Cervical Cancer Prevention Methods for Zambia, Using the Social Ecological Model and the Theory of Triadic Influence
17 December 2018
UAntwerp - Campus Drie Eiken - Building R - room R.106 - Universiteitsplein 1 - 2610 WILRIJK (route: UAntwerpen, Campus Drie Eiken
Prof G. Van Hal & Prof J. Kampen
PhD defence Anayawa Nyambe - Faculty of Medicine and Health Sciences
Abstract (Presentation in English)
Primary and secondary prevention methods have proved to be successful in controlling the spread of cervical cancer. Despite these developments cervical cancer remains the leading cancer among women in Zambia. Such that approximately 81% of the women diagnosed with cervical cancer die from the disease every year. The aim of the research was to identify the optimal cervical cancer prevention procedures that can be practiced in Zambia.
To achieve this aim, the Social Ecological Model and the Theory of Triadic Influence were systematically reviewed and used to study cervical cancer prevention behaviors among Zambians. This involved conducting a case study in Lusaka from February to May 2016. Quantitative data by means of questionnaire was initially collected from the general public (women and men). Then data was collected qualitatively through focus groups discussions with the general public, and interviews with stakeholders (health care providers, teachers and religious leaders), special interest groups (advocacy groups and non-governmental organizations), and policy makers. Finally, a small-scale intervention study assessing knowledge among the general public in Lusaka was conducted from August to September 2017.
Descriptive statistics and appropriate statistical tests (chi square test, analysis of variance, logistic regression) were used to describe and analyze the quantitative data according to hypotheses developed. A knowledge grade (range: 1 – 10 points) which linked causes to risk factors for cervical cancer was used to assess the knowledge of respondents. Qualitative data was coded into predetermined themes (cervical cancer in general, screening, vaccination) and an organizational chart of the administration of cervical cancer prevention services in Zambia was developed.
The population was found to have low levels of awareness, knowledge and practice of screening and vaccination. According to the theoretical frameworks, awareness, knowledge, personal beliefs, social influence, availability of facilities/services, and policy are among the factors that affected the practice of cervical cancer prevention behaviors.
The Zambian cervical cancer prevention system has covered several areas to control the spread of cervical cancer. To optimize this program, awareness, social support and facilities can be improved. Since film was demonstrated to increase awareness and knowledge, it can be used for sensitization campaigns. Interventions must include men because they greatly influence women in the practice of prevention. Furthermore, with increased knowledge screening practice by self-screening can be better promoted and a future national roll-out of the human papillomavirus-vaccine would mean a reduction in cases of cervical cancer and better survival.