi, Khadidja, Kenfack, Bruno, Tincho Foguem, Eveline, Sormani, Jessica, Wisniak, Ania, Lemoupa Makajio, Sophie, Manga, Engelbert, Vassilakos, Pierre, Petignat, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8933918/
https://www.ncbi.nlm.nih.gov/pubmed/35305588
http://dx.doi.org/10.1186/s12889-022-12951-1
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author Pham, Marie-Anne
Benkortbi, Khadidja
Kenfack, Bruno
Tincho Foguem, Eveline
Sormani, Jessica
Wisniak, Ania
Lemoupa Makajio, Sophie
Manga, Engelbert
Vassilakos, Pierre
Petignat, Patrick
author_facet Pham, Marie-Anne
Benkortbi, Khadidja
Kenfack, Bruno
Tincho Foguem, Eveline
Sormani, Jessica
Wisniak, Ania
Lemoupa Makajio, Sophie
Manga, Engelbert
Vassilakos, Pierre
Petignat, Patrick
author_sort Pham, Marie-Anne
collection PubMed
description OBJECTIVES: The World Health Organization’s (WHO) global strategy for cervical cancer elimination has set the target of 70% of women screened in all countries by 2030. Community sensitization through media is often used, but community health workers’ (CHW) involvement may contribute to improving screening coverage. We aimed to assess effectiveness and costs of two cervical cancer screening recruitment strategies conducted in a low-resource setting. METHODS: The study was conducted in the West Region of Cameroon, in the Health District of Dschang, a community of 300,000 inhabitants. From September 2018 to February 2020, we recruited and screened women for cervical cancer in a single-visit prevention campaign at Dschang District Hospital. During the first 9 months, recruitment was only based on Community Information Channels (CIC) (e.g.. street banners). From the tenth month, participation of CHW was added in the community after training for cervical cancer prevention counselling. Population recruitment was compared between the two strategies by assessing the number of recruited women and direct costs (CHW costs included recruitment, teaching, certification, identification badge, flyers, transport, and incentives). The intervention’s cost-effectiveness was expressed using an incremental cost-effectiveness ratio (ICER). RESULTS AND DISCUSSION: During the period under study, 1940 women were recruited, HPV positive rate was 18.6% (n = 361) and 39 cases of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) were diagnosed. Among included participants, 69.9% (n = 1356) of women were recruited through CIC as compared to 30.1% (n = 584) by CHW. The cost per screened woman and CIN2+ diagnosed was higher in the CHW group. The ICER was 6.45 USD or 16.612021Int’l$ per screened woman recruited by CHW. Recruitment in rural areas increased from 12.1 to 61.4% of all women included between CIC-led and CHW-led interventions. These outcomes highlight the importance of training, preparing, and deploying CHW to screen hard-to-reach women, considering that up to 45% of Cameroon’s population lives in rural areas. CONCLUSION: CHW offer an important complement to CIC for expanding coverage in a sub-Saharan African region such as the West Region of Cameroon. CHW play a central role in building awareness and motivation for cervical cancer screening in rural settings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-12951-1.
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spelling pubmed-89339182022-03-23 Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon Pham, Marie-Anne Benkortbi, Khadidja Kenfack, Bruno Tincho Foguem, Eveline Sormani, Jessica Wisniak, Ania Lemoupa Makajio, Sophie Manga, Engelbert Vassilakos, Pierre Petignat, Patrick BMC Public Health Research OBJECTIVES: The World Health Organization’s (WHO) global strategy for cervical cancer elimination has set the target of 70% of women screened in all countries by 2030. Community sensitization through media is often used, but community health workers’ (CHW) involvement may contribute to improving screening coverage. We aimed to assess effectiveness and costs of two cervical cancer screening recruitment strategies conducted in a low-resource setting. METHODS: The study was conducted in the West Region of Cameroon, in the Health District of Dschang, a community of 300,000 inhabitants. From September 2018 to February 2020, we recruited and screened women for cervical cancer in a single-visit prevention campaign at Dschang District Hospital. During the first 9 months, recruitment was only based on Community Information Channels (CIC) (e.g.. street banners). From the tenth month, participation of CHW was added in the community after training for cervical cancer prevention counselling. Population recruitment was compared between the two strategies by assessing the number of recruited women and direct costs (CHW costs included recruitment, teaching, certification, identification badge, flyers, transport, and incentives). The intervention’s cost-effectiveness was expressed using an incremental cost-effectiveness ratio (ICER). RESULTS AND DISCUSSION: During the period under study, 1940 women were recruited, HPV positive rate was 18.6% (n = 361) and 39 cases of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) were diagnosed. Among included participants, 69.9% (n = 1356) of women were recruited through CIC as compared to 30.1% (n = 584) by CHW. The cost per screened woman and CIN2+ diagnosed was higher in the CHW group. The ICER was 6.45 USD or 16.612021Int’l$ per screened woman recruited by CHW. Recruitment in rural areas increased from 12.1 to 61.4% of all women included between CIC-led and CHW-led interventions. These outcomes highlight the importance of training, preparing, and deploying CHW to screen hard-to-reach women, considering that up to 45% of Cameroon’s population lives in rural areas. CONCLUSION: CHW offer an important complement to CIC for expanding coverage in a sub-Saharan African region such as the West Region of Cameroon. CHW play a central role in building awareness and motivation for cervical cancer screening in rural settings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-12951-1. BioMed Central 2022-03-19 /pmc/articles/PMC8933918/ /pubmed/35305588 http://dx.doi.org/10.1186/s12889-022-12951-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Pham, Marie-Anne
Benkortbi, Khadidja
Kenfack, Bruno
Tincho Foguem, Eveline
Sormani, Jessica
Wisniak, Ania
Lemoupa Makajio, Sophie
Manga, Engelbert
Vassilakos, Pierre
Petignat, Patrick
Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon
title Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon
title_full Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon
title_fullStr Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon
title_full_unstemmed Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon
title_short Recruitment strategies to promote uptake of cervical cancer screening in the West Region of Cameroon
title_sort recruitment strategies to promote uptake of cervical cancer screening in the west region of cameroon
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8933918/
https://www.ncbi.nlm.nih.gov/pubmed/35305588
http://dx.doi.org/10.1186/s12889-022-12951-1
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