School of Nursing and Midwifery, East Africa
Cervical cancer is one of the few diseases that reflect global inequities. In low and middle income countries, its incidence is nearly twice as high and its death rates three times as high compared to high income countries. Programs must focus on changing these trends. Visualizing with acetic acid encompasses the following: First, the health Care provider (HCP) does vaginal examination using a speculum, then dilute (3-5%) acetic acid (vinegar) is applied to the cervix. The presence of abnormal tissue often temporarily appears white when exposed to vinegar and then cervical color changes are observed with a naked eye. The outcome of Visual inspection with acetic acid is very subjective and depends with the level of skill of health care provider as well as availability of procedure supplies and adhering to Via procedure guidelines. The aim of this study was to determine the Extent to which Visual Inspection with acetic acid guidelines are adhered to in selected health facilities in Embu county prior to intervention and after intervention. An intervention study design was used. In particular, fourteen health care providers who were the initial study respondents were taken through an intensive VIA training for two days didactic and a four days clinical practice with guidance of preceptors. The facilities where respondents were recruited from were selected using a purposeful sampling method. Prior to intervention, a baseline data was taken that included use of questionnaires and observational checklist to determine adherence to VIA guidelines. The health care providers were then followed up for a period of four months where by 434 women were screened. The study area was Embu County in Kenya and the target population was the health services providers who provided VIA services in government facilities. The data was collected through self-administered questionnaires and observational checklists. In addition, secondary data was obtained from the health facility records and KDHS 2014. For data analysis, quantitative techniques of analysis were used. This study established that, despite all the respondents having some form of prior training on cervical cancer screening using VIA/VILLI, positivity rate was low before intervention. Cervical cancer screening guidelines were poorly adhered to prior to training compared to improved adherence after training. After intervention, healthcare providers were able to make the correct diagnosis and identify precancerous lesions. Cervical cancer screening uptake also scaled up. Baseline positivity was 0.8% and after training it was 14.1%. The study Concludes and Recommends that based on the key findings of this study, the MOH VIA training guidelines and curriculum should be revised to accommodate clinical practice for at least 4 days after 2 days didactic training with use of preceptors and cervical images.
Publication (Name of Journal)
Journal of Nursing and Practice
M., E. M.,
(2022). Extent to which Visual Inspection with Acetic Acid Screening Guidelines are Adhered to in Selected Health Facilities in Embu County, Kenya before and after Intervention. Journal of Nursing and Practice, 5(1), 433-443.
Available at: https://ecommons.aku.edu/eastafrica_fhs_sonam/428
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