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Open Access Research article

Cervical cancer prevention in reproductive health services: knowledge, attitudes and practices of midwives in Côte d’Ivoire, West Africa

Boris K Tchounga123*, Antoine Jaquet23, Patrick A Coffie14, Apollinaire Horo5, Catherine Sauvaget6, Innocent Adoubi78, Privat Guie9, François Dabis23, Annie J Sasco23 and Didier K Ekouevi123

Author Affiliations

1 Programme PAC-CI, CHU de Treichville, Abidjan, Côte d’Ivoire

2 Université Bordeaux, ISPED, Centre INSERM U897-Epidémiologie-Bio statistique, Bordeaux F-33000, France

3 INSERM, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, Bordeaux F-33000, France

4 Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire

5 Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d’Ivoire

6 Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France

7 Service de Cancérologie, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire

8 Programme National de Lutte contre le Cancer, Abidjan, Côte d’Ivoire

9 Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire

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BMC Health Services Research 2014, 14:165  doi:10.1186/1472-6963-14-165

Published: 11 April 2014

Abstract

Background

Cervical cancer is the most common cancer among women and the leading cause of cancer deaths in women in Côte d’Ivoire. Low resource countries can now prevent this cancer by using HPV vaccine and effective and affordable screening tests. However the implementation of these prevention strategies needs well-trained human resources. Part of the solution could come from midwives by integrating cervical cancer prevention into reproductive health services. The aim of this survey was to assess knowledge, attitudes and practices of midwives towards cervical cancer prevention in Abidjan, Côte d’Ivoire, and to find out factors associated with appropriate knowledge.

Methods

A cross-sectional survey was conducted among midwives in the urban district of Abidjan, using a self-administered questionnaire. Knowledge was assessed by two scores. Factors associated with appropriate knowledge were determined using a logistic regression analysis. Attitudes and practices were described and compare using the Chi2 test.

Results

A total of 592 midwives were enrolled, including 24.5% of final-year students. 55.7% of midwives had appropriate knowledge on cervical cancer, and 42.4% of them had appropriate knowledge on cervical cancer prevention strategies. Conferences, courses taken at school of midwifery and special training sessions on cervical cancer (OR = 4.9, 95% CI [1.9 to 12.6], p <0.01) were associated with good knowledge on the management of this disease. Among these midwives, 18.4% had already benefited from a screening test for themselves, 37.7% had already advised screening to patients and 8.4% were able to perform a visual inspection. 50.3% of midwives knew HPV vaccine as a preventive method; among them 70.8% usually recommended it to young girls.

Conclusion

Despite sufficient knowledge about cervical cancer prevention, attitudes and practices of midwives should be improved by organizing capacity building activities. This would ensure the success of integration of cervical cancer prevention into reproductive health services in countries like Côte d’Ivoire.

Keywords:
Cervical cancer; Prevention; Screening; HPV vaccine; Midwives; Reproductive health; Africa