Healthcare utilisation, cancer screening and potential barriers to accessing cancer care in rural South West Nigeria: A cross-sectional study Journal Article
| Authors: | Sharma, A.; Alatise, O. I.; O'Connell, K.; Ogunleye, S. G.; Aderounmu, A. A.; Samson, M. L.; Wuraola, F.; Olasehinde, O.; Kingham, T. P.; Du, M. |
| Article Title: | Healthcare utilisation, cancer screening and potential barriers to accessing cancer care in rural South West Nigeria: A cross-sectional study |
| Abstract: | Background/aims Cancer burden is predicted to double by 2030 in sub-Saharan Africa; access to healthcare services for cancer management is a priority in the region. In Nigeria, National Cancer Control Plan aims to ensure >50% cancer screening of eligible populations by 2022 for all Nigerians. We describe healthcare utilisation, cancer screening activities and potential barriers to accessing cancer care within an understudied rural community-based adult population in South West Nigeria. Methods In April 2018, we conducted a cross-sectional study of community-based adults (>18 years) ∼130 km east of Ibadan, 250 km from Lagos in Osun State, South West Nigeria. Participants completed a face-to-face survey in local dialect. We used a questionnaire to assess demographics, health status, income, medical expenditures, doctor visits and cancer screening history. Results We enrolled 346 individuals: with median age of 52 years and 75% women. Of the entire cohort, 4% had medical insurance. 46% reported a major medical cost in the last year. Cancer screening activities were infrequent in eligible participants: 1.5% reported having had cervical cancer screening, 3.3% mammogram and 5% colonoscopy screening. Cancer screening assessment was less frequent in those with less income and lower education levels. Using a multivariable logistic regression model including personal income, insurance status and education, higher personal income was associated with more cancer screening activity (OR 2.7, 95% CI 1.3 to 5.7, p<0.01). Despite this, most individuals had contact with a primary healthcare doctor (52% in the last year), and over 70% access to radio and TV suggesting the opportunity to expand community-based screening interventions and awareness exists. Conclusions Despite national increases in cancer cases, we highlight a deficiency in cancer screening and universal healthcare coverage within a community-based adult Nigerian population. Subject to availability of governmental resources, increasing financial risk protection, awareness and targeted resource allocation may help expand access in Nigeria. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. |
| Keywords: | health economics; health policy; public health; epidemiology; preventive medicine; organisation of health services |
| Journal Title: | BMJ Open |
| Volume: | 11 |
| Issue: | 7 |
| ISSN: | 2044-6055 |
| Publisher: | BMJ Publishing Group Ltd. |
| Date Published: | 2021-07-01 |
| Start Page: | e040352 |
| Language: | English |
| DOI: | 10.1136/bmjopen-2020-040352 |
| PUBMED: | 34312189 |
| PROVIDER: | scopus |
| PMCID: | PMC8314695 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 September 2021 -- Source: Scopus |
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