249959 Inclusion of Zambian men in cervical cancer prevention: A missing link?

Wednesday, November 2, 2011

Heather White, MPH , Department of Epidemiology, Univeristy of Alabama at Birmingham, Birmingham, AL
Chishimba Mulambia, MPH , Institute of Economic and Social Research, University of Zambia, Lusaka, Zambia
Chibesa Wamulume, MBBS, MPH , Lusaka District Health Management Team, Zambia Ministry of Health, Lusaka, Zambia
Linda Moneyham, DNS, RN, FAAN , School of Nursing, University of Alabama at Birmingham, Birmingham, AL
Groesbeck Parham, MD , Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL
Eric Chamot, MD, PhD , Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
Background: Developing countries incur the largest disease burden from invasive cervical cancer (ICC) worldwide. Associated morbidity and mortality comes as a failure to identify high-risk women. Affordable, low-tech ICC screening modalities are becoming increasingly available in developing countries.

Purpose: Qualitative methods, e.g., focus group discussions (FGD) and in-depth interviews (IDI) were employed to identify interpersonal factors which influence women's decision to undergo cervical cancer screening using visual inspection with acetic acid (VIA) screen-and-treat methods in a primary care clinic in Lusaka, Zambia.

Methods: Between September, 2009-July, 2010, we conducted a total of 8 FGDs (6 with women eligible for screening, 1 with screening nurses, 1 with lay peer educators). Low-level, thematic content analysis was performed (QSR Nvivo, v.8.0) by a team of Zambian and American investigators. Subsequently, 10 IDIs were held with individual women to compare initial findings from FGDs and discuss identified themes in detail.

Results: While a majority of women said that they sought their partner's permission for screening or treatment, others felt this was a personal decision. Some women conveyed a fear of undergoing screening or treatment due to spousal repercussions, e.g., divorce, infidelity, or abuse. Healthcare personnel articulated a need to include men in ICC education and screening promotion. Peer educators suggested lay male counselors be identified and trained to educate men in the community about ICC prevention.

Recommendations: The role of male peer educators should be further investigated to involve Zambian men in discussions regarding the importance of VIA screening and treatment as ICC prevention.

Learning Areas:
Assessment of individual and community needs for health education
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning
Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
Explain the importance of including Zambian men in cervical cancer education, prevntion and screening promotion. Identify interpersonal factors which may influence a Zambian woman's decision to undergo VIA cervical cancer screening.

Keywords: Women's Health, Cervical Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have actively participated in the conduct of the research presented as a doctoral student and co-investigator on the project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.