Piloting digital tools to understand cancer prevention in Uganda: a case study of cervical cancer prevention in Western Uganda

Ndawula, A

Abstract

Background
In Uganda cancer of the cervix is still a public health problem ranked as the leading cause of female cancer related deaths. According to the World Health Organisation (2018) Uganda has one of the highest incidence rates in the world estimated at 54.8 per 100,000 women. This is due to low uptake of available cancer services, limited awareness of the disease, and uncoordinated health systems with limited trained human resource, financial constraints, and poor infrastructure. And there is no reliable data describing population characteristics to rely on for health planning and decision making.
The fight against elimination of cervical cancer among women in Uganda does not only need clinical interventions as emphasized by most influencers such as WHO, it also needs a collective engagement involving systematic approaches and initiatives to achieve targeted prevention and control objectives.
Cancer of the cervix is totally preventable through primary interventions such as creating awareness and health education programs, HPV vaccinations and cervical screening in specific (eligible) populations. Monitoring of such interventions and determining specific locations to target eligible women would potentially be beneficial.
Aims of the study
1. This study was designed primarily to map cervical cancer awareness among the population of eligible women in western Uganda. The mapping process supports a benchmarking process to guide and evaluate cervical cancer preventative programs including screening and HPV vaccination.
2. It also aimed at mapping the spatial distribution of women eligible for cervical screening and the geography of awareness-raising interventions.
3. Finally, it used a cervical screening intervention to test the role of digital tools in tackling a wider range of public health challenges in low resource settings.
Methodology
The study used a descriptive cross-sectional survey that involved door to door household visits in the west division of Fort Portal Municipality, western Uganda. The survey targeted females aged 18 years and above. A structured questionnaire was developed on a website interface and loaded onto a mobile device application (Epicollect). Epicollect is an Open-Source Software tool with free interfaces mobile and website facilitating field data collection and data visualisation.
A mobile device (Tablet) with a remote sensing feature called the ‘Global Positioning System’ (GPS) was used to save location coordinates for every household visited.
Data analysis was done using Microsoft excel for statistical results and ArcGIS-online to analyse spatial/geographic data for the creation of imagery maps from the data collected.
Results
Broad themes from the study included coverage of awareness programs, the spatial distribution of women eligible for screening, knowledge about cervical cancer, and trends in terms of attendance for cervical screening. The study also captured demographic characteristics of women who have and have not attended cervical screening such as age, education and occupation.
In general, there was a high population of women eligible for cervical screening distributed uniformly over the study area with a high level of basic cervical cancer awareness among them (represented as 98% in Fort Portal Municipality). However, there were low levels of cervical screening uptake with over 80% of eligible women never attended cervical screening distributed randomly all over the study area.
Conclusion
Digital tools proved to be an exciting platform to address the demand and need for public health data for health interventions and research in developing countries for example in Uganda where the prevalence of communicable and non-communicable diseases is high in addition to pandemics such as COVID-19 and Ebola.
The study has demonstrated the powerful role that digital tools can play in guiding and evaluating health awareness interventions to support cervical cancer prevention. This provides the Ministry of Health with legitimate tools to clearly improve data collection and management, planning and monitoring and evaluation of health related interventions such as screening, community awareness-raising, HPV vaccination and treatment plans.
The introduction of digital tools in cervical cancer prevention and control intervention has made it possible for health managers and policy makers to see the potential application of the approach to control the spread of other community preventable diseases such as measles, malaria, and Ebola.

Citation

Ndawula, A. (2022). Piloting digital tools to understand cancer prevention in Uganda: a case study of cervical cancer prevention in Western Uganda. (Dissertation). University of Salford

• Thesis Type: Dissertation
• Deposit Date: Apr 12, 2023
• Publicly Available Date: May 30, 2023
• Award Date: Jul 29, 2022