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Application of the hub and spokes model in improving access to cervical cancer screening in Ghana
Kofi Effah1, Evans K Attivor2, Bernard H Atuguba1
1Catholic Hospital, Battor, Ghana.
Objective:
To examine the contribution of lower-level health facilities in increasing access to cervical cancer screening in the North Tongu District.
Design:
A descriptive cross-sectional study design was used. The Cervical Cancer Prevention and Training Centre (CCPTC) of the Catholic Hospital, Battor, served as the hub, and six health facilities (3 health centres and 3 CHPS compounds) served as the spokes. From April 2018 to September 2019, the well-resourced CCPTC trained 6 nurses at selected Community-based Health Planning and Services (CHPS) / Health Centres (HCs) (spokes) to provide cervical cancer screening services. The nurses, after training, started screening with VIA and HPV DNA testing.
Participants:
A total of 3,451women were screened by the trained nurses. This comprised 1,935 (56.1%) from the hub and 1,516 (43.9%) from the spokes.
Main Outcome Measure:
The detection of screen positives.
Results:
The screen positives were 19.4% (375/1935) at the hub and 4.9% (74/1516) at the spokes.
Conclusion:
We have demonstrated that a hub and spokes model for cervical cancer screening is possible in limited resource settings. Designating and resourcing a 'hub' that supports a network of 'spokes' could increase women's access to cervical cancer screening. This approach could create awareness about cervical cancer screening services and how they can be accessed.
Funding:
None declared.
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