Promoting cervical screening by involving men as motivators
Cervical cancer is the second most common cancer and the most common cancer among Black South African women. Despite having a national cervical cancer screening programme, most women present with advanced disease. Men play a role in cervical cancer as the Human Papilloma Virus (HPV), the major cause of cervical cancer, is sexually transmitted. The purpose of the study was to develop and pilot test an educational programme focused on men acting as motivators to encourage women to present for cervical cancer screening in resource poor community in the West Rand and to assess the programme in terms of primary and secondary outcomes. The primary outcome was presenting for screening and the secondary outcomes were knowledge and behaviour. The educational programme was also evaluated. The study consisted of two Phases; the first phase was a survey design and convenience sampling to select 101 men older than 18 years (n=101). An intervention research design and one group posttest only was used in the second Phase of the study which focused on the development and pilot testing of the educational programme by using men as motivators. A pre-tested self-questionnaire was used to collect data from the women who presented for screening with the referral notes and the men who participated in the educational programme. Convenience sampling was used and 30 women (n=30) and 100 men (n=100) participated. Descriptive data analysis was used for both Phases. All the data were entered onto an Excel spread sheet and analysed using the SPSS version 22 computer program with the assistance of a statician. Content analysis was used to analyse the data obtained by means of the openended questions. Chi-Square tests were used to measure the association between the variables. The study provided evidence that the level of knowledge about cervical cancer and cervical cancer screening was low. Despite the fact 120 men participated in the intervention and 66 women were informed by the participants, only 30 reported to the clinic to be screened. The intervention was unsuccessful and it is debatable whether it should be refined. Men who participated in the educational programme showed interest in learning more about the disease and gaining more knowledge, but unfortunately, it seems as if cultural taboos prevented from educating their sex partners and female family members about cervical screening. In addition, some of women who were informed did not come for screening. The results of the study emphasis the complexity of finding methods to improve cervical cancer screening uptake.
A thesis submitted to the faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Doctor of Philosophy, 2018