MHealth to Train Community Health Nurses in Visual Inspection with Acetic Acid for Cervical Cancer Screening in Ghana

Ramin Asgary, Philip Baba Adongo, Adanna Nwameme, Helen V S Cole, Ernest Maya, Mengling Liu, Karen Yeates, Richard Adanu, Olugbenga Ogedegbe

Research output: Contribution to journalArticle

Abstract

Objective There is a shortage of trained health care personnel for cervical cancer screening in low-/middle-income countries. We evaluated the feasibility and limited efficacy of a smartphone-based training of community health nurses in visual inspection of the cervix under acetic acid (VIA). Materials and Methods During April to July 2015 in urban Ghana, we designed and developed a study to determine the feasibility and efficacy of an mHealth-supported training of community health nurses (CHNs, n = 15) to perform VIA and to use smartphone images to obtain expert feedback on their diagnoses within 24 hours and to improve VIA skills retention. The CHNs completed a 2-week on-site introductory training in VIA performance and interpretation, followed by an ongoing 3-month text messaging-supported VIA training by an expert VIA reviewer. Results Community health nurses screened 169 women at their respective community health centers while receiving real-time feedback from the reviewer. The total agreement rate between all VIA diagnoses made by all CHNs and the expert reviewer was 95%. The mean (SD) rate of agreement between each CHN and the expert reviewer was 89.6% (12.8%). The agreement rates for positive and negative cases were 61.5% and 98.0%, respectively. Cohen κ statistic was 0.67 (95% CI = 0.45-0.88). Around 7.7% of women tested VIA positive and received cryotherapy or further services. Conclusions Our findings demonstrate the feasibility and efficacy of mHealth-supported VIA training of CHNs and have the potential to improve cervical cancer screening coverage in Ghana.

Original languageEnglish (US)
Pages (from-to)239-242
Number of pages4
JournalJournal of Lower Genital Tract Disease
Volume20
Issue number3
DOIs
StatePublished - Jul 1 2016

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Ghana
Community Health Nurses
Telemedicine
Early Detection of Cancer
Uterine Cervical Neoplasms
Acetic Acid
Text Messaging
Community Health Centers
Cryotherapy
Cervix Uteri
Health Personnel
Delivery of Health Care
Smartphone

Keywords

  • cervical cancer
  • community health nurses
  • Key Words mHealth
  • screening
  • sub-Saharan Africa

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

MHealth to Train Community Health Nurses in Visual Inspection with Acetic Acid for Cervical Cancer Screening in Ghana. / Asgary, Ramin; Adongo, Philip Baba; Nwameme, Adanna; Cole, Helen V S; Maya, Ernest; Liu, Mengling; Yeates, Karen; Adanu, Richard; Ogedegbe, Olugbenga.

In: Journal of Lower Genital Tract Disease, Vol. 20, No. 3, 01.07.2016, p. 239-242.

Research output: Contribution to journalArticle

Asgary, Ramin ; Adongo, Philip Baba ; Nwameme, Adanna ; Cole, Helen V S ; Maya, Ernest ; Liu, Mengling ; Yeates, Karen ; Adanu, Richard ; Ogedegbe, Olugbenga. / MHealth to Train Community Health Nurses in Visual Inspection with Acetic Acid for Cervical Cancer Screening in Ghana. In: Journal of Lower Genital Tract Disease. 2016 ; Vol. 20, No. 3. pp. 239-242.
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