| dc.description.abstract | Cervical cancer burden keeps rising with Kenya recording 5845 cases and 3591 deaths in 2022. The burden is higher in the developing countries due to lower screening rates. The low screening rates are due to low knowledge on cervical cancer among women of reproductive age (WRA) resulting from ineffective communication strategies. This study assessed the effectiveness of dialogue-trained CHPs in promoting uptake of cervical cancer screening among WRA in Nyando and Nyakach sub-Counties. Specifically, the study; assessed CHPs’ knowledge on cervical cancer following the dialogue-based training, compared the pre- and post-intervention knowledge on cervical cancer and screening rates among WRA following dialogue-trained CHPs intervention, and investigated the factors affecting uptake of cervical cancer screening among the WRA in Nyando and Nyakach sub-Counties. In this quasi-experimental study, 384 WRA were recruited. The educational intervention using CHPs was conducted in Nyando while Nyakach was the control. The knowledge was assessed using questionnaires and screening rates using self-reports before and after the intervention. Focus group discussion (FGD) with the WRA explored the factors affecting screening uptake. Change in knowledge and screening rate was analysed using Wilcoxon rank-sum test and difference in difference, while the factors affecting screening uptake using chi-square. Statistical significance was assessed at p≤0.05. The CHPs’ knowledge significantly improved from 30.1%, to 53.4% following the dialogue-based training (MD=23.3, Z=9.507, 95%CI, p<0.001). For WRA in the intervention arm, knowledge improved from 19.41% to 28.23% (SE=1.1, Z=-7.152, 95%CI, p<0.001) at post-intervention. At pre-intervention the control arm recorded better mean score than the intervention arm (SE=0.7, Z=7.671, 95%CI, p<0.001), this changed post-intervention with the intervention arm posting a better mean score than the control (SE=1.2, Z=-2.114, 95%CI, p=0.035). Those who scored average knowledge category in the intervention arm also increased at post-intervention (=28.372, 95%CI, p<0.001). Only 27.37% and 28.00% had been screened, in the intervention and control arms, respectively. This improved at post-intervention to 40.53% (Z=7.335, 95%CI, p=0.007) in the intervention arm. The number of those screened due to the health talks conducted by the CHPs also increased significantly at post-intervention (=4.385, 95%CI, p=0.036). The barriers to screening included violation of ones’ privacy (=17.504, 95%CI, p<0.001) and not feeling at risk (=30.001, 95%CI, p=0.001). Staff shortage, long waiting time, and male providers were reported as some of the barriers to screening from the FGD. Dialogue-based communication improved the knowledge on cervical cancer and the uptake of screening services in Nyando and Nyakach sub-Counties. | en_US |
