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Kassa RN, Shifti DM, Alemu K, Omigbodun AO. Integration of cervical cancer screening into healthcare facilities in low- and middle-income countries: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003183. [PMID: 38743652 DOI: 10.1371/journal.pgph.0003183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/11/2024] [Indexed: 05/16/2024]
Abstract
Cervical cancer is a prevalent disease among women, especially in low- and middle-income countries (LMICs), where most deaths occur. Integrating cervical cancer screening services into healthcare facilities is essential in combating the disease. Thus, this review aims to map evidence related to integrating cervical cancer screening into existing primary care services and identify associated barriers and facilitators in LMICs. The scoping review employed a five-step framework as proposed by Arksey and O'Malley. Five databases (MEDLINE, Maternity Infant Care, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science) were systematically searched. Data were extracted, charted, synthesized, and summarised. A total of 28 original articles conducted in LMICs from 2000 to 2023 were included. Thirty-nine percent of the reviewed studies showed that cervical cancer screening (CCS) was integrated into HIV clinics. The rest of the papers revealed that CCS was integrated into existing reproductive and sexual health clinics, maternal and child health, family planning, well-baby clinics, maternal health clinics, gynecology outpatient departments, and sexually transmitted infections clinics. The cost-effectiveness of integrated services, promotion, and international initiatives were identified as facilitators while resource scarcity, lack of skilled staff, high client loads, lack of preventive oncology policy, territorial disputes, and lack of national guidelines were identified as barriers to the services. The evidence suggests that CCS can be integrated into healthcare facilities in LMICs, in various primary care services, including HIV clinics, reproductive and sexual health clinics, well-baby clinics, maternal health clinics, and gynecology OPDs. However, barriers include limited health system capacity, workload, waiting times, and lack of coordination. Addressing these gaps could strengthen the successful integration of CCS into primary care services and improve cervical cancer prevention and treatment outcomes.
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Affiliation(s)
- Rahel Nega Kassa
- Pan African University Life and Earth Sciences Institute (including Health and Agriculture), University of Ibadan, Ibadan, Oyo State, Nigeria
- School of Nursing, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | - Kassahun Alemu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Akinyinka O Omigbodun
- College of Medicine, University of Ibadan, University College Hospital, Ibadan, Oyo State, Nigeria
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2
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Haffejee F, Ducray J, Basdav J, Kell C. Factors influencing the adoption of HIV prevention measures in low socio-economic communities of inner-city Durban, South Africa. SAHARA J 2023; 20:2185806. [PMID: 36880791 PMCID: PMC10013356 DOI: 10.1080/17290376.2023.2185806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
South Africa is the epicentre of the HIV pandemic. Although there have been health promotion education campaigns to reduce HIV incidence, these have not achieved the desired outcomes. When exploring the effectiveness of these campaigns, it is useful not only to examine HIV knowledge, but also to explore the relationship between that knowledge and health-related behaviour. This study aimed to determine the (1) level of knowledge of HIV prevention, (2) relationship between the level of knowledge and the adoption of these behaviours and (3) barriers to sexual behaviour change of vulnerable women in Durban's city centre, KwaZulu-Natal, South Africa. A mixed methods approach was used to collect information from a marginalised population of women (n = 109) attending a non-governmental organisation, which provides for the needs of people from low socio-economic strata. Data were collected during September 2018 at a wellness day programme at the centre. A total of 109 women, over the age of 18 years answered the questionnaire. Knowledge of HIV transmission was high, with majority of participants correctly identifying modes of transmission. Almost all the participants (91.2%) had been tested for HIV, with 68.8% tested a minimum of three times. Despite this, sexual risk behaviour was high. Despite the high level of knowledge of HIV transmission, there was no relationship between HIV knowledge and adoption of behaviours for the prevention of HIV transmission (p = .457). However, bivariate analysis showed an association between transactional sex and living in informal housing (OR = 31.94, 95% CI: 5.65-180.63, p < .001). Living in informal housing was also associated with having multiple current sexual partners (OR = 6.30, 95% CI: 1.39-28.42, p = .02). Multivariate analysis, after adjusting for all other factors, indicated that the odds of having transactional sex was increased by 23 times in those who did not have formal housing (OR = 23.306, 95% CI: 3.97-144.59, p = .001). Qualitative responses showed that women perceived poverty as the overarching factor determining the lifestyle choices which impacted their health. They indicated a need for employment opportunities and provision of housing to alleviate both poverty as well as transactional sex. Although, participants from this study understood the benefits of the protective behaviours to prevent HIV transmission, economic and social factors do not afford this vulnerable group the opportunity nor the motivation to adopt such behaviours. In the current climate of increasing unemployment and escalating GBV, urgent interventions are needed in terms of employment opportunities and empowerment drives to prevent an increase in HIV transmission.
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Affiliation(s)
- Firoza Haffejee
- Department of Basic Medical Sciences, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Jennifer Ducray
- Department of Basic Medical Sciences, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Jyotika Basdav
- Department of Basic Medical Sciences, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Colette Kell
- Department of Basic Medical Sciences, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
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Haffejee F, Maharajh R, Sibiya MN. Exploring the Lived Experiences of Vulnerable Females from a Low-Resource Setting during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7040. [PMID: 37998271 PMCID: PMC10671480 DOI: 10.3390/ijerph20227040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023]
Abstract
The onset of the Coronavirus disease 2019 (COVID-19) pandemic has affected the mental health and well-being of women in vulnerable settings. Currently, there is limited evidence that explores the wellness of elderly women under the associated restrictions. This study explores the lived experiences of elderly women in a vulnerable community in Durban, South Africa. A face-to-face, in-depth qualitative approach was implemented to interview 12 women aged 50 years and over. Thematic analysis was used to analyse the data. The findings suggest that social interactions, the effect of a high death rate, and financial strain predominantly affect stress and anxiety levels. Despite the women being in receipt of pensions and/or other grants, their supplementary income was reduced. This, together with the additional expenses incurred during the lockdown, resulted in anxiety over finances. The lack of social interaction, with limits on visiting family and other loved ones when they were ill, along with the limit on the number of people attending the funerals of loved ones were also stressful. This study also reports on the resulting coping mechanisms, which included using hobbies such as baking and sewing as a means of self-care. Religious beliefs also relieved stress while home remedies were used as preventative measures during the lockdown restrictions due to COVID-19.
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Affiliation(s)
- Firoza Haffejee
- Department of Basic Medical Sciences, Durban University of Technology, Durban 4000, South Africa;
| | - Rivesh Maharajh
- Department of Basic Medical Sciences, Durban University of Technology, Durban 4000, South Africa;
| | - Maureen Nokuthula Sibiya
- Division of Research, Innovation and Engagement, Mangosuthu University of Technology, Umlazi 4031, South Africa;
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Ferreira MDCM, Nogueira MC, Ferreira LDCM, Bustamante-Teixeira MT. [Early detection and prevention of cervical cancer: knowledge, attitudes and practices of FHS professionals]. CIENCIA & SAUDE COLETIVA 2022; 27:2291-2302. [PMID: 35649017 DOI: 10.1590/1413-81232022276.17002021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 11/03/2021] [Indexed: 11/21/2022] Open
Abstract
The study aimed to investigate the knowledge, attitudes and practices of professionals of the Family Health Strategy (FHS) on the control of uterine cervical cancer (CCU) recommended by the Ministry of Health (MS). This is a cross-sectional study, which used a self-administered questionnaire with the doctors and nurses of the FHS of Juiz de Fora, MG, in 2019. For analysis, the chi-square and Fisher's exact test were used, 5% level of significance. Among the 170 surveyed, which corresponded to 93% of FHS professionals in the city, the prevalence of adequate knowledge was 39.4% and had association with younger age and female gender. The prevalence of an adequate attitude was 59.5% and of appropriate practices 77.6%, both associated with a longer time since graduation. The presence of the Ministry of Health guidelines in the units was associated with the outcomes, knowledge and adequate practice, confirming the importance of support material for consultation by professionals. Only 28.2% of professionals reported having received training in the last 3 years and 50.3% carried out educational actions for users. The need for permanent education actions with professionals is highlighted, aiming at a more effective action to confront and eradicate CCU.
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Affiliation(s)
| | - Mário Círio Nogueira
- Departamento de Saúde Coletiva, Faculdade de Medicina, Universidade Federal de Juiz de Fora. Juiz de Fora MG Brasil
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Ducray JF, Kell CM, Basdav J, Haffejee F. Cervical cancer knowledge and screening uptake by marginalized population of women in inner-city Durban, South Africa: Insights into the need for increased health literacy. WOMEN'S HEALTH 2021; 17:17455065211047141. [PMID: 34553644 PMCID: PMC8474337 DOI: 10.1177/17455065211047141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Cervical cancer in South Africa accounts for 15.85% of all female cancers and
30.29% of African female cancers, resulting in over 5000 deaths annually.
South Africa’s proposed move towards universal healthcare places emphasis on
health promotion through education and screening, but there is little data
on the baseline levels of knowledge and screening uptake regarding cervical
cancer. This study explored the levels of knowledge and screening rates of
cervical cancer among vulnerable women living in the inner-city of Durban,
South Africa. Methods: A mixed-method study was conducted within the context of a Women’s Health
outreach initiative. Data were collected from women attending the outreach
(n = 109), many of whom were from marginalized
communities. A pre-intervention survey was used to collect the data. This
was followed by cervical cancer education sessions and the opportunity for a
free Pap smear. Results: Knowledge of cervical cancer was low (<25%) and only a third of the women
had previously been screened. After the educational sessions, 64% of women
(n = 70) took advantage of the opportunity for Pap
smears, with many expressing the need for wider cervical cancer education,
screening centres and support groups. Only 20% of the Pap smears were normal
(n = 14). Half of the women tested positive for
infections (n = 36; 51.4%), and a small proportion
(n = 8; 11.4%) tested positive for human papilloma
virus. Abnormal cervical intra-epithelial neoplasia (CIN1 and CIN 2) were
also detected in this population (n = 12; 17.1%). Conclusion: Cervical cancer knowledge and screening among vulnerable women in Durban,
South Africa, is inadequate, especially considering the high levels of
abnormality found in the Pap smears. Education drives, accompanied with the
provision of free testing, are required. Community health outreach
initiatives in collaboration with non-government organizations set in
accessible locations could be a possible course of action.
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Affiliation(s)
- Jennifer F Ducray
- Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
| | - Colette M Kell
- Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
| | - Jyotika Basdav
- Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
| | - Firoza Haffejee
- Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
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Moucheraud C, Kawale P, Kafwafwa S, Bastani R, Hoffman RM. Health care workers' experiences with implementation of "screen and treat" for cervical cancer prevention in Malawi: A qualitative study. Implement Sci Commun 2020; 1:112. [PMID: 33317633 PMCID: PMC7734769 DOI: 10.1186/s43058-020-00097-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/25/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Cervical cancer remains a major cause of mortality and morbidity in low- and middle-income countries, despite the availability of effective prevention approaches. "Screen and treat" (a single-visit strategy to identify and remove abnormal cervical cells) is the recommended secondary prevention approach in low-resource settings, but there has been relatively scarce robust implementation science evidence on barriers and facilitators to providing "screen and treat" from the provider perspective, or about thermocoagulation as a lesion removal technique. METHODS Informed by the Consolidated Framework for Implementation Research (CFIR), we conducted interviews with ten experienced "screen and treat" providers in Malawi. We asked questions based on the CFIR Guide, used the CFIR Guide codebook for a descriptive analysis in NVivo, and added recommended modifications for studies in low-income settings. RESULTS Seven CFIR constructs were identified as positively influencing implementation, and six as negatively influencing implementation. The two strong positive influences were the relative advantage of thermocoagulation versus cryotherapy (Innovation Characteristics) and respondents' knowledge and beliefs about providing "screen and treat" (Individual Characteristics). The two strong negative influences were the availability of ongoing refresher trainings to stay up-to-date on skills (Inner Setting, Implementation Climate) and insufficient resources (staffing, infrastructure, supplies) to provide "screen and treat" to all women who need it (Inner Setting, Readiness for Implementation). Weak positive factors included perceived scalability and access to knowledge/information, as well as compatibility, leadership engagement, and team characteristics, but these latter three were mixed in valence. Weak negative influences were structural characteristics and donor priorities; and mixed but weakly negative influences were relative priority and engaging clients. Cross-cutting themes included the importance of broad buy-in (including different cadres of health workers and leadership at the facility and in the government) and the opportunities and challenges of offering integrated care (screening plus other services). CONCLUSIONS Although "screen and treat" is viewed as effective and important, many implementation barriers remain. Our findings suggest that implementation strategies will need to be multi-level, include a diverse set of stakeholders, and explicitly address both screening and treatment.
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Affiliation(s)
- Corrina Moucheraud
- University of California Fielding School of Public Health, Los Angeles, CA USA
| | - Paul Kawale
- African Institute for Development Policy, Lilongwe, Malawi
| | | | - Roshan Bastani
- University of California Fielding School of Public Health, Los Angeles, CA USA
| | - Risa M. Hoffman
- University of California Geffen School of Medicine, Los Angeles, CA USA
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Pierz AJ, Randall TC, Castle PE, Adedimeji A, Ingabire C, Kubwimana G, Uwinkindi F, Hagenimana M, Businge L, Musabyimana F, Munyaneza A, Murenzi G. A scoping review: Facilitators and barriers of cervical cancer screening and early diagnosis of breast cancer in Sub-Saharan African health settings. Gynecol Oncol Rep 2020; 33:100605. [PMID: 32637528 PMCID: PMC7327246 DOI: 10.1016/j.gore.2020.100605] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 01/11/2023] Open
Abstract
To address gaps in access to cervical cancer screening and early diagnosis of breast cancer services in Sub-Saharan African (SSA), this scoping review was conducted to explore facilitators and barriers that exist on the patient-, provider-, and system-level. An extensive literature search was conducted in accordance with scoping review methodology and the Cochrane guidelines. Our search criteria were limited to original research studies conducted in community or clinical settings in SSA within the last 10 years (2010-2020). Themes found from this review included patient knowledge and provider education, access to screening services, trust, health-related behaviors, attitudes, values, and practices, community and social values, health infrastructure, resource allocation, and political will. Identified barriers included lack of knowledge about cervical and breast cancer among patients, gaps in education and training among providers, and lack of resources and health infrastructure at the facility level and within the overall health system. Facilitators included perceived risk of cancer, support and encouragement of the provider, and utilization of novel approaches in low-resource settings by health systems. To better address individual-, provider-, and health system and facility-based facilitators and barriers to care, there is a need for political and financial investment and further research on the health service delivery in specific national health systems, especially in the context of the global campaign to eliminate cervical cancer as a public health problem.
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Affiliation(s)
- Amanda J. Pierz
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Thomas C. Randall
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
| | - Philip E. Castle
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Charles Ingabire
- Division of Clinical Education and Research, Rwanda Military Hospital, Kigali, Rwanda
| | | | | | - Marc Hagenimana
- Cancer Diseases Unit, Rwanda Biomedical Center, Kigali, Rwanda
| | - Lydia Businge
- Division of Clinical Education and Research, Rwanda Military Hospital, Kigali, Rwanda
| | - Francoise Musabyimana
- Division of Clinical Education and Research, Rwanda Military Hospital, Kigali, Rwanda
| | - Athanase Munyaneza
- Division of Clinical Education and Research, Rwanda Military Hospital, Kigali, Rwanda
| | - Gad Murenzi
- Division of Clinical Education and Research, Rwanda Military Hospital, Kigali, Rwanda
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New-Aaron M, Meza JL, Goedert MH, Kibusi SM, Mkhoi ML, Mayengo CD, Charles J, Shabani S, Musil KM, Cheney A, Sumba S. Cervical Cancer Screening among Women Receiving Antiretroviral Therapy in a Resource-Limited Environment. Asian Pac J Cancer Prev 2020; 21:2035-2045. [PMID: 32711430 PMCID: PMC7573407 DOI: 10.31557/apjcp.2020.21.7.2035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Cervical cancer is among the most prevalent cancer among women worldwide and women living with HIV are at increased risk, especially in a resource-limited environment. Objective: This study aimed to determine levels of awareness, knowledge, uptake, and willingness to screen for cervical cancer among women receiving care in an HIV clinic at Dodoma Regional Referral Hospital (DRRH), Tanzania. Methods: Data were collected for a period of three weeks from July 21 to August 11, 2017 using a mobile phone data collection App. A total of 421 Women aged 18-50 years old were included in the study. Results: Majority of the women interviewed (n=306, 73%) were aware of cervical cancer. Among those who were aware, 84% (n=257) did not recall ever being screened for cervical cancer, and majority had a poor knowledge of cervical cancer. Educational level completed (p=0.01), income per month (p=0.02), age group (p<0.0001), and area of residence (p<0.0001) were all significantly associated to awareness of cervical cancer. Most of the women who have never screened (n=231, 91%) expressed willingness to be screened. Prior uptake of cervical cancer screening was associated with number of live births (p=0.001) and area of residence (p=0.04). And Willingness to screen was significantly associated with age groups (p=0.03) and the number of live births (p=0.03). Moreover, we found that younger age and urban residence was positively associated with awareness and uptake of cervical cancer screening. Willingness was found to decrease as age increased. Conclusion: The study found that despite older women’s higher risk of cervical cancer, those who indicated willingness to screen were younger. Additional education, health promotion, and integration of cervical cancer screening services is needed to improve cervical cancer awareness and screening uptake at the HIV clinic.
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Affiliation(s)
- Moses New-Aaron
- Department of Environmental Health, Occupational Health and Toxicology, University of Nebraska Medical Center, Omaha, Nebraska, USA.,Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jane L Meza
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Martha H Goedert
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Stephen M Kibusi
- College of Health Sciences, Public Health, The University of Dodoma, Dodoma, Tanzania
| | - Mkhoi L Mkhoi
- University of Dodoma, College of Health Sciences, Department of Microbiology and Immunology, Dodoma, Tanzania
| | - Caroline Damian Mayengo
- Ministry of Health, Community Development, Gender, Elderly & Children, Dodoma, Tanzania.,Dodoma Regional Referral Hospital, Dodoma, Tanzania
| | | | | | - Kelsie M Musil
- Department of Environmental Health, Occupational Health and Toxicology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Anlan Cheney
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Implementation science for integration of HIV and non-communicable disease services in sub-Saharan Africa: a systematic review. AIDS 2018; 32 Suppl 1:S93-S105. [PMID: 29952795 DOI: 10.1097/qad.0000000000001897] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE As the burden of chronic non-communicable diseases (NCDs) rises across sub-Saharan Africa (SSA), global donors and governments are exploring strategies to integrate HIV and NCD care. Implementation science is an emerging research paradigm that can help such programs achieve health impact at scale. We define implementation science as a systematic, scientific approach to ask and answer questions about how to deliver what works in populations who need it with greater speed, appropriate fidelity, efficiency, and relevant coverage. We identified achievements and gaps in the application of implementation science to HIV/NCD integration, developed an HIV/NCD implementation science research agenda, and detailed opportunities for capacity building and training. DESIGN We conducted a systematic review of the application of implementation science methods to integrated HIV/NCD programs in SSA. METHODS We searched PubMed, CINAHL, PsycINFO, and EMBASE for evaluations of integrated programs in SSA reporting at least one implementation outcome. RESULTS We identified 31 eligible studies. We found that most studies used only qualitative, economic, or impact evaluation methods. Only one study used a theoretical framework for implementation science. Acceptability, feasibility, and penetration were the most frequently reported implementation outcomes. Adoption, appropriateness, cost, and fidelity were rare; sustainability was not evaluated. CONCLUSIONS Implementation science has a promising role in supporting HIV/NCD integration, although its impact will be limited unless theoretical frameworks, rigorous study designs, and reliable measures are employed. To help support use of implementation science, we need to build sustainable implementation science capacity. Doing so in SSA and supporting implementation science investigators can help expedite HIV/NCD integration.
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Haffejee F, O’Connor L, Govender N, Reddy P, Sibiya MN, Ghuman S, Ngxongo T, Borg D. Factors associated with unintended pregnancy among women attending a public health facility in KwaZulu-Natal, South Africa. S Afr Fam Pract (2004) 2017. [DOI: 10.1080/20786190.2017.1396790] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Firoza Haffejee
- Department of Basic Medical Sciences, Durban University of Technology , Durban, South Africa
| | - Laura O’Connor
- Department of Chiropractic and Somatology, Durban University of Technology , Durban, South Africa
| | - Nalini Govender
- Department of Basic Medical Sciences, Durban University of Technology , Durban, South Africa
| | - Poovendhree Reddy
- Department of Community Health Studies, Durban University of Technology , Durban, South Africa
| | | | - Shanaz Ghuman
- Department of Community Health Studies, Durban University of Technology , Durban, South Africa
| | - Thembelihle Ngxongo
- Department of Nursing, Durban University of Technology , Durban, South Africa
| | - Dorinda Borg
- Department of Chiropractic and Somatology, Durban University of Technology , Durban, South Africa
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11
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Ganta V, Moonie S, Patel D, Hunt AT, Richardson J, Di John D, Ezeanolue EE. Timely reminder interventions to improve annual Papanicolaou (Pap) smear rates among HIV-infected women in an outpatient center of southern Nevada: a short report. AIDS Care 2017; 29:1099-1101. [PMID: 28460538 DOI: 10.1080/09540121.2017.1322677] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Current guidelines recommend annual Papanicolaou (Pap) smears for human immunodeficiency virus (HIV)-infected women for cervical cancer screening. Rates for such screening in Nevada are below the national rate. Our cohort includes 485 eligible HIV-infected adult women from an outpatient center in Southern Nevada of which only 12 women had obtained a Pap smear in the past year. An intervention was conducted from June 2015 to September 2015, in which reminders to schedule a Pap smear were sent to the remaining cohort of 473 women via sequential text messaging, followed by phone call attempts. Of all subjects, 94% contacted by text messages and 41% contacted by phone calls were successfully reached. There was an increase in the rate of completed Pap smears from 2.5% (12/485) at baseline to 11.8% (56/473) after interventions (p < 0.0001) in a period of three months. Out of the 68 Pap smear results, 20 (29.4%) were abnormal. Our intervention, utilizing methods of communication such as text messaging and phone calls, markedly increased the rate of completed Pap smear screening in our population.
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Affiliation(s)
- Vimala Ganta
- a School of Community Health Sciences , University of Nevada Las Vegas , Las Vegas , NV , USA.,b University Medical Center of Southern Nevada , Las Vegas , NV , USA
| | - Sheniz Moonie
- a School of Community Health Sciences , University of Nevada Las Vegas , Las Vegas , NV , USA.,b University Medical Center of Southern Nevada , Las Vegas , NV , USA
| | - Dina Patel
- a School of Community Health Sciences , University of Nevada Las Vegas , Las Vegas , NV , USA.,b University Medical Center of Southern Nevada , Las Vegas , NV , USA
| | - Aaron T Hunt
- a School of Community Health Sciences , University of Nevada Las Vegas , Las Vegas , NV , USA.,b University Medical Center of Southern Nevada , Las Vegas , NV , USA
| | - Jan Richardson
- a School of Community Health Sciences , University of Nevada Las Vegas , Las Vegas , NV , USA.,b University Medical Center of Southern Nevada , Las Vegas , NV , USA
| | - David Di John
- a School of Community Health Sciences , University of Nevada Las Vegas , Las Vegas , NV , USA.,b University Medical Center of Southern Nevada , Las Vegas , NV , USA
| | - Echezona E Ezeanolue
- a School of Community Health Sciences , University of Nevada Las Vegas , Las Vegas , NV , USA.,b University Medical Center of Southern Nevada , Las Vegas , NV , USA
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12
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Datta S, Bhattacherjee S, Sherpa PL, Banik S. Perceived HIV Related Stigma among Patients Attending ART Center of a Tertiary Care Center in Rural West Bengal, India. J Clin Diagn Res 2016; 10:VC09-VC12. [PMID: 27891432 DOI: 10.7860/jcdr/2016/21366.8669] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/10/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Despite the advent of modern technologies, India is still grappling with the HIV/AIDS pandemic. Stigma is one of the key aspects which can interfere with HIV test-seeking behaviour, care-seeking behaviour upon diagnosis, quality of care given to HIV-positive patients and perception and treatment of People Living with HIV/AIDS (PLHA) by communities, families, and partners. AIM To determine the perceived stigma associated with HIV/AIDS and its correlates among PLHAs attending the Anti Retroviral Therapy (ART) centre of North Bengal Medical College, Darjeeling, West Bengal, India. MATERIALS AND METHODS An observational cross-sectional study was conducted over a period of four months among 454 patients aged ≥18years attending ART centre of North Bengal Medical College. Perceived stigma among the study subjects were assessed using a face and content validated version of Berger's HIV stigma scale. Linear regression analysis was used for statistical analysis of the predictors of perceived stigma. Data were analysed using SPSS version 16 software. RESULTS The majority of the study population had moderate to low stigma. Regression analysis showed that being on treatment with ART had the highest contribution towards stigma followed by gender and HIV serostatus of the patients. CONCLUSION The patients attending ART centre of North Bengal Medical College had moderate to low level of stigma. In absence of any efficacious stigma reduction programs in this region, more work needs to be done to assist PLHA in coping with stigma.
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Affiliation(s)
- Saikat Datta
- Associate Professor, Department of Medicine, North Bengal Medical College , Sushrutanagar, Darjeeling, West Bengal, India
| | - Sharmistha Bhattacherjee
- Assistant Professor, Department of Community Medicine, North Bengal Medical College , Sushrutanagar, Darjeeling, West Bengal, India
| | - Pasang Lahmu Sherpa
- Associate Professor, Department of Medicine, North Bengal Medical College , Sushrutanagar, Darjeeling, West Bengal, India
| | - Smarajit Banik
- Assistant Professor, Department of Medicine, North Bengal Medical College , Sushrutanagar, Darjeeling, West Bengal, India
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