Focused training of community health volunteers on cervical cancer in rural Kisumu

Abstract

The cancer disease burden is higher in the low- and middle-income countries like Kenya where uptake of screening services is low. Community health volunteers (CHVs) have been shown to be effective in improving uptake of health services and could also be used in cervical cancer screening. However, they still have inadequate knowledge hindering effective public education. The aim of this study is to determine the effect of focused training of the CHVs on their knowledge on cervical cancer and screening uptake among women of reproductive age. This was a quasi-experimental study in rural sub-counties of Nyando and Nyakach. Nyando was the intervention arm with 186 CHVs and Nyakach the control with 239 CHVs. Participants’ knowledge on cervical cancer was assessed using a self-administered questionnaire. CHVs in the intervention arm were trained about cervical cancer and screening. Knowledge was re-assessed following a 6-month public education period. The focused training improved the CHVs’ knowledge on cervical cancer to 60.9% compared to 13.4% in the control arm (p = 0.004) at the end-line. The knowledge was dependent on the level of education (χ2 = 34.41, p = 0.045), religion (χ2 = 25.85, p = 0.007), and occupation (χ2 = 95.04, p < 0.0001). Screening uptake was significantly associated with knowledge of risk factors (p = 0.019) and sign and symptoms (p = 0.017). Screening uptake improved in the intervention arm while declined in the control arm. The training significantly improved the CHVs’ knowledge on cervical cancer and uptake of screening services in the intervention area, Kisumu County, Kenya, and should be continuous.