1. Evaluation of Provider Skills in Performing Visual Inspection with Acetic Acid in the Cervical Cancer Screening Program in the Meknes-Tafilalet Region of Morocco.
- Author
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Selmouni F, Sauvaget C, Zidouh A, Plaza CA, Muwonge R, Rhazi KE, Basu P, and Sankaranarayanan R
- Subjects
- Cross-Sectional Studies, Early Detection of Cancer methods, Female, Humans, Indicators and Reagents administration & dosage, Male, Mass Screening methods, Middle Aged, Morocco, Rural Population, Urban Population, Vaginal Smears methods, Acetic Acid administration & dosage, Clinical Competence standards, Health Personnel standards, Uterine Cervical Neoplasms diagnosis
- Abstract
Background: This study documented the performance of providers of visual inspection with acetic acid (VIA) at primary health centers, assessing their compliance with the VIA skills checklist and determinants of non-compliance, and exploring their perceptions of VIA training sessions., Materials and Methods: A cross- sectional study was conducted among VIA providers in the Meknes-Tafilalet region of Morocco. Structured observation of their performance was conducted through supervisory visits and multiple focus group discussions (FGDs)., Results: Performance of all the recommended steps for effective communication was observed in a low proportion of procedures (36.4%). Midwives/nurses had higher compliance than general practitioners (GPs) (p<0.001). All recommended steps for VIA examination were performed for a high proportion of procedures (82.5%). Compliance was higher among midwives/nurses than among GPs (p<0.001) and among providers in rural areas than those in urban areas (p<0.001). For pre-VIA counselling, all recommended steps were performed for only 36.8% of procedures. For post-VIA counseling, all recommended steps were performed in a high proportion (85.5% for VIA-negative and 85.1% for VIA-positive women). Midwives/nurses had higher compliance than GPs when advising VIA-positive women (p=0.009). All infection prevention practices were followed for only 14.2% of procedures, and compliance was higher among providers in rural areas than those in urban areas (p<0.001). Most FGD participants were satisfied with the content of VIA training sessions. However, they suggested periodic refresher training and supportive supervision., Conclusions: Quality assurance of a cervical cancer screening program is a key element to ensure that the providers perform VIA correctly and confidently.
- Published
- 2016