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Mori AT, Nyabakari CJ. Cost of image-guided percutaneous nephrostomy among cervical cancer patients at Muhimbili National Hospital in Tanzania. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2023; 21:33. [PMID: 37254170 DOI: 10.1186/s12962-023-00445-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 05/18/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Most cervical cancer patients in developing countries seek care in health facilities with an advanced disease, often characterized by obstructive uropathy. This study aims to estimate the cost of an image-guided percutaneous nephrostomy (PCN), which was recently introduced at Muhimbili National Hospital to manage obstructive uropathy. METHODS This was a cross-sectional study that was conducted between February and June 2021, from the provider's perspective. The study involved forty-eight (n = 48) cervical cancer patients with obstructive uropathy. A micro-costing approach was used to identify, quantify and value both capital and recurrent cost items consumed by the patients. Cost data were collected in Tanzanian shillings and converted to USD with the relevant exchange rate. Analysis was performed in Microsoft Excel (Microsoft Excel®, Microsoft Corporation). RESULTS The unit cost of image-guided PCN at Muhimbili National Hospital was estimated at 380.4 USD. The main cost drivers were the single-use Nephrostomy catheters, Amplatz guide wire, and Micro-puncture set. The estimated unit cost is higher than the reimbursement price of 237.4 USD charged by the National Health Insurance Fund, and the 259.4 USD and 172.9 USD charged by the hospital for private and public patients, respectively. CONCLUSION Image-guided PCN for cervical cancer patients costs three times the minimum monthly government wage. The study underscores the importance of conducting costing studies to inform pricing and reimbursement decisions in Tanzania.
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Affiliation(s)
- Amani Thomas Mori
- Department of Developmental Studies, Muhimbili University of Health and Allied Sciences, P.O. Box 65011, Dar es Salaam, Tanzania.
- National Institute for Medical Research, Muhimbili Research Centre, P.O. Box 9653, Dar es salaam, Tanzania.
- Section for Ethics and Health Economics, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, Bergen, 5020, Norway.
| | - Cecilia J Nyabakari
- Department of Developmental Studies, Muhimbili University of Health and Allied Sciences, P.O. Box 65011, Dar es Salaam, Tanzania
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Eshetu HB, Shitu K, Handebo S. Predictors of intention to receive cervical cancer screening among commercial sex workers in Gondar city, northwest Ethiopia: application of the theory of planned behavior. BMC Womens Health 2022; 22:462. [PMID: 36404309 PMCID: PMC9830899 DOI: 10.1186/s12905-022-02055-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 11/08/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cervical cancer is a global public health problem & is the fourth leading cause of cancer morbidity and mortality. Abnormal cervical lesion is common in commercial sex workers and is at a higher risk of developing cervical cancer due to multiple sexual partners besides other factors. Intention is an important predictor of behavior and is an initiative to transform their desire into action. Therefore, this study aimed to assess the predictors of intention to receive cervical cancer screening among commercial sex workers in Gondar city, northwest Ethiopia. METHODS A community-based cross-sectional study was conducted from March 27 to May 25, 2021, in Gondar city, northwest Ethiopia. A total of 425 commercial sex workers selected using convenience sampling techniques were included in the study. Linear regression with robust standard errors was carried out to identify predictors of intention to receive cervical cancer screening. A 95% confidence interval and a p-value of less than 0.05 were used to declare statistical significance. RESULTS A total of 393 commercial sex workers participated in the study with a response rate of 92.4%. The mean age of the participants was 27.68 ± 6.62. The median (interquartile range) of intention was 4 (3-4.25). The theory of planned behaviour variables explained 38.51% of the variance in intention to receive cervical cancer screening. Direct subjective norm (β = 0.09), 95% CI (0.05, 0.13)), direct Attitude (β = 0.09, 95% CI (0.04, 0.13)), past behaviour (β = 0.27; 95% CI (0.09, 0.46), and positive HIV status (β = 0.26; 95% CI (0.06, 0.46) were significant predictors of intention. CONCLUSIONS Commercial sex workers' intention to undergo cervical cancer screening was high. The theory of planned behavior showed adequate utility in predicting commercial sex workers' intention to receive cervical cancer screening. Participant's attitudes, subjective norm, past behavior, and positive HIV status were important factors affecting their intention to receive cervical cancer screening. Thus, interventions aimed at enhancing commercial sex workers' cervical cancer screening behavior should target creating positive social pressure and attitudinal change towards cervical cancer screening.
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Affiliation(s)
- Habitu Birhan Eshetu
- grid.59547.3a0000 0000 8539 4635Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, PO.Box.196, Gondar, Ethiopia
| | - Kegnie Shitu
- grid.59547.3a0000 0000 8539 4635Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, PO.Box.196, Gondar, Ethiopia
| | - Simegnew Handebo
- School of Public Health, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Endale H, Mulugeta T, Habte T. The Socioeconomic Impact of Cervical Cancer on Patients in Ethiopia: Evidence from Tikur Anbessa Specialized Hospital. Cancer Manag Res 2022; 14:1615-1625. [PMID: 35535268 PMCID: PMC9078746 DOI: 10.2147/cmar.s352389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Cervical cancer is very common among women living in low-resource environments, according to the literature. About 85% of the cases and 88% of the deaths due to cervical cancer occurred in developing countries. Women in low- and middle-income countries have a 35% higher average life risk of cervical cancer than women in high-income countries. However, research on the socioeconomic impact of cervical cancer on patients is virtually absent in the country. Objective To assess the socioeconomic impact of cervical cancer on patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia in 2021. Methods Institutional based cross-sectional study design was employed. A structured and semi-structured questionnaire was used. The participants were selected using a simple random sampling technique. The collected data was entered and analyzed using the SPSS version 24 statistical software package. Results Out of 423 sampled respondents, 416 agreed to participate in the study and the response rate was 98%. The study revealed that cervical cancer has a social impact on patients in terms of social discrimination 61.8%, loss of body image 63%, loss of sexual functioning 78%, and loss of femininity 89%. It has also an economic impact in terms of loss of income of 45.7%, financial distress due to medical and nonmedical expenditures 71%, work and employment challenges 66.8%. Conclusion and Recommendation Cervical cancer has an enormous socioeconomic impact on patients in terms of social discrimination, loss of body image, loss of sexual functioning, loss of femininity, loss of income, financial distress, work and employment challenges. Hence, efforts on reduction of social discrimination, psychotherapy support, and financial support are needed to limit the socioeconomic impact of cervical cancer on patients.
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Affiliation(s)
- Helen Endale
- Department of Nursing, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tefera Mulugeta
- Department of Nursing, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Teshome Habte
- Department of Nursing, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Correspondence: Teshome Habte, Department of Nursing, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, PO Box: 5657, Addis Ababa, Ethiopia, Tel +251 911436150, Email
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Machado ADS, Machado ADS, Guilhem DB. Profile of hospitalizations for neoplasms in the Brazilian Unified Health System: a time-series study. Rev Saude Publica 2021; 55:83. [PMID: 34816984 PMCID: PMC8687653 DOI: 10.11606/s1518-8787.2021055003192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/16/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Describe the profile of hospitalizations for cancer diagnosis in Brazil from 2008 to 2018 at Unified Health System (SUS). METHODS Time series study of hospitalization rate for malignant neoplasms at SUS. Data were extracted from the Hospital Information System of DataSUS. The trend was estimated using generalized linear regression, applying the Prais-Winsten estimation procedure. RESULTS From 2008 to 2018, the hospitalization rate for malignant neoplasms showed an increasing trend at SUS, with an annual variation of 10.7% (p < 0.001; CI = 9.4-11.7). An increasing trend of hospitalizations in all regions of Brazil was observed, except in the Northern region, which remained unchanged. The Northeastern region presented the highest annual variation (13.5%; p < 0.001), whereas the Southern and Southeastern regions had the highest hospitalization rates per 100,000 inhabitants, resulting in 506 and 325 hospitalizations, respectively. We observed a significant increasing trend in hospitalizations of children aged 0 to 9 years (annual variation = 10.9%; p < 0.001); young people, 10 and 19 years (annual variation = 6.9%; p < 0.001); and older adults; over 60 years (annual variation = 7.9%; p < 0.001). Among women, hospitalizations occurred mainly due to malignant neoplasm of the breast (annual variation = 13.2%; p < 0.001); and among men, malignant neoplasm of the prostate (annual variation = 4.7%; p < 0.001). CONCLUSION Hospitalizations for malignant neoplasms showed an increasing trend, in line with the increased incidence of cancer, in particular, the most frequent neoplasms between men and women. Although the Northeastern region showed the highest variation in the period, the Southern and Southeastern regions had the highest hospitalization rates in the country. We also observed an increase in hospitalizations among the young (between 0 and 19 years old) and older adults (over 60 years) population. Hospitalizations for neoplasm of the cervix in women, although still the third cause of hospitalizations, showed decreasing behavior.
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Affiliation(s)
- Analy da Silva Machado
- Universidade de BrasíliaFaculdade de Ciências da SaúdePrograma de pós-graduação em EnfermagemBrasíliaDFBrasilUniversidade de Brasília. Faculdade de Ciências da Saúde. Programa de pós-graduação em Enfermagem. Brasília, DF, Brasil
| | - Anaely da Silva Machado
- Universidade de BrasíliaFaculdade de Administração, Contabilidade Economia, e Gestão PúblicaPrograma de Pós-Graduação em EconomiaBrasíliaDFBrasilUniversidade de Brasília. Faculdade de Administração, Contabilidade Economia, e Gestão Pública. Programa de Pós-Graduação em Economia. Brasília, DF, Brasil
| | - Dirce Bellezi Guilhem
- Universidade de BrasíliaFaculdade de Ciências da SaúdeDepartamento de EnfermagemBrasíliaDFBrasilUniversidade de Brasília. Faculdade de Ciências da Saúde. Departamento de Enfermagem. Brasília, DF, Brasil
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Sargazi N, Daroudi R, Zendehdel K, Hashemi FA, Tahmasebi M, Darrudi A, Nahvijou A. Economic Burden of Gynecological Cancers in Iran. Value Health Reg Issues 2021; 28:1-6. [PMID: 34794064 DOI: 10.1016/j.vhri.2021.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 02/11/2021] [Accepted: 02/23/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Gynecological cancers (GCs) are an important cause of morbidity and mortality among women worldwide. The incidence of cancer is increasing in Iran, and according to statistics, it has become the most important cause of mortality. This study aimed to assess the economic burden of GCs, including cervical, ovarian, and endometrial cancers, in Iran in 2014. METHODS We used a prevalence-based cost of illness methodology to investigate the annual healthcare cost of GCs and to determine the productivity loss. The productivity loss was estimated, using the human capital approach. We obtained our data from a referral hospital for the year 2014; we also used expert opinion and occupational and statistical data. To estimate direct medical cost, we used bottom-up approach and we estimated the average cost of each procedure, multiplied by the number of patients receiving the procedure. RESULTS The total cost of GCs in Iran was estimated at $51 million in 2014. The direct costs were $32 million, and indirect costs were $19 million of the total annual cost. The total cost of ovarian cancer was the highest among 3 cancers. CONCLUSIONS Knowing that the cost of GCs has a significant impact on the burden of disease and imposes an economic burden on the country could force policy makers to allocate their resource in the prevention programs and new approach in patient's management. This could lead to diagnose more GCs in the early stages, reduce mortality, and increase the quality of life.
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Affiliation(s)
- Nasrin Sargazi
- Health Economics and Management Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Rajabali Daroudi
- Health Economics and Management Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Zendehdel
- Cancer Biology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran; Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran; Breast Disease Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mamak Tahmasebi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Darrudi
- Health Economics and Management Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Nahvijou
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Shing JZ, Griffin MR, Nguyen LD, Slaughter JC, Mitchel EF, Pemmaraju M, Rentuza AB, Hull PC. Improving Cervical Precancer Surveillance: Validity of Claims-Based Prediction Models in ICD-9 and ICD-10 Eras. JNCI Cancer Spectr 2020; 5:pkaa112. [PMID: 33554035 PMCID: PMC7853170 DOI: 10.1093/jncics/pkaa112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/16/2020] [Accepted: 11/01/2020] [Indexed: 11/23/2022] Open
Abstract
Background Human papillomavirus vaccine (HPV) impact on cervical precancer (cervical intraepithelial neoplasia grades 2+ [CIN2+]) is observable sooner than impact on cancer. Biopsy-confirmed CIN2+ is not included in most US cancer registries. Billing codes could provide surrogate metrics; however, the International Classification of Diseases, ninth (ICD-9) to tenth (ICD-10) transition disrupts trends. We built, validated, and compared claims-based models to identify CIN2+ events in both ICD eras. Methods A database of Davidson County (Nashville), Tennessee, pathology-confirmed CIN2+ from the HPV Vaccine Impact Monitoring Project (HPV-IMPACT) provided gold standard events. Using Tennessee Medicaid 2008-2017, cervical diagnostic procedures (N = 8549) among Davidson County women aged 18-39 years were randomly split into 60% training and 40% testing sets. Relevant diagnosis, procedure, and screening codes were used to build models from CIN2+ tissue diagnosis codes alone, least absolute shrinkage and selection operator (LASSO), and random forest. Model-classified index events were counted to estimate incident events. Results HPV-IMPACT identified 983 incident CIN2+ events. Models identified 1007 (LASSO), 1245 (CIN2+ tissue diagnosis codes alone), and 957 (random forest) incident events. LASSO performed well in ICD-9 and ICD-10 eras: 77.3% (95% confidence interval [CI] = 72.5% to 81.5%) vs 81.1% (95% CI = 71.5% to 88.6%) sensitivity, 93.0% (95% CI = 91.9% to 94.0%) vs 90.2% (95% CI = 87.2% to 92.7%) specificity, 61.3% (95% CI = 56.6% to 65.8%) vs 60.3% (95% CI = 51.0% to 69.1%) positive predictive value, 96.6% (95% CI = 95.8% to 97.3%) vs 96.3% (95% CI = 94.1% to 97.8%) negative predictive value, 91.0% (95% CI = 89.9% to 92.1%) vs 88.8% (95% CI = 85.9% to 91.2%) accuracy, and 85.1% (95% CI = 82.9% to 87.4%) vs 85.6% (95% CI = 81.4% to 89.9%) C-indices, respectively; performance did not statistically significantly differ between eras (95% confidence intervals all overlapped). Conclusions Results confirmed model utility with good performance across both ICD eras for CIN2+ surveillance. Validated claims-based models may be used in future CIN2+ trend analyses to estimate HPV vaccine impact where population-based biopsies are unavailable.
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Affiliation(s)
- Jaimie Z Shing
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marie R Griffin
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Linh D Nguyen
- Data Science Institute, Vanderbilt University, Nashville, TN, USA
| | - James C Slaughter
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Edward F Mitchel
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manideepthi Pemmaraju
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alyssa B Rentuza
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pamela C Hull
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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Hung YW, Hoxha K, Irwin BR, Law MR, Grépin KA. Using routine health information data for research in low- and middle-income countries: a systematic review. BMC Health Serv Res 2020; 20:790. [PMID: 32843033 PMCID: PMC7446185 DOI: 10.1186/s12913-020-05660-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 08/16/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Routine health information systems (RHISs) support resource allocation and management decisions at all levels of the health system, as well as strategy development and policy-making in many low- and middle-income countries (LMICs). Although RHIS data represent a rich source of information, such data are currently underused for research purposes, largely due to concerns over data quality. Given that substantial investments have been made in strengthening RHISs in LMICs in recent years, and that there is a growing demand for more real-time data from researchers, this systematic review builds upon the existing literature to summarize the extent to which RHIS data have been used in peer-reviewed research publications. METHODS Using terms 'routine health information system', 'health information system', or 'health management information system' and a list of LMICs, four electronic peer-review literature databases were searched from inception to February 202,019: PubMed, Scopus, EMBASE, and EconLit. Articles were assessed for inclusion based on pre-determined eligibility criteria and study characteristics were extracted from included articles using a piloted data extraction form. RESULTS We identified 132 studies that met our inclusion criteria, originating in 37 different countries. Overall, the majority of the studies identified were from Sub-Saharan Africa and were published within the last 5 years. Malaria and maternal health were the most commonly studied health conditions, although a number of other health conditions and health services were also explored. CONCLUSIONS Our study identified an increasing use of RHIS data for research purposes, with many studies applying rigorous study designs and analytic methods to advance program evaluation, monitoring and assessing services, and epidemiological studies in LMICs. RHIS data represent an underused source of data and should be made more available and further embraced by the research community in LMIC health systems.
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Affiliation(s)
- Yuen W Hung
- University of Waterloo, School of Public Health and Health Systems, Waterloo, Canada
| | - Klesta Hoxha
- University of Waterloo, School of Public Health and Health Systems, Waterloo, Canada
| | - Bridget R Irwin
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Canada
| | - Michael R Law
- Centre for Health Services and Policy Research, The University of British Columbia, Vancouver, Canada
| | - Karen A Grépin
- School of Public Health, Hong Kong University, Pok Fu Lam, Hong Kong.
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Gattegno MV, Vertamatti MAF, Bednarczyk RA, Evans DP. A cross-sectional survey of parental attitudes towards Human papillomavirus vaccination exclusion categories in Brazil. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2019; 19:6. [PMID: 30819169 PMCID: PMC6394080 DOI: 10.1186/s12914-019-0195-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 02/18/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND In 1988, Brazil established a constitutional right to health and universal access to health care for all Brazilians through the creation of the Unified Health System (SUS). As part of its efforts to fulfill this right, the quadrivalent Human papillomavirus (HPV) vaccine was introduced into the national immunization program in 2014. The non-discriminatory provision of healthcare goods, facilities, and services is a fundamental part of the right to health. Yet HPV vaccination was limited to females aged 9-13, despite the universal nature of SUS and scientific support for the vaccination of males and older females. The purpose of this cross-sectional study was to describe parental attitudes regarding age- and gender-based HPV vaccination exclusions, as well as parental knowledge of HPV and the HPV vaccine. METHODS Data were gathered from parents with children aged 9-17 in a health post located in the municipality of Mauá (São Paulo, Brazil) through interviewer-administered questionnaires. We analyzed attitudes regarding HPV vaccination and its eligibility guidelines by comparing parents of HPV vaccine eligible and ineligible children. RESULTS In this low-income population, the majority of the 219 parents surveyed supported the inclusion of males and females over 13 into the HPV vaccination program; support for the non-discriminatory provision of the HPV vaccine was high among parents - especially if financially accessible. Additionally, there were high levels of knowledge and positive parental attitudes regarding HPV vaccination safety and efficacy among both parent groups suggesting information accessibility - a key component of the right to health and informed decision-making. CONCLUSIONS Support for the expansion of HPV vaccination for excluded populations exists, and is not based on current eligibility, or differential knowledge and attitudes about the vaccine. Moving forward, careful consideration of gender- based eligibility for vaccination, informed decision-making, and the importance of community participation in health policy development and implementation may be gleaned from the case of Brazil and beyond.
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Affiliation(s)
- Mariana V Gattegno
- Emory University, Rollins School of Public Health, 1518 Clifton Rd NE, Mailstop 1518-002-7BB, Atlanta, GA, 30322, USA
| | - Maria A F Vertamatti
- Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, Santo André, SP, 09060-650, Brazil
| | - Robert A Bednarczyk
- Emory University, Rollins School of Public Health, 1518 Clifton Rd NE, Mailstop 1518-002-7BB, Atlanta, GA, 30322, USA
| | - Dabney P Evans
- Emory University, Rollins School of Public Health, 1518 Clifton Rd NE, Mailstop 1518-002-7BB, Atlanta, GA, 30322, USA.
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Bazaz M, Shahry P, Latifi SM, Araban M. Cervical Cancer Literacy in Women of Reproductive Age and Its Related Factors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:82-89. [PMID: 28799072 DOI: 10.1007/s13187-017-1270-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Cancer health literacy, which is the ability to search, understand, and use health information to make appropriate health decisions, plays an important role in the use of preventative and screening information. The present study aims to evaluate cervical cancer health literacy in women of reproductive age and its related factors. In this cross-sectional study, 231 women of reproductive age who referred to health centers of Khuzestan Province, Iran, were selected via convenience sampling. A valid and reliable measure was employed to collect information about various dimensions of cervical cancer health literacy, including having access to, reading, understanding, appraising, using, and communicating it. The data collected were analyzed using SPSS 16. Data analysis was conducted by independent sample t test, one-way ANOVA, Spearman's correlation, chi-square, and linear regression. The participants' average health literacy score was 97.88 ± 12.7 (from 135 points), and 47.2% of the participants had limited health literacy. Health literacy was associated with education, employment, income, searching, mothers' and young friends' counseling, and duration of the study time (p < 0.05). In linear regression model, there was a significant association between income (p = 0.011), searching (p = 0.01), study time (p = 0.009), and young friends' counseling (p = 0.002) and cervical cancer literacy scores. In this study, no significant association was observed between age and health literacy. This study indicated that the cervical cancer literacy in women of reproductive age was not at good levels. Health workers should pay more attention to groups who are at greater risk of having low health literacy. Moreover, targeting and tailoring educational interventions with respect to different levels of cervical cancer literacy might increase cervical cancer screening.
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Affiliation(s)
- Maryam Bazaz
- Department of Health Education and Promotion, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Shahry
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sayed Mahmood Latifi
- Department of Biostatistics, Diabetes Research Center, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzieh Araban
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Department of Health Education and Health Promotion, Public Health School, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.
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Van Minh H, My NTT, Jit M. Cervical cancer treatment costs and cost-effectiveness analysis of human papillomavirus vaccination in Vietnam: a PRIME modeling study. BMC Health Serv Res 2017; 17:353. [PMID: 28506297 PMCID: PMC5433243 DOI: 10.1186/s12913-017-2297-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 05/08/2017] [Indexed: 02/01/2023] Open
Abstract
Background Cervical cancer is currently the leading cause of cancer mortality among women in South Vietnam and the second leading cause of cancer mortality in North Vietnam. Human papillomavirus (HPV) vaccination has the potential to substantially decrease this burden. The World Health Organization (WHO) recommends that a cost-effectiveness analysis of HPV vaccination is conducted before nationwide introduction. Methods The Papillomavirus Rapid Interface for Modeling and Economics (PRIME) model was used to evaluate the cost-effectiveness of HPV vaccine introduction. A costing study based on expert panel discussions, interviews and hospital case note reviews was conducted to explore the cost of cervical cancer care. Results The cost of cervical cancer treatment ranged from US$368 – 11400 depending on the type of hospital and treatment involved. Under Gavi-negotiated prices of US$4.55, HPV vaccination is likely to be very cost-effective with an incremental cost per disability-adjusted life year (DALY) averted in the range US$780 - 1120. However, under list prices for Cervarix and Gardasil in Vietnam, the incremental cost per DALY averted for HPV vaccination can exceed US$8000. Conclusion HPV vaccine introduction appears to be economically attractive only if Vietnam is able to procure the vaccine at Gavi prices. This highlights the importance of initiating a nationwide vaccination programme while such prices are still available.
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Affiliation(s)
- Hoang Van Minh
- Hanoi University of Public Health, Building A, 1A Duc Thang Road, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam.
| | - Nguyen Thi Tuyet My
- Hanoi University of Public Health, Building A, 1A Duc Thang Road, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam
| | - Mark Jit
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.,Modelling and Economics Unit, Public Health England, London, UK
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Refaei M, Dehghan Nayeri N, Khakbazan Z, Pakgohar M. Cervical Cancer Screening in Iranian Women: Healthcare Practitioner Perceptions and Views. Asian Pac J Cancer Prev 2017; 18:357-363. [PMID: 28345331 PMCID: PMC5454727 DOI: 10.22034/apjcp.2017.18.2.357] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Although regular screening for cervical cancer with the Papanicolaou test is an important element for reducing the incidence and mortality of cervical cancer, the actual screening program in Iranian women is not sufficiently comprehensive at present. The purpose of this study was to explore healthcare provider perceptions of factors affecting cervical cancer screening in Iranian women. Methods: In this qualitative study performed from September 2015 to August 2016 in Hamadan, Iran, we conducted semi-structured in depth interviews with 14 healthcare providers selected purposefully. All interviews were recorded, transcribed and analyzed according to a conventional thematic analysis approach. MAXQDA10 software was employed for data analysis. Results: Four themes were extracted from data: “Inefficient management of cervical cancer screening process, Personal and professional characteristics of health care providers, Individual barriers and facilitators, Need for health system authorities to pay attention”. Conclusion: Increased official attention to screening, and identifying challenges and providing strategies based on these challenges will help in achieving a successful screening program. It is necessary to attend to professional features of medical science students and increase the skills of interaction with clients in addition to academic training. Efforts should be made to increase trust in healthcare providers regarding the Pap test and receptiveness of society to this screening modality through informing the public, with encouragement through the media.
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Affiliation(s)
- Mansoureh Refaei
- Department of Reproductive Health, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
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