Factors affecting compliance with clinical practice guidelines for pap smear screening among healthcare providers in africa: systematic review and meta-summary of 2045 individuals.

dc.contributor.author

Asonganyi, Etienne

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Vaghasia, Meenakshi

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Rodrigues, Clarissa

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Phadtare, Amruta

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Ford, Anne

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Pietrobon, Ricardo

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Atashili, Julius

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Lynch, Catherine

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Cheung, Annie NY

dc.date.accessioned

2024-05-21T20:29:33Z

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2024-05-21T20:29:33Z

dc.date.issued

2013-01

dc.description.abstract

Background

Although the importance of the Pap smear in reducing cancer incidence and mortality is known, many countries in Africa have not initiated yet widespread national cervical cancer screening programs. The World Health Organization (WHO) has published Clinical Practice Guidelines (CPGs) on cervical cancer screening in developing countries; however, there is a gap between expectations and clinical performance. Thus, the aim of this study was to conduct a systematic review and meta-summary to identify factors affecting compliance with CPGs for Pap screening among healthcare providers in Africa.

Methods

And Findings: MEDLINE, Scirus, Opengate and EMBASE databases were searched in January 2012. Studies involving medical personnel practicing in Africa, whose outcome measured any factors that affect medical personnel from using a Pap smear to screen for cervical cancer, were included. Two reviewers independently evaluated titles and abstracts, then full-texts, extracted data and assessed quality of the included studies. A descriptive analysis of the included studies was conducted. We calculated Frequency effect sizes (FES) for each finding and Intensity effect sizes (IES) for each article to represent their magnitudes in the analyses. Of 1011 studies retrieved, 11 studies were included (2045 individuals). Six different themes related to the factors affecting compliance with CPGs were identified: Insufficient Knowledge/Lack of awareness (FES = 82%), Negligence/Misbeliefs (FES = 82%), Psychological Reasons (FES = 73%), Time/Cost Constraint (FES = 36%), Insufficient infrastructure/training (FES = 45%) and also no reason given (FES = 36%). IES for articles ranged between 33 and 83%.

Conclusions

These results suggest that prevention initiatives should be comprehensive to include education and resources needs assessments and improvement, Pap smear test training, strategies on costing, and practitioner time studies.
dc.identifier

PONE-D-13-07051

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1932-6203

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1932-6203

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https://hdl.handle.net/10161/30727

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eng

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Public Library of Science (PLoS)

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PloS one

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10.1371/journal.pone.0072712

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https://creativecommons.org/licenses/by-nc/4.0

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Humans

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Vaginal Smears

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Health Personnel

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Africa

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Uterine Cervical Neoplasms

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Female

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Factors affecting compliance with clinical practice guidelines for pap smear screening among healthcare providers in africa: systematic review and meta-summary of 2045 individuals.

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Journal article

duke.contributor.orcid

Ford, Anne|0000-0001-6371-4359

duke.contributor.orcid

Lynch, Catherine|0000-0001-7061-5762|0000-0002-6468-2894

pubs.begin-page

e72712

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9

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Duke

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School of Medicine

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Clinical Science Departments

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Obstetrics and Gynecology

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University Institutes and Centers

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Duke Global Health Institute

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Neurosurgery

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Emergency Medicine

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Obstetrics and Gynecology, Duke Women's Health Wake North

pubs.publication-status

Published

pubs.volume

8

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