Integration and acceptability of cervical cancer screening as part of postnatal care among women attending postnatal clinics in the Accra Metropolis, Greater Accra Region, Ghana.

Cervical cancer is a recognized preventable disease yet the fourth most common cancer among women globally. This study assessed the integration and acceptability of cervical cancer screening as part of routine sixth-week postnatal care among women attending a postnatal clinic. This was a cross-secti...

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Main Authors: Lawrence Oppong Buadi, Raphael Odame, Ali Samba, Mumuni Kareem, Angela Amoanimaa Boateng, Claudette Ahliba Diogo, Rebecca Tricia Morrision, George Kumi Kwakye, Cecilia Smith-Togobo
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLOS Global Public Health
Online Access:https://doi.org/10.1371/journal.pgph.0004070
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author Lawrence Oppong Buadi
Raphael Odame
Ali Samba
Mumuni Kareem
Angela Amoanimaa Boateng
Claudette Ahliba Diogo
Rebecca Tricia Morrision
George Kumi Kwakye
Cecilia Smith-Togobo
author_facet Lawrence Oppong Buadi
Raphael Odame
Ali Samba
Mumuni Kareem
Angela Amoanimaa Boateng
Claudette Ahliba Diogo
Rebecca Tricia Morrision
George Kumi Kwakye
Cecilia Smith-Togobo
author_sort Lawrence Oppong Buadi
collection DOAJ
description Cervical cancer is a recognized preventable disease yet the fourth most common cancer among women globally. This study assessed the integration and acceptability of cervical cancer screening as part of routine sixth-week postnatal care among women attending a postnatal clinic. This was a cross-sectional descriptive study among 347 postpartum women who were attending their 6th-week postnatal visit. A Pap smear test was performed on each consenting study participant. Only conventional cervical smears were performed. The Pap smear samples were taken using a special kit (PAP-PAK Cytology brush kit) for a 3-smear sampling of the ectocervix (emphasis on the squamo-columnar junction), endocervix (endocervical canal past squamo-columnar junction) and the posterior fornix via a cervical-vaginal scraper and a CytoSoft cytology brush respectively. All smears were fixed with 95% ethyl alcohol and allowed to dry in cool air. The samples were sent to the cytology laboratory and stained with the Pap staining technique. All the smears were examined and reported by the cytology department of Korle-Bu Teaching Hospital. Descriptive statistics such as frequency tables were drawn and proportions were estimated. Bivariable analysis between categorical variables and outcome variables was done. A p-value ≤ 0.05 was considered statistically significant. Most (90.5%) of the study participants were satisfied with the Pap test procedure and about 52.7% indicated that paying Gh₵60.00 ($12.50) for screening test was affordable. The outcome of Pap smear tests revealed that most (90.8%) of the participants had normal Pap test results. In the univariable analysis, participants' educational level (p = 0.006); occupation (p < 0.001), and contraceptive use (p = 0.019) were significantly associated with the acceptability of the Pap test procedure. The multivariable analysis revealed that educational level (aOR = 3.27; 95% CI = 1.05-10.21; p = 0.041) and occupation (aOR = 6.49; 95% CI = 1.67-25.29; p = 0.007) were significantly associated with the acceptability of the Pap test procedure and showed higher odds of acceptability. Integration of cervical cancer screening into the routine sixth-week postnatal clinic has the potential to be feasible with anticipated high uptake. We therefore recommend a pilot study be initiated to integrate cervical cancer screening into the routine maternal health services as part of postnatal care. Also, the Ministry of Health/Ghana Health Service should initiate discussion with the National Health Insurance Authority for possible inclusion as part of the national health insurance scheme's benefit package in the nearby future.
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spelling doaj-art-147064d84557480eb71a8ed0d51057162025-01-08T05:51:32ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752024-01-01412e000407010.1371/journal.pgph.0004070Integration and acceptability of cervical cancer screening as part of postnatal care among women attending postnatal clinics in the Accra Metropolis, Greater Accra Region, Ghana.Lawrence Oppong BuadiRaphael OdameAli SambaMumuni KareemAngela Amoanimaa BoatengClaudette Ahliba DiogoRebecca Tricia MorrisionGeorge Kumi KwakyeCecilia Smith-TogoboCervical cancer is a recognized preventable disease yet the fourth most common cancer among women globally. This study assessed the integration and acceptability of cervical cancer screening as part of routine sixth-week postnatal care among women attending a postnatal clinic. This was a cross-sectional descriptive study among 347 postpartum women who were attending their 6th-week postnatal visit. A Pap smear test was performed on each consenting study participant. Only conventional cervical smears were performed. The Pap smear samples were taken using a special kit (PAP-PAK Cytology brush kit) for a 3-smear sampling of the ectocervix (emphasis on the squamo-columnar junction), endocervix (endocervical canal past squamo-columnar junction) and the posterior fornix via a cervical-vaginal scraper and a CytoSoft cytology brush respectively. All smears were fixed with 95% ethyl alcohol and allowed to dry in cool air. The samples were sent to the cytology laboratory and stained with the Pap staining technique. All the smears were examined and reported by the cytology department of Korle-Bu Teaching Hospital. Descriptive statistics such as frequency tables were drawn and proportions were estimated. Bivariable analysis between categorical variables and outcome variables was done. A p-value ≤ 0.05 was considered statistically significant. Most (90.5%) of the study participants were satisfied with the Pap test procedure and about 52.7% indicated that paying Gh₵60.00 ($12.50) for screening test was affordable. The outcome of Pap smear tests revealed that most (90.8%) of the participants had normal Pap test results. In the univariable analysis, participants' educational level (p = 0.006); occupation (p < 0.001), and contraceptive use (p = 0.019) were significantly associated with the acceptability of the Pap test procedure. The multivariable analysis revealed that educational level (aOR = 3.27; 95% CI = 1.05-10.21; p = 0.041) and occupation (aOR = 6.49; 95% CI = 1.67-25.29; p = 0.007) were significantly associated with the acceptability of the Pap test procedure and showed higher odds of acceptability. Integration of cervical cancer screening into the routine sixth-week postnatal clinic has the potential to be feasible with anticipated high uptake. We therefore recommend a pilot study be initiated to integrate cervical cancer screening into the routine maternal health services as part of postnatal care. Also, the Ministry of Health/Ghana Health Service should initiate discussion with the National Health Insurance Authority for possible inclusion as part of the national health insurance scheme's benefit package in the nearby future.https://doi.org/10.1371/journal.pgph.0004070
spellingShingle Lawrence Oppong Buadi
Raphael Odame
Ali Samba
Mumuni Kareem
Angela Amoanimaa Boateng
Claudette Ahliba Diogo
Rebecca Tricia Morrision
George Kumi Kwakye
Cecilia Smith-Togobo
Integration and acceptability of cervical cancer screening as part of postnatal care among women attending postnatal clinics in the Accra Metropolis, Greater Accra Region, Ghana.
PLOS Global Public Health
title Integration and acceptability of cervical cancer screening as part of postnatal care among women attending postnatal clinics in the Accra Metropolis, Greater Accra Region, Ghana.
title_full Integration and acceptability of cervical cancer screening as part of postnatal care among women attending postnatal clinics in the Accra Metropolis, Greater Accra Region, Ghana.
title_fullStr Integration and acceptability of cervical cancer screening as part of postnatal care among women attending postnatal clinics in the Accra Metropolis, Greater Accra Region, Ghana.
title_full_unstemmed Integration and acceptability of cervical cancer screening as part of postnatal care among women attending postnatal clinics in the Accra Metropolis, Greater Accra Region, Ghana.
title_short Integration and acceptability of cervical cancer screening as part of postnatal care among women attending postnatal clinics in the Accra Metropolis, Greater Accra Region, Ghana.
title_sort integration and acceptability of cervical cancer screening as part of postnatal care among women attending postnatal clinics in the accra metropolis greater accra region ghana
url https://doi.org/10.1371/journal.pgph.0004070
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