Ikemeafula Amadi, Azubulke (2025) Healthcare professionals and women's experience and perception of colposcopy method of cervical cancer screening in rural area of Rivers State, Nigeria. Doctoral thesis, University of West London.

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Abstract

Introduction
Cervical cancer is a significant public health concern in Nigeria, with high mortality rates partly attributed to limited access to screening services, especially in rural areas. Colposcopy, a procedure involving the examination of the cervix using a low-powered microscope, serves as a valuable diagnostic tool for detecting precancerous lesions. Despite the potential benefits of colposcopy for cervical cancer screening, recent times have witnessed a persistent drop in the utilisation of this screening method, particularly among women residing in rural areas. Comprehensive reviews of scientific literature reveal a paucity of research delving into this subject area. Consequently, there exists a pressing need to conduct a qualitative study that sheds light on the lived experiences and perceptions surrounding colposcopy as a cervical cancer screening technique in rural settings. Additionally, this investigation should aim to uncover the underlying factors contributing to the low uptake of this vital cervical cancer screening service from the vantage points of both healthcare providers and service users in Nigeria. Gaining insights into these perspectives can inform strategies to bolster the adoption and effective implementation of colposcopy screening initiatives, ultimately improving cervical cancer prevention efforts in underserved rural communities.

Methodology
This qualitative study utilised constructivist phenomenological approach to explore the experiences and perceptions of healthcare professionals and women regarding the uptake of colposcopy for cervical cancer screening in rural communities in Nigeria. In this sequential study, comprehensive in-depth interviews were carried out with 41 women who had either undergone or were yet to undergo colposcopy screening in rural settings, followed by focus group discussions involving 18 healthcare professionals actively engaged in cervical cancer screening programmes. Thematic analysis revealed several key themes.

Findings
Synthesis of the findings using the Health Belief Model revealed convergent/ divergence barriers and facilitators affecting cervical cancer screening in rural settings. Barriers included limited knowledge reducing perceived susceptibility, multifaceted challenges (socioeconomic, logistical, psychological), HIV-related stigma complications, technological limitations, economic constraints, gender dynamics affecting autonomy, alternative health beliefs, psychological impacts, and follow-up difficulties. Facilitators encompassed health consciousness among some women, trusted healthcare provider relationships, policy-level considerations, social support networks, and potential for mobile services. Both women and providers recognised how misconceptions, transportation difficulties, infrastructure limitations, and fear of diagnosis hindered screening uptake. However, community engagement opportunities, service integration, and healthcare provider trust emerged as leverage points for improvement. A key divergence emerged in perceived screening importance - providers universally recognised its critical value, while many women did not share this perspective.

Conclusion
The findings underscore the importance of addressing healthcare system constraints, raising community awareness, and providing culturally sensitive education to both service providers and users to enhance the uptake and effective delivery of colposcopy screening services in rural Nigerian communities. Strengthening healthcare infrastructure, training healthcare workers, and promoting community engagement are crucial steps towards improving cervical cancer prevention efforts in these underserved regions.

Item Type:	Thesis (Doctoral)
Identifier:	10.36828/thesis/14388
Date Deposited:	03 Dec 2025
URI:	https://repository.uwl.ac.uk/id/eprint/14388

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