Impact of Integrating Anti-cervical Cancer Teachings Into the Curriculum of High Schools in Nigeria

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Abstract Background: The global quest to eliminate cervical cancer, along with the attainment of the 2030 SDG goals, can only be achieved if realistic approaches for improving outcomes in lower-middle-income countries (LMICS) are entrenched. Targeting young, mostly teenage adults in high schools of these countries, which generally lack universally-affordable cervical cancer-tackling measures, has recently been promoted as a game-changing approach. Integration of relevant teachings into the schools’ regular academic curricula, along with in-built measures that enhance engagement, are the advocated measures. A program with these principles, designed with the help of the Harvard Medical School, and introduced into Nigerian schools in 2019, was a global first. This paper evaluates that initiative.Method: A 12-month Cohort Study involving high schools in South-east Nigeria.Results: At Phase-1 (baseline) there were 1,699 Intervention responses, while Phases 2 (one-month post-intervention) and 4 (12-month post-intervention) had 1,797 and 500 responses, respectively. COVID-19 lockdowns washed out Phase-3 (six-month post-intervention). There were increased knowledge on “General Awareness”, “HPV Vaccinations”, “Risk Factors” and “Symptoms”, with levels at Phase-4 being higher than at Phase-2. Observed changes were non-different between gender, age groups, and classes of high schools. “Pap Smears” was an exception, since increased knowledge at Phase-2 were not sustained, and, after initial significant increases at Phase-2, knowledge associated with myths were reversed back to the Phase-1 levels.Conclusion: Anti-cervical cancer enlightenment interventions to teenage high school students were largely effective, but only guaranteed if engagement-enhancing measures are maintained over time. Extra efforts should be put into debunking prevailing myths.

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