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By 2040, the predicted global cancer burden is expected to be more than 27 million new cancer cases per year. Understanding primary health care workers’ (HCWs) perception on cancer can highlight new ways in which cancer advocacy can be increased. This study aimed to explore the perceptions of primary HCWs in Lautoka, Fiji, towards common cancers with focus on knowledge, risk perceptions, barriers and preventive approaches.
Methods:
The study used a qualitative method approach. The study was conducted among primary HCWs at four purposively selected health centres in Lautoka Subdivision, Fiji, from 1 March 2021 to 1 April 2021. Focus group discussions (FGDs) were conducted with primary HCWs. A semi-structured open-ended questionnaire was used to collect data, and the FGDs were audio-recorded. These audio recordings were transcribed and analysed using thematic analysis.
Results:
The responses from the four FGDs with six primary HCWs in each group emerged four major themes. These themes were cancer knowledge, health professional training, barriers and challenges and awareness strategies. Primary HCWs were not fully aware about common cancers and were not confident to discuss about cancer with their patients which is an important role of primary HCWs in cancer management. This lack of knowledge was attributed to less training received in primary care setting. Barriers to accessing cancer screening included misconceptions about cancer, negative attitudes from patients, stigmatization, lack of resources at health facility and less informed health staff. Community outreach programmes, opportunistic screening, community HCWs and the concept of a cancer hub centre were awareness strategies highlighted by primary HCWs.
Conclusions:
Lack of knowledge about common cancers among primary HCWs is a concern that is depicted well in this study. This low knowledge was attributed to lack of training on cancers received by primary HCWs. Guidelines on cancer screening and diagnosis can be developed by the health ministry to assist primary HCWs in detecting patients at pre-cancerous stage.
The study explored the knowledge and service delivery skills of primary health care (PHC) workers to conduct cervical cancer screening programmes in Sango primary health centre in Sango town, Ado-Odo Ota, Ogun State in Nigeria.
Background:
Cervical cancer is the second most common cancer affecting women. The prevention and control services in Nigeria are provided mainly at post-primary health facilities. Authorities have advocated the integration of cervical cancer prevention into reproductive health services provided at PHC centres. The service delivery capabilities of PHC workers are critical for successful implementation of screening programmes.
Method:
Exploratory qualitative research design was used. Data were collected among 10 PHC workers who were purposively sampled at Sango PHC. Semi-structured interview guide with broad items and a checklist were used to assess participants’ cervical cancer screening knowledge and service delivery skills using visual inspection screening methods. Data were analysed thematically and triangulated.
Findings:
A range of roles were represented in the interviews of the health care workers at the PHC studied. They had poor knowledge and skills about cervical cancer screening using visual inspection with acetic acid and visual inspection with Lugol’s iodine. Study participants perceived nurses as most equipped PHC workers to conduct screening at PHC level, followed by the community health officers. Participants reported no cervical cancer services at the centre and community. The findings provided useful insight that guided the training of primary health workers and the development of a community-based cervical cancer screening model for women in rural communities.
Conclusion:
Nurses and other PHC workers should be trained on visual inspection screening method. This low-cost but effective methodology could be incorporated into their training curricula as a strategy for scaling up cervical cancer prevention programmes across Nigeria.
Mental health problems are common in primary care, with prevalence rates of up to 40% reported in developing countries. The study aim was to evaluate the impact of a specially designed toolkit used to train primary health care (PHC) workers in mental health on the rates of diagnosed cases of common mental disorders, malaria and non-specific musculoskeletal pains in primary care in Malawi.
Method
Clinics with out-patient services in the designated district were randomly divided into control and intervention arms. Using a two-phase sampling process, Self-Reporting Questionnaire scores, data on diagnoses made by PHC workers and results of the Structured Clinical Interview for DSM-IV for depression were collected from 837 consecutively attending adult patients in the pre-intervention study and 2600 patients in the post-intervention study.
Results
The point prevalence rates for probable common mental disorder and depression were 28.8% and 19%, respectively. Rates for both anxiety and depression diagnoses by PHC workers at baseline were 0% in both arms. Following training, there were significant differences between the two arms in the rates of diagnosed cases of depression [9.2% v. 0.5%, odds ratio (OR) 32.1, 95% confidence interval (CI) 7.4–144.3, p ⩽ 0.001], anxiety (1.2% v. 0%, p ⩽ 0.001) and malaria (31% v. 40%, OR 0.62, 95% CI 0.43–0.89, p = 0.01). The intervention arm had more cases diagnosed with depression and anxiety while the control arm had more cases diagnosed with malaria.
Conclusions
Training of PHC workers in mental health with an appropriate toolkit will contribute significantly to the quality of detection and management of patients seen in primary care in developing countries.
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