Towards the development of a community-based model for promoting cervical cancer prevention among Yoruba women in Ibadan Nigeria: application of PEN-3 model

Abstract

Objective: Through the identification of the barriers to the uptake of prevention services for cervical cancer and ways to promote prevention of cervical cancer in the community, this research study purposed the development of a community-based model for promoting cervical cancer prevention among Yoruba women living in Ibadan, Nigeria. Method: An exploratory, descriptive design was used to collect data from 20 health workers and four policy makers using semi-structured interviews and key informant interviews respectively. The PEN-3 cultural model developed by Airhenbuwa in 1998 guided the exploration of the barriers to the uptake of available prevention services for cervical cancer, and the ways to promote the prevention of cervical cancer. Three interrelated and interdependent primary domains, namely cultural identity, relationships and expectations, and cultural empowerment, form the basis of the PEN-3 model. Cultural identity emphasises the subjective responses in relation to the community and cervical cancer prevention. Relationships and expectations determined health workers’ and policy-makers’ experience of community members’ perception of cervical cancer. Enablers and nurturers alluded to the availability and accessibility of cervical cancer prevention resources, and the reinforcing factors that the women receive from their social networks. The central assumption of this theory is that health beliefs and actions that are harmful to health should be changed and the community's positive decisions and practices related to promoting a healthy lifestyle should be identified. Results: Findings from the health workers and policy-makers confirmed that community members lack knowledge and awareness of cervical cancer. Moreover, the findings show that the inaccessibility and unavailability of cervical cancer screening services play a role in its poor uptake. Conclusion: There is need for awareness creation of cervical cancer, and provision of prevention services at the community level. Screening services should be provided to women at subsidised cost. In order to contextualise the discussion, theoretical perspectives on cervical cancer are alluded to.