Reducing Barriers and Sustaining Utilization of a Cervical Cancer Screening Program in Rural Senegal

Abstract

Senegal ranks 15th in the world in incidence of cervical cancer, which is the No. 1 cancer killer among women there. Participation in cervical cancer screening in Senegal (where incidence peaks between the ages of 45 and 54) is very low. Women living in 10 of the 13 rural Senegalese regions have no access to screening for this cancer, even though screening of the cervix by visual inspection using acetic acid is affordable and highly effective.

To address this public health challenge, Dr. Dykens has led a partnership between the Kedougou regional health system, the University of Illinois at Chicago, the U.S. Peace Corps and the Institute of Health and Development (ISED) of the University Cheikh Anta Diop in the Senegalese capital, Dakar, since 2010. This partnership has implemented a cervical cancer screening program based on visual inspection in Kedougou, a rural region in far southeastern Senegal. The partnership has made screening services available to over 18,300 women regionwide as of 2014. However, the utilization by eligible women, especially the high-risk older cohort, remains very low. In 2014, only 509, roughly 5% of eligible women targeted through a mass campaign that year, were screened and only 10% were 45 years or older.

This research addresses preliminary data describing poor uptake and barriers to screening access in this region through a multi-level mixed methods assessment of the barriers and facilitators of initial uptake. This knowledge will guide the partnership in developing and adapting a peer-education health promotion intervention to this specific context in order to demonstrate an increased rate of initial screenings and re-screenings over time.

Using mixed methods, this project will do the following:

  1. Assess cervical cancer screening access determinants in Kedougou, Senegal, by identifying barriers and facilitators of service uptake over time at the person, household, and community levels.
  2. Develop and deploy a wide-reaching, multi-level responsive peer education curriculum aimed at motivating eligible women to seek cervical cancer screenings in Kedougou.
  3. Evaluate the impact of the peer education intervention on initial screening uptake and re-screening rates.
Principal investigator
Funding Agency

Fogarty International Center of the National Institutes of Health (Award Number K01TW010494)

Start date
09/28/2016
End date
08/31/2021
Total award
$704,860
About this grant

This is a Research Scientist Development Award that supports Dr. Dykens’s professional development through a mentored research project.

Related publications


Rahman R, Clark MD, Collins Z, Traore F, Dioukhane EM, Thiam H,... Dykens JA. Cervical cancer screening decentralized policy adaptation: an African rural-context-specific systematic literature review. Glob Health Action. 2019;12(1):1587894. doi: 10.1080/16549716.2019.

Dykens JA, Linn AM, Irwin T, Peters KE, Pyra M, Traoré F, Touré Diarra M, Hasnain M, Wallner K, Linn P, Ndiaye Y. Implementing visual cervical cancer screening in Senegal: a cross-sectional study of risk factors and prevalence highlighting service utilization barriers. Int J Womens Health. 2017 Jan 27;9:59-67. doi: 10.2147/IJWH.S115454.