Author:
Addo-Lartey Adolphina Addoley,Bonful Harriet Affran,Sefenu Ransford Selasi,Abagre Timothy Agandah,Asamoah Alexander,Bandoh Delia Akosua,Awua Adolf Kofi,Adu-Aryee Nii Armah,Dedey Florence,Adanu Richard Mawuena Kofi,Okuyemi Kolawole Stephen
Abstract
Abstract
Introduction
Despite breakthroughs in cervical cancer detection, resource-constrained countries continue to have a disproportionately high incidence and death rate. Mhealth has been identified as an important tool for increasing cervical cancer screening rates in Sub-Saharan Africa. We determined whether sending Ghanaian women culturally tailored one-way mobile phone SMS text messages about cervical cancer would encourage the uptake of the human papillomavirus (HPV) test.
Methods
From August to November 2016, 88 women aged 18 to 39 living or working in an urban community (Accra, Ghana) participated in a quasi-experimental study. For 8 weeks, 32 SMS messages regarding cervical cancer were developed and sent to the personal phones of intervention arm participants (n = 42). Women in the control group (n = 46) received SMS texts with general health and lifestyle advice. Fischer’s exact tests were performed to assess cervical cancer screening uptake and associated reasons for non-uptake between the intervention and control groups (p < 0.05).
Results
At the baseline, women differed in terms of ethnicity and wealth. After the intervention, participants’ self-reported risk factors for cervical cancer, such as early menarche, usual source of medical treatment, family history of cancer, smoking, and alcohol history, changed. None of the women in the intervention group sought cervical cancer screening after the intervention, but only one (2.2%) of the control arm participants did. Almost all the women (> 95%) agreed that an HPV test was essential and that regular healthcare check-ups could help prevent cervical cancer. Some women believed that avoiding particular foods could help prevent cervical cancer (23.8% intervention vs. 58.7% control, p < 0.001). Time constraints and out-of-pocket expenses were significant barriers to cervical cancer screening. Conclusion: A one-way SMS delivered to urban women did not increase cervical cancer screening attendance. The time spent in screening facilities and the lack of coverage by the National Health Insurance Scheme limited screening uptake. We urge for the establishment of screening centers in all healthcare facilities, as well as the inclusion of cervical cancer screening in healthcare programs through cost-sharing.
Publisher
Springer Science and Business Media LLC
Reference60 articles.
1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer statistics 2020: GLOBOCAN estimates of incidence and Mortality Worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–49.
2. Tsu V, Jerónimo J. Saving the World’s women from Cervical Cancer. N Engl J Med. 2016;374:2509–11.
3. Effah K, JE A, CM PDGAYK. Raising funds through Social Media to Subsidise Cervical Cancer Screening with HPV Testing in Rural Ghana-the Battor experience. J Health Care Poor Underserved. 2021;32:1136–44.
4. Ashtarian H, Mirzabeigi E, Mahmoodi E, Khezeli M. Knowledge about Cervical Cancer and Pap Smear and the factors influencing the pap test screening among women. 2016.
5. Bula Id AK, Lee F, Chapola Id J, Mapanje C, Tsidya M, Thom A, et al. Perceptions of Cervical cancer and motivation for screening among women in Rural Lilongwe, Malawi: a qualitative study. PLoS ONE. 2022. https://doi.org/10.1371/journal.pone.0262590.