Cervical Cancer Screening in HIV-Positive Farmers in South Africa: Mixed-Method Assessment

Background: In 2015, a See and Treat cervical cancer screening program was implemented at a local HIV clinic in Limpopo, South Africa, where infrastructure limited adequate Pap smear usability. Objective: The purpose of this evaluation was to determine the quality and sustainability of the implement...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Molly Lieber, Omara Afzal, Kathryn Shaia, Adrienne Mandelberger, Christine Du Preez, Ann Marie Beddoe
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2019
Materias:	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/c0421fecc19c4b9096e5de8a66f72af3
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:c0421fecc19c4b9096e5de8a66f72af3
record_format	dspace
spelling	oai:doaj.org-article:c0421fecc19c4b9096e5de8a66f72af32021-12-02T03:08:50ZCervical Cancer Screening in HIV-Positive Farmers in South Africa: Mixed-Method Assessment2214-999610.5334/aogh.37https://doaj.org/article/c0421fecc19c4b9096e5de8a66f72af32019-04-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/37https://doaj.org/toc/2214-9996Background: In 2015, a See and Treat cervical cancer screening program was implemented at a local HIV clinic in Limpopo, South Africa, where infrastructure limited adequate Pap smear usability. Objective: The purpose of this evaluation was to determine the quality and sustainability of the implemented program. Methods: A mixed-methods program analysis was conducted at 18-months post implementation. Data collection techniques included in-depth interviews of staff and patients, observation of healthcare workers delivering screening, and review of charts and patient logs. Findings: Eighteen in-depth interviews revealed improved cervical cancer screening understanding and awareness. Privacy concerns and negative perceptions of medical care were barriers to screening. Informal observations revealed continued clinical competence among healthcare workers who had been previously trained. Review of charts demonstrated positive correlation between VIA and Pap smear results. In evaluating loss to attrition, about half of the first cohort of patients were lost to follow-up. VIAs and Pap smears were offered on an ongoing basis, and month-over-month change for overlapping four months of programming between 2015 and 2016 showed a 4.4% negative change in number of Pap smears and a 57% negative change in VIAs. Conclusion: Our evaluation reveals successful integration of See and Treat into current clinic services in rural South Africa and increased awareness of cervical cancer among health workers and participants. Program sustainability was challenging to assess as many patients were lost to follow-up, given the migrant and transient population attending this clinic. Acceptance by health workers and patients alike is vital for the long-term impact on cervical cancer incidence in this region.Molly LieberOmara AfzalKathryn ShaiaAdrienne MandelbergerChristine Du PreezAnn Marie BeddoeUbiquity PressarticleInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 85, Iss 1 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Molly Lieber Omara Afzal Kathryn Shaia Adrienne Mandelberger Christine Du Preez Ann Marie Beddoe Cervical Cancer Screening in HIV-Positive Farmers in South Africa: Mixed-Method Assessment
description	Background: In 2015, a See and Treat cervical cancer screening program was implemented at a local HIV clinic in Limpopo, South Africa, where infrastructure limited adequate Pap smear usability. Objective: The purpose of this evaluation was to determine the quality and sustainability of the implemented program. Methods: A mixed-methods program analysis was conducted at 18-months post implementation. Data collection techniques included in-depth interviews of staff and patients, observation of healthcare workers delivering screening, and review of charts and patient logs. Findings: Eighteen in-depth interviews revealed improved cervical cancer screening understanding and awareness. Privacy concerns and negative perceptions of medical care were barriers to screening. Informal observations revealed continued clinical competence among healthcare workers who had been previously trained. Review of charts demonstrated positive correlation between VIA and Pap smear results. In evaluating loss to attrition, about half of the first cohort of patients were lost to follow-up. VIAs and Pap smears were offered on an ongoing basis, and month-over-month change for overlapping four months of programming between 2015 and 2016 showed a 4.4% negative change in number of Pap smears and a 57% negative change in VIAs. Conclusion: Our evaluation reveals successful integration of See and Treat into current clinic services in rural South Africa and increased awareness of cervical cancer among health workers and participants. Program sustainability was challenging to assess as many patients were lost to follow-up, given the migrant and transient population attending this clinic. Acceptance by health workers and patients alike is vital for the long-term impact on cervical cancer incidence in this region.
format	article
author	Molly Lieber Omara Afzal Kathryn Shaia Adrienne Mandelberger Christine Du Preez Ann Marie Beddoe
author_facet	Molly Lieber Omara Afzal Kathryn Shaia Adrienne Mandelberger Christine Du Preez Ann Marie Beddoe
author_sort	Molly Lieber
title	Cervical Cancer Screening in HIV-Positive Farmers in South Africa: Mixed-Method Assessment
title_short	Cervical Cancer Screening in HIV-Positive Farmers in South Africa: Mixed-Method Assessment
title_full	Cervical Cancer Screening in HIV-Positive Farmers in South Africa: Mixed-Method Assessment
title_fullStr	Cervical Cancer Screening in HIV-Positive Farmers in South Africa: Mixed-Method Assessment
title_full_unstemmed	Cervical Cancer Screening in HIV-Positive Farmers in South Africa: Mixed-Method Assessment
title_sort	cervical cancer screening in hiv-positive farmers in south africa: mixed-method assessment
publisher	Ubiquity Press
publishDate	2019
url	https://doaj.org/article/c0421fecc19c4b9096e5de8a66f72af3
work_keys_str_mv	AT mollylieber cervicalcancerscreeninginhivpositivefarmersinsouthafricamixedmethodassessment AT omaraafzal cervicalcancerscreeninginhivpositivefarmersinsouthafricamixedmethodassessment AT kathrynshaia cervicalcancerscreeninginhivpositivefarmersinsouthafricamixedmethodassessment AT adriennemandelberger cervicalcancerscreeninginhivpositivefarmersinsouthafricamixedmethodassessment AT christinedupreez cervicalcancerscreeninginhivpositivefarmersinsouthafricamixedmethodassessment AT annmariebeddoe cervicalcancerscreeninginhivpositivefarmersinsouthafricamixedmethodassessment
_version_	1718401943164944384

Cervical Cancer Screening in HIV-Positive Farmers in South Africa: Mixed-Method Assessment

Ejemplares similares