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Focused Training of Community Health Volunteers on Cervical Cancer in Rural Kisumu 

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Abstract

The cancer disease burden is higher in the low- and middle-income countries like Kenya where uptake of screening services is low. Community health volunteers (CHVs) have been shown to be effective in improving uptake of health services and could also be used in cervical cancer screening. However, they still have inadequate knowledge hindering effective public education. The aim of this study is to determine the effect of focused training of the CHVs on their knowledge on cervical cancer and screening uptake among women of reproductive age. This was a quasi-experimental study in rural sub-counties of Nyando and Nyakach. Nyando was the intervention arm with 186 CHVs and Nyakach the control with 239 CHVs. Participants’ knowledge on cervical cancer was assessed using a self-administered questionnaire. CHVs in the intervention arm were trained about cervical cancer and screening. Knowledge was re-assessed following a 6-month public education period. The focused training improved the CHVs’ knowledge on cervical cancer to 60.9% compared to 13.4% in the control arm (p = 0.004) at the end-line. The knowledge was dependent on the level of education (χ2 = 34.41, p = 0.045), religion (χ2 = 25.85, p = 0.007), and occupation (χ2 = 95.04, p < 0.0001). Screening uptake was significantly associated with knowledge of risk factors (p = 0.019) and sign and symptoms (p = 0.017). Screening uptake improved in the intervention arm while declined in the control arm. The training significantly improved the CHVs’ knowledge on cervical cancer and uptake of screening services in the intervention area, Kisumu County, Kenya, and should be continuous.

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Abbreviations

CDC:

Centre for Disease Control and Prevention

CHV:

Community health volunteer

KHIS:

Kenya Health Information System

HPV:

Human papillomavirus

IREC:

Institutional Research and Ethics Committee

VIA:

Visual inspection using acetic acid

VILI:

Visual inspection using Lugol’s iodine

WHO:

World Health Organization

WRA:

Women of reproductive age

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Acknowledgments

We acknowledge the Health Department of the County Government of Kisumu for allowing us to carry out this study within their jurisdiction, the community health volunteers in Nyakach and Nyando sub-counties, the data collection team, Sostine Akinyi and Dinozof Achoki, the AMPATH Cervical Cancer Program Manager Kapten Muthoka, and my advisor Dr. Anisa Mburu.

Availability of Data and Materials

The data from which the study conclusions are drawn can be requested from the authors.

Funding

The study was funded by the National Institutes of Health under the U54 Cervical Cancer Prevention Mentoring Core Research Grant (grant no. 233).

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Authors and Affiliations

  1. AMPATH Cervical Cancer Program, P.O. Box 4606, Eldoret, Kenya

    Edwin Onyango Ochomo, Samson Ndege & Peter Itsura

  2. School of Public Health, Moi University, P.O. Box 4606, Eldoret, Kenya

    Samson Ndege

  3. School of Medicine, Moi University, P.O. Box 4606, Eldoret, Kenya

    Peter Itsura

Authors
  1. Edwin Onyango Ochomo
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  2. Samson Ndege
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  3. Peter Itsura
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Contributions

OEO designed and carried out the data collection in the field and participated in the drafting of the manuscript. PI and SN made substantial contributions to the design and interpretation of the data. PI and SN were also involved in revising the manuscript critically for important intellectual content. They also gave the final approval of the version to be published and have agreed to be accountable for all aspects of this work. All authors read and approved the final manuscript.

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Correspondence to Edwin Onyango Ochomo.

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Ochomo, E.O., Ndege, S. & Itsura, P. Focused Training of Community Health Volunteers on Cervical Cancer in Rural Kisumu . J Canc Educ 37, 466–473 (2022). https://doi.org/10.1007/s13187-020-01839-6

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  • DOI: https://doi.org/10.1007/s13187-020-01839-6

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