Self-assessed competence of nurses-midwives on cervical cancer screening in primary health care facilities in the cape metropole
Background: Cervical cancer ranks fourth in terms of global incidence and mortality among women, with an anticipated 604,000 new cases and 342,000 deaths reported worldwide. Cervical cancer is the second most prevalent cancer among women in South Africa, following breast cancer, and it poses a lifetime risk of being diagnosed of one in every 42 women. Nurses and midwives working at the primary healthcare facilities play a crucial role in implementing the preventive measures of cervical cancer. This study aimed to evaluate the self-assessed competence of nurses and midwives on cervical cancer screening in primary health care facilities in the Cape Metropole. The competence was measured by assessing the knowledge, behaviour, and skills of nurses and midwives in implementing cervical cancer screening in Primary Health Care Facilities in the Cape Metropole. Methods: A quantitative cross-sectional descriptive study was conducted in 16 Primary Health Care (PHC) facilities within the Cape Metropole of the Western Cape, South Africa. A self-administered questionnaire was used to assess demographic characteristics, knowledge, behaviour, and implementation skills among 131 respondents. Data were captured in an Excel spreadsheet and exported to SPSS version 30. A 70% threshold, covering two-thirds of the questions, was set to determine the adequacy level for both knowledge and behaviour. For knowledge, 12 out of 16 correct answers were considered adequate, while 9 out of 13 correct responses were considered adequate for behaviour. Pearson correlation, chi-square, and logistic regression were used to assess the relationships among knowledge, behaviour, and skills in the implementation of the preventive measures for cervical cancer. Results: 135 questionnaires were distributed, and only 131 completed questionnaires were retrieved. The study reveals that more than half of the respondents had adequate knowledge (n = 94, 71.9%) regarding cervical cancer, its risk factors, signs and symptoms, and the South African guidelines and policies for implementing cervical cancer preventive measures. Also, a large number of respondents (n = 114, 87%) demonstrated positive behaviour towards cervical cancer screening across all items in the study. Specifically, more than two-thirds (n = 116, 88.5%) of respondents were interested in obtaining more knowledge about cervical cancer and (n = 69, 52.7%) communicated very often with women about cervical cancer. The correlation results demonstrated a strong positive linear association between knowledge and the skills in implementing cervical cancer preventive measures (r = 0.710, p < 0.002). Likewise, behaviour shows a strong positive association with implementation skills (r = 0.776, p < 0.002). However, the self-reported percentage of women screened for cervical cancer, as indicated by the respondents, compared to the number of women that are seen monthly in some of the facilities, shows that cervical screening was not adequately utilised. Only 44.3% of respondents reported performing a pap smear on 1-25 patients, compared with 56.7% who reported attending to 1-50 patients in the clinic monthly Conclusion: The nurses and midwives in the primary healthcare facilities of Cape Town metropole have adequate knowledge of cervical cancer and the preventive measures, but the uptake of screening by women remains low in some of the facilities. The number of women who accept cervical screening in a month in most of the facilities was low when compared to the number of women attended to monthly. It is therefore recommended that further studies be carried out to determine the low screening.
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