The development of an educational programme to enhance the utilisation of cervical cancer services among women of reproductive age in the Otjozondjupa region, Namibia

Abstract

The aim of the study was to develop an educational programme to enhance the utilisation of cervical cancer services among women of reproductive age in the Otjozondjupa region, Namibia. Cervical cancer is among the top ten most common causes of cancer-related deaths among women globally. The setting of this study is the Otjozondjupa region, which is one of the fourteen regions of Namibia. The study was conducted in four phases as follows: Phase one entailed the situational analysis which described the knowledge, attitudes, and practices of the reproductive aged women regarding the prevention, screening, and treatment of cervical cancer in the Otjozondjupa region. Phase two of the study entailed the development of a conceptual framework of the study. Phase three was concerned with the process of developing the educational programme, and Phase four focused on identifying the guidelines for the implementation and evaluation of the educational programme interventions. The guidelines were identified in terms of the objectives and activities based on the cyclic curriculum development model. The study applied a quantitative approach with descriptive and cross-sectional designs to address the aim and specific objectives of the study in Phase one. A study population of 37066 women was divided into four strata representing four districts in the Otjozondjupa region and the sample was proportionally distributed to each stratum. Sample power calculation was done to determine the study sample size (381) using the Rao software programme. Multistage stratified random sampling was used in this study. Stage one: All four districts were included in the study and considered as strata. Stage two: All health centres and clinics were selected from each stratum for the study. Stage three: Proportionate stratified random sampling was used to select the clinics and respondents for the study at the facility level. Data were collected through a structured questionnaire with closed-ended questions using the 5 level Likert scale questions for the respondents to indicate their level of agreement to a statement as well as dichotomous questions. The quantitative data were analysed descriptively using Statistical Package for Social Science version 25. Chi-square statistical analysis was applied to establish the association between demographic data as the independent variable, and knowledge, attitude and practices as the dependent ii variables. Pearson correlation was used to determine the correlations between the study variables. The findings of the study revealed that the majority of the respondents (86.7%) scored low on knowledge regarding prevention, screening, and treatment of CC; 90.8% scored neutral level of attitudes regarding screening, prevention and treatment of CC and 32% scored low in terms of the uptake of cervical cancer screening. A conceptual framework was developed using the framework of the Practice-Oriented Theory by Dickoff et al., (1968). Subsequently, an educational programme to enhance the utilisation of cervical cancer services among women of reproductive age living in the Otjozondjupa region, Namibia, was developed. This was done according to the programme development process by Meyer and Van Niekerk (2008), the Cyclic curriculum development model of Nicholls and Nicholls (1972) as well as Kolb’s four stage model experiential learning theory (1984). Knowles’s learning theories will be used to facilitate teaching and learning during the implementation of the educational programme to the reproductive aged women regarding screening, prevention, and treatment for cervical cancer in the Otjozondjupa region. Finally, guidelines to facilitate the implementation and evaluation of the educational programme activities to enhance the utilisation of cervical cancer screening services among women of reproductive age in Otjozondjupa region were identified. Keywords: Knowledge, attitude, practices, screening, prevention, treatment, cervical cancer, reproductive and women