Abstract
BackgroundCervical cancer is the most common cancer among women and the leading cause of cancer deaths in women in Côte d’Ivoire. Low resource countries can now prevent this cancer by using HPV vaccine and effective and affordable screening tests. However the implementation of these prevention strategies needs well-trained human resources. Part of the solution could come from midwives by integrating cervical cancer prevention into reproductive health services. The aim of this survey was to assess knowledge, attitudes and practices of midwives towards cervical cancer prevention in Abidjan, Côte d’Ivoire, and to find out factors associated with appropriate knowledge.MethodsA cross-sectional survey was conducted among midwives in the urban district of Abidjan, using a self-administered questionnaire. Knowledge was assessed by two scores. Factors associated with appropriate knowledge were determined using a logistic regression analysis. Attitudes and practices were described and compare using the Chi2 test.ResultsA total of 592 midwives were enrolled, including 24.5% of final-year students. 55.7% of midwives had appropriate knowledge on cervical cancer, and 42.4% of them had appropriate knowledge on cervical cancer prevention strategies. Conferences, courses taken at school of midwifery and special training sessions on cervical cancer (OR = 4.9, 95% CI [1.9 to 12.6], p <0.01) were associated with good knowledge on the management of this disease. Among these midwives, 18.4% had already benefited from a screening test for themselves, 37.7% had already advised screening to patients and 8.4% were able to perform a visual inspection. 50.3% of midwives knew HPV vaccine as a preventive method; among them 70.8% usually recommended it to young girls.ConclusionDespite sufficient knowledge about cervical cancer prevention, attitudes and practices of midwives should be improved by organizing capacity building activities. This would ensure the success of integration of cervical cancer prevention into reproductive health services in countries like Côte d’Ivoire.
Highlights
Cervical cancer is the most common cancer among women and the leading cause of cancer deaths in women in Côte d’Ivoire
The main information sources of midwives on CC was colleagues (70.0%) followed by courses taken at school of midwifery (60.8%); 18% of midwives had attended conferences on CC but 6.0% only had taken part to special training sessions on CC prevention
This study reveals that more than half of the midwives surveyed in Abidjan had appropriate knowledge on CC disease and more than 40% had appropriate knowledge on CC prevention, by screening and vaccination
Summary
Cervical cancer is the most common cancer among women and the leading cause of cancer deaths in women in Côte d’Ivoire. Low resource countries can prevent this cancer by using HPV vaccine and effective and affordable screening tests. In Côte d’Ivoire, West Africa, CC is the leading cancer in women: in 2008 its incidence and mortality were estimated at 26.9 cases and 19.1 deaths per 100,000 women, respectively [1]. Developed countries significantly reduced the burden of CC by implementing organized national screening programs based on cytology [7,8,9] and have made HPV vaccine widely available for young children [10]. Côte d’Ivoire has not succeeded in implementing those actions yet, mainly because of the high cost of HPV vaccine and cytology, as well as the lack of qualified human resources. Some studies showed that this technique has a diagnostic accuracy close to cytology and could be performed by paramedical staff [15,16]
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