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Cung cấp dịch vụ phòng ngừa ung thư cổ tử cung ở Bắc Uganda: một cuộc khảo sát các nhân viên y tế tại các trung tâm y tế nông thôn
Tóm tắt
Ung thư cổ tử cung là loại ung thư hàng đầu ở phụ nữ Uganda, chiếm 40% tổng số trường hợp ung thư được ghi nhận trong sổ đăng ký ung thư. Nhận thấy tác động to lớn của ung thư cổ tử cung đối với phụ nữ Uganda, Bộ Y tế đã phát động Kế hoạch Chiến lược phòng ngừa và kiểm soát ung thư cổ tử cung vào năm 2010. Nghiên cứu này được thực hiện nhằm xác định xem các nhân viên y tế làm việc tại các trung tâm y tế nông thôn (HCs) III và IV ở miền Bắc Uganda có cung cấp dịch vụ sàng lọc ung thư cổ tử cung như được khuyến nghị trong Kế hoạch Chiến lược hay không. Một cuộc khảo sát cắt ngang sử dụng bảng hỏi có cấu trúc đã được thực hiện đối với các y tá, nữ hộ sinh và viên chức lâm sàng làm việc tại các HCs III và IV ở miền Bắc Uganda. Dữ liệu được nhập vào Epidata 3.1 và phân tích bằng phần mềm thống kê Stata 16. Các phân tích đơn biến, đôi biến và đa biến đã được thực hiện. Bất kỳ yếu tố nào có giá trị p ≤ 0.05 được coi là dự đoán có ý nghĩa cho kết quả. Chúng tôi đã khảo sát 286 nhân viên y tế. Năm mươi mốt (18%) nhân viên y tế đang sàng lọc phụ nữ cho ung thư cổ tử cung. Năm mươi tám (21%) nhân viên y tế có hướng dẫn về sàng lọc ung thư cổ tử cung tại HCs của họ, 93 (33%) người tham gia đã được đào tạo để sàng lọc phụ nữ cho ung thư cổ tử cung. Hai trăm sáu mươi hai (92%) người tham gia đã cung cấp vắc-xin HPV. Hai trăm bốn mươi sáu (87%) người tham gia đang thực hiện giáo dục sức khỏe về ung thư cổ tử cung tại HCs của họ. Các yếu tố liên quan đến việc sàng lọc phụ nữ cho ung thư cổ tử cung bao gồm: là nhân viên tại HCs III (AOR = 0.30, 95% CI 0.13–0.68, p = 0.00), là nhân viên của HCs có tổ chức hỗ trợ dịch vụ sàng lọc ung thư cổ tử cung (AOR = 4.38, 95% CI 1.99–9.63, p=0.00), là nhân viên y tế đã được đào tạo để sàng lọc ung thư cổ tử cung (AOR = 2.21, 95% CI 1.00–4.90, p = 0.05) và nhân viên từ HCs có hướng dẫn về sàng lọc ung thư cổ tử cung (AOR = 2.89, 95% CI 1.22–6.86, p = 0.02). Nghiên cứu này cho thấy một vấn đề cấu trúc tổng thể liên quan đến việc cung cấp dịch vụ sàng lọc ung thư cổ tử cung tại HCs III và IV ở miền Bắc Uganda mà Kế hoạch Chiến lược chưa giải quyết. Những vấn đề cấu trúc này cần được chú ý khẩn cấp nếu chính phủ Uganda và các quốc gia khác ở châu Phi cận Sahara (SSA) muốn thực hiện mục tiêu 90–70–90 của Tổ chức Y tế Thế giới (WHO) vào năm 2030 để tiến tới việc loại bỏ ung thư cổ tử cung.
Từ khóa
#ung thư cổ tử cung #nhân viên y tế #sàng lọc #phòng ngừa #UgandaTài liệu tham khảo
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