COMMUNITY-BASED EDUCATIONAL INTERVENTIONS TO IMPROVE CERVICAL SCREENING UPTAKE IN RURAL NIGERIA: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Cervical cancer remains a leading cause of morbidity and mortality among women globally, particularly in low- and middle-income countries (LMICs) like Nigeria. Despite the availability of preventive measures, screening uptake remains low, especially in rural communities where barriers such as low literacy, cultural stigma, and limited access to healthcare services persist.

Methods: This randomized controlled trial aimed to evaluate the effectiveness of two community-based educational interventions: Focus Group Discussions (FGD) and Teacher-Led Education (TLE), on cervical pre-cancer screening uptake among women aged 25 to 65 years in Arochukwu Local Government Area, Abia State, Nigeria. A total of 42 participants were recruited and randomly assigned to either the FGD (n=21) or TLE (n=21) group. Pre- and post-intervention data were collected on screening uptake.

Results: Pre-intervention screening uptake was notably low, with only 4.8% of women in the FGD group and 0% in the TLE group having previously undergone screening. Post-intervention results indicated a significant increase in screening uptake, with 85.7% of participants in the FGD group attending screening, compared to 47.6% in the TLE group (X² = 6.857, p = 0.009).

Conclusion: The study demonstrates that participatory educational strategies, such as FGDs, significantly improve cervical screening uptake among rural women in Nigeria. These findings underscore the need for culturally tailored, community-driven interventions to address barriers to screening and align with global health goals for cervical cancer prevention.