Role of Training Sessions on Cervical Cancer Preventive Strategies in Improving Knowledge and Attitude of Accredited Social Health Activists

Abstract

Background: India has the world’s largest load of cervical malignancy. A lot of it can be attributed to lack of cervical cancer screening awareness among the general population. The Accredited Social Health Activists (ASHA) are grass root workers who have good reach in the remote areas, where health care facilities are lacking. Training these ASHAs may increase the general awareness about cervical cancer screening. The aim of the study was to train ASHA workers via lectures and question answer sessions and assess the training with pre and post tests.
 Methods: We organized two training programs of 500 ASHA workers in two tertiary care hospitals with aim of improving their knowledge and attitude about cervical cancer screening which will eventually improve their practice of training women in general population. It comprised of five lectures in language they understand, slogans, posters, question answer session etc. A test comprising of 17 questions was conducted before and after session to check their knowledge and attitude. 
 Results: There was an overall improvement of 35% in knowledge of the ASHAs i.e. 48% answers were correct in pre-test and 78% were correct in post-test. Questions were pertaining to symptomatology, risk factors, screening methods, their utility and prerequisites of performing the screening tests, when and how often to repeat. Improvement was seen in all the areas. There was improvement in attitude too and most of them wanted themselves (98%), their relatives (100%) and the woman within their area (98%) to be screened for cancer cervix.
 Conclusion: It was a small initiative and successful result was obtained after the training session of ASHAs. These grass root workers may act as key link of awareness for cervical cancer prevention. They live in same community as the client and therefore, have better repo and communication as compared to medical personnel. Though, this study showed improved knowledge and motivation in ASHAs yet the impact on general population needs further evaluation.