*Co esponding au ho : Pe e O. Nwadike
Copy igh © 2025 Au ho (s) e ain he copy igh o his a icle. This a icle is published unde he e ms o he C ea i e Commons A ibu ion Liscense 4.0.
U ban–Ru al G adien in Ce ical Cance Awa eness: Compa a i e E alua ion o
Ambassado -Led Ou each Impac Ac oss Local Go e nmen A eas in Imo S a e,
Nige ia
Pe e O. Nwadike 1, 2, *, Syl ia O. Anyadoh-Nwadike 3, Chukwunonye em C. Ogwunga 3, Nki u N. Nwokoye 2
and Ikechukwu N.S. Dozie 4
1 Texila Ame ican Uni e si y, Guyana.
2 KNCV Nige ia, Abuja, Nige ia.
3 Depa men o Bio echnology, Fede al Uni e si y o Technology, Owe i, Imo S a e, Nige ia.
4 Depa men o Public Heal h, Fede al Uni e si y o Technology, Owe i, Imo S a e, Nige ia.
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 24(01), 001-017
Publica ion his o y: Recei ed on 15 Augus 2025; e ised on 28 Sep embe 2025; accep ed on 01 Oc obe 2025
A icle DOI: h ps://doi.o g/10.30574/wjbphs.2025.24.1.0863
Abs ac
Ce ical cance emains a signi ican public heal h challenge, pa icula ly in low- and middle-income coun ies, despi e
being la gely p e en able. In Nige ia, signi ican dispa i ies in ce ical cance knowledge and sc eening up ake emain
along he u ban– u al g adien . This s udy was unde aken o compa a i ely e alua e he e ec i eness o ambassado -
led ou each in e en ions in imp o ing ce ical cance knowledge and sc eening beha iou among women in u ban,
semi-u ban, and u al Local Go e nmen A eas (LGAs) in Imo S a e, Nige ia. Employing a quasi-expe imen al p e–pos
in e en ion design, 139 communi y ambassado s we e ained and deployed ac oss 15 LGAs (u ban: 3; semi-u ban: 6;
u al: 6). Da a we e collec ed using s uc u ed ques ionnai es (C onbach’s α = 0.929; Validi y Index = 0.96) and ield
logs. Chi-squa e and Pea son co ela ion analyses we e used o assess ou comes. Findings e ealed s a is ically
signi ican imp o emen s in knowledge o ce ical cance among all a ge popula ions ac oss all g adien s as epo ed
by 100% o ambassado s in u ban and u al (χ², p < 0.001), e ec i ely b idging he u ban- u al gap, while in semi-u ban
was 94.6%. Ma ked disc epancy, howe e , exis ed be ween sc eening consen and ac ual up ake. Ambassado s in semi-
u ban zones no ably epo ed he highes baseline knowledge and sc eening a es, as well as he highes inc ease in
pos -ambassado ac i i y sc eening consen (up o 60%), as epo ed by 78.2% o ambassado s. This indica es a
nuanced socio-geog aphic ecep i eness o in e en ions. Ru al a eas eco ded he lowes sc eening a endance, as only
21.59% o he consen ing women ul ima ely p esen ed o sc eening. Key ba ie s ci ed by he women eached included
inancial/ anspo a ion challenges (51.8%); Ru al (53.5%), semi-u ban a eas (52.7%), and u ban (46.2%). Cul u al
/ eligious ba ie s, hough minimal/leas we e obse ed in u al a eas (3.5%) and u ban a eas (3.8%). Ambassado
ec ui men a es we e highes in u al LGAs (96.7%), con ibu ing o high le els o communi y engagemen ; hey also
aced he mos ield- ela ed challenges, peaking a 91.4% on lack o unding. In conclusion, he ambassado -led ou each
ini ia i e e ec i ely closed he u ban- u al knowledge gap in ce ical cance awa eness, wi h u al a eas ha ing he
highes ela i e gains. The indings con i m he scalabili y and cul u al adap abili y o he ce ical cance ambassado -
led ou each model ac oss di e se se ings. Howe e , he di e se challenges aced by ambassado s unde sco e he need
o loca ion/con ex -speci ic, mul isec o al in e en ions o equi able sc eening up ake and sus ained impac s.
Keywo ds: Ce ical cance ; U ban- u al dispa i ies; Communi y ambassado s; Sc eening up ake; Knowledge; Imo
S a e
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 24(01), 001-017
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1. In oduc ion
Ce ical cance is he ou h mos common cance in women globally and anks second among women in Nige ia (WHO,
2024; WHO, 2024; Ogwunga e al., 2020; Dozie e al., 2020; Mai anmi e al., 2020). I is p ima ily caused by pe sis en
in ec ion wi h oncogenic s ains o human papilloma i us (HPV), pa icula ly HPV ypes 16 and 18, which a e sexually
ansmi ed (Dozie e al., 2020; Nee ia e al., 2018; Jedy e al., 2016; B uni e al., 2019). In 2020, 604,000 new cases o
ce ical cance we e epo ed globally, wi h abou 342,000 dea hs. An es ima ed 85% o he dea hs occu ed in low-
and middle-income coun ies (LMICs) (WHO, 2022). The bu den inc eased o 660,000 new cases wi h 350,000 dea hs,
ou o which abou 94% we e in low- and middle-income coun ies (LMICs) (WHO, 2024).
Despi e i s p e en abili y h ough egula sc eening and accina ion, up ake emains low in LMICs, including Nige ia,
leading o an inc ease in he disease bu den (Akinyemiju e al., 2015; Nwankwo e al., 2011). Ce ical cance ’s
disp opo iona e impac on LMICs is exace ba ed by inequi ies in access o heal hca e, limi ed in as uc u e, and
p e ailing sociocul u al a i udes (Nwadike e al., 2025; Okunowo e al., 2018; Ezechi e al., 2013), wo se s ill in u al
a eas. Nige ia exempli ies hese challenges, wi h signi ican ly lowe sc eening a es in u al egions compa ed o u ban
cen e s (Ogwunga e al., 2020). Se e al public heal h s a egies, including na ional cance con ol policies and he
p omo ion o HPV accina ion, ha e been implemen ed in Nige ia (Beddoe, 2019), ye awa eness and pa icipa ion
emain subop imal (Akinyemiju e al., 2015; Bisi-Onyemaechi e al., 2018). Awa eness and educa ion play a pi o al ole
in inc easing sc eening up ake (Ndikom & O i, 2012). Howe e , s udies ha e consis en ly shown ha u al and semi-
u ban popula ions exhibi lowe le els o knowledge due o illi e acy, poo heal h communica ion, and es ic ed access
o se ices (Makadzange e al., 2022).
Communi y-based in e en ions u ilizing local heal h ambassado s o champions ha e demons a ed e ec i eness in
a ious con ex s. These p og ams bene i om he cul u al alignmen and us enjoyed by communi y membe s,
allowing o mo e e ec i e communica ion and beha iou al in luence (Lo e s e al., 2023). Ambassado ou each
p og ams, which le e age ained local olun ee s o p omo e heal h educa ion, ha e shown success in domains such
as HIV p e en ion and ma e nal heal h (Dozie e al., 2020). Howe e , hei e ec i eness in cance con ol in Nige ia
emains nascen and unde explo ed. This s udy adap s he ambassado model h ough h ee inno a ions: Task-shi ing
o non-medical ambassado s, In eg a ion o mobile heal h acking, and con ex ualized beha iou al nudges.
Nige ia's di e se geog aphy and popula ion dis ibu ion c ea e signi ican dispa i ies in heal h ou comes and access o
se ices. U ban a eas, cha ac e ized by be e heal hca e in as uc u e and highe educa ional a ainmen , gene ally
epo highe awa eness and u iliza ion o ce ical cance sc eening (Akinyemiju e al., 2015). In con as , u al
communi ies ace nume ous ba ie s, including limi ed access o heal hca e acili ies, lowe li e acy le els (Nwadike e
al., 2025), and en enched adi ional belie s (Nwankwo e al., 2011; Ndikom & O i, 2012). Semi-u ban a eas, o en
o e looked in esea ch, p esen a unique blend o challenges and oppo uni ies. These a eas may bene i om p oximi y
o u ban cen e s bu s ill ace in as uc u al and sociocul u al cons ain s simila o u al se ings (Oluwole e al., 2017).
Heal h awa eness p og ams a e low in u al a eas o Nige ia (Oluwole e al., 2017). Wo se s ill, a g ea e numbe o
u al dwelle s a e illi e a e and poo , hence canno easily access hei in o ma ion (Makadzange e al., 2022; Zhang e
al., 2022; Ze e ino & De chain, 2006). I he e o e becomes c ucial o ha e p ope ly ained public heal h ambassado s
p o ide con inuous ace- o- ace ac ual heal h in o ma ion, especially in u al a eas. By unde s anding he ole o
ambassado -led p og ams, policymake s and heal hca e p ac i ione s can de elop scalable s a egies o enhance cance
p e en ion e o s in simila unde se ed popula ions.
The Social Cogni i e Theo y (Bandu a, 1986) and he Heal h Belie Model p o ide heo e ical ounda ions o he
ambassado app oach. These models emphasize he ole o obse a ional lea ning, pe cei ed ba ie s, and bene i s in
beha iou change. When indi iduals obse e pee s engaging in heal h-p omo ing beha iou and ecei e consis en
messaging om us ed sou ces, hey a e mo e likely o adop simila p ac ices (Walle e al., 2016).
This s udy gene ally explo es he compa a i e impac o applying he Ambassado -led ou each model o ce ical cance
awa eness and p e en ion among women in u ban, semi-u ban, and u al LGAs o Imo S a e.
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 24(01), 001-017
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1.1. Objec i es
1.1.1. Gene al Objec i e
The gene al objec i e o he s udy is o compa a i ely e alua e he e ec i eness o ambassado -led ou each
in e en ions in imp o ing ce ical cance knowledge and sc eening beha iou among women in u ban, semi-u ban,
and u al Local Go e nmen A eas (LGAs) o Imo S a e, Nige ia
1.1.2. Speci ic Objec i es
The speci ic objec i es include o;
• En oll, ain and deploy olun ee ce ical cance ambassado s in he i een selec ed LGAs
• Assess and compa e baseline knowledge and a i udes ac oss loca ion ypes.
• De e mine he e ec i eness o ambassado -led in e en ions.
• Analyze he impac o ambassado -led in e en ions on knowledge and a i ude o esponden s owa ds
ce ical cance sc eening
• Iden i y logis ical and sociocul u al challenges encoun e ed by ambassado .
2. Me hodology
2.1. S udy Design and A ea
A quasi-expe imen al design was adop ed, wi h in e en ions adminis e ed ac oss 15 LGAs ep esen ing he h ee
sena o ial zones o Imo S a e, Sou h-Eas , Nige ia. S a i ied andom sampling was used o ensu e equi able
ep esen a ional di e si y by LGA ypology (u ban, semi-u ban, u al).
Figu e 1 Physical Map o Imo S a e showing he s udy loca ions / LGAs
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 24(01), 001-017
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Figu e 2 Mind map o Imo S a e
2.2. S udy Popula ion and Sampling
Ambassado s we e ec ui ed ia an open call o olun ee s a e a ce ical cance semina o emale wo ke s in he
LGAs. C i e ia included basic sma phone li e acy, luency in English and Igbo, and o mal educa ion. Ten ambassado s
pe LGA we e a ge ed; howe e , a o al o 139 women olun ee ed.
2.3. Fu he T aining and Deploymen
Ambassado s unde wen s uc u ed in-dep h aining on ce ical cance , HPV, sc eening me hods, and communi y
engagemen s a egies. T aining ma e ials we e dissemina ed ia Wha sApp. Field ac i i ies we e moni o ed using
s uc u ed logs and supe iso o e sigh .
The ained ambassado s we e deployed o hei espec i e LGAs/communi ies o he ou each in e en ions. They
conduc ed awa eness ou each p og ams, dis ibu ed in o ma ional ma e ials, and pa ien ly engaged in one-on-one
discussions wi h pa icipan s, indi idually (in o ices and homes) and a g oup mee ings (Communi y, o ices, ai h-
based ga he ings, e c). The epo s we e logged and moni o ed weekly o wo mon hs.
As pa o an incen i e o ambassado s and in u he ance o hei ac i i ies, a p esump i e sc eening es o hei
ce ical cance s a us was conduc ed in all he s udy LGAs using he Enzyme Linked Immunoso ben Assay (ELISA) ki
me hod.
2.4. Da a Collec ion ool and p ocedu e
Ambassado s collec ed and logged hei daily/weekly ac i i ies ou comes in a ime book p o ided by he esea che o
ease o comp ehensi e epo ing a he end o he ield wo k. This was moni o ed weekly by he esea che o ensu e
comp ehensi eness and compliance wi h de ails.
Da a we e collec ed om ambassado s using a s uc u ed ques ionnai e di ided in o h ee sec ions: demog aphics,
ou each ac i i y e alua ion, and challenges aced. Reliabili y and alidi y es ing yielded a C onbach’s alpha o 0.929
and a Con en Validi y Index o 0.96. C onbach’s α was calcula ed om pilo esponses while CVI was based on expe
panel a ings.
2.5. Da a analysis
S a is ical analyses, including chi-squa e and Pea son co ela ion analyses, we e pe o med o assess he changes in
knowledge and a i udes as well.
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 24(01), 001-017
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3. Resul s
3.1. Loca ional /Geog aphic dis ibu ion o Ambassado s
F om he s udy design, he expec ed numbe o ambassado s was 10 pe LGA. Howe e , U ban A eas had a o al o 26
ambassado s, anging om 8 o 10 pe loca ion, implying 86.7% achie emen o he expec ed numbe . Ru al a eas had
he highes o al o 58 ambassado s, also anging om 8 o 10 pe loca ion, implying 96.7% achie emen o he expec ed
numbe o he 6 LGAs (Table 1).
Table 1 Numbe o Ambassado s acco ding o Loca ion ype
Loca ion Type
LGA
Numbe o Ambassado s (Range)
U ban
Owe i municipal
10
O lu
8
Okigwe
8
To al
26 (8-10)
Semi-u ban
Owe i wes
10
Mbai oli
10
Nkwe e
10
Nwangele
10
Isiala Mbano
8
Ehime Mbano
7
To al
55 (7-10)
Ru al A eas
Ezinihi e Mbaise
10
Ngo Okpala
10
Ohaji
10
Idea o Sou h
10
Ihi e Uboma
8
Obowo
10
To al
58 (8-10)
3.2. Demog aphic Cha ac e is ics o Ambassado s
Table 2 below shows he dis ibu ion o age and educa ion-le el b eakdowns ac oss he h ee loca ion ypes, along wi h
chi-squa e es esul s: The age g oup 20–30 was he leas ep esen ed ac oss all loca ion ypes. The e was no
s a is ically signi ican di e ence in he age dis ibu ion be ween loca ion ypes (p = 0.215).
In u ban a eas, Te ia y educa ion was mos common, 17(65.4%) ambassado s, bu also well- ep esen ed in semi-
u ban, 26 (47.3%), and u al a eas, 22 (37.9%). Ambassado s wi h jus P ima y educa ion we e only ound in u al
a eas, 6 (10.3%) ambassado s. Chi-squa e es e ealed ha educa ion le el dis ibu ion ac oss he s udy a eas was
signi ican ly di e en ac oss loca ion ypes (p = 0.0133), indica ing educa ion le el was associa ed wi h loca ion ype.
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 24(01), 001-017
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Table 2 Demog aphic Cha ac e is ics o Ambassado s
Ambassado da a
Indica o s
U ban
(N =26)
Semi-u ban
(N = 55)
Ru al
(N= 58)
Chi-squa e
(P alue)*
Age
20 -30
2
5
5
5.814 (0.215)
31 – 40
18
23
27
>40
6
27
26
Educa ion
P ima y
0
0
6
12.62 (0.0133)**
Seconda y
9
29
30
Te ia y
17
26
22
3.3. Ambassado s’ ield wo k/ ou each ac i i ies
Almos all he ambassado s (97.8%) ecei ed in-dep h men o ing. All (100%) pa icipa ed in ield wo k, hough a
a ying le els, and ob ained da a. The ambassado s in u ban a eas showed he highes adhe ence a es, u al
ambassado s showed good adhe ence, while less han 50% o semi-u ban ambassado s adhe ed ully o hei weekly
awa eness schedule (Table 3).
U ban ambassado s u ilized ai h-based dissemina ion a mo e han o he s, hence eaching ou o mo e women, wi h
20% add essing o e 100 women. Semi-u ban emphasized indi idual isi s, wi h low communi y/ ai h ou each, while
Ru al ambassado s had he lowes engagemen in s uc u ed mee ings; hence, abo e 50% o en eached ewe han 50
women. In all he LGAs, he end seemed o be he same; many women had no hea d abou Ce ical cance and i s
sc eening. The u al a eas seem o be he wo s hi . Upon Ambassado ac i i ies, many ag eed o go o sc eening, bu
gene ally less han 30% ( he highes being om u ban a eas, 34.06%) did.
Da a analysis e ealed a signi ican gap be ween consen and a endance ac oss all s udied LGAs. This was especially
p ominen in u al a eas; while abou 49% o u al women consen ed o sc eening, abo e 70% o hose who consen ed
o sc eening did no a end (Table 4), possibly due o logis ical and e hical challenges.
On easons o non-consen /a endance o sc eening, und /cos conce ns we e gene ally he highes (51. 8%) ac oss
he s udied LGAs ollowed by lack o awa eness. Ru al a eas e ealed highe esis ance due o lack o awa eness, semi-
u ban a eas had he same conce ns bu a lowe a es while U ban a eas epo ed mo e conce ns abou cos , ea and
p i acy.
Table 3 Ambassado s’ ac i i ies acco ding o indica o s
Indica o s
Numbe (%) o Ambassado Responden s
U ban (26)
Semi-U ban (55)
Ru al (58)
O e all (139)
T aining Recei ed
Recei ed in dep h T aining
26 (100)
54 (98.2)
55 (94.8)
135(97.1)
Me hod o in o ma ion dissemina ion
Indi idually (Homes/o ices)
24 (92.3)
55 (100)
55 (94.8)
134 (96.4)
Communi y/wo k mee ings
18 (69.2)
35 (63.6)
30 (51.7)
83 (59.7)
Fai h-based mee ings/ ellowships
20 (76.9)
21 (38.2)
19 (32.8)
60 (43.2)
Ambassado o ganized mee ings
4 (15.4)
3 (5.5)
6 (13.8)
13 (9.4)
Adhe ence o weekly Schedule
% Fully Adhe ence
20 (76.9)
26 (47.3)
33 (56.9)
79 (56.8)
% Pa ial Adhe ence
5(19.2)
19 (34.5)
18 (31.0)
42 (30.2)
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% Non-Adhe ence
1 (3.9)
10 (18.2)
7(12.1)
18 (13)
To al numbe o Women Add essed:
<30
2 (7.6)
20 (36.4)
17 (29.3)
39 (28.1)
50–100
4 (15.4)
20 (36.4)
25 (43.1)
49 (35.2)
101–150
10 (38.5)
6(10.9)
10 (17.2)
26 (18.7)
>150
10 (38.5)
9 (16.3)
6 (10.4)
25 (18)
Numbe wi h p io knowledge o Ce ical cance
None
0 (0)
3 (5.5)
5 (8.6)
8 (5.8)
<10
13 (50)
40 (72.7)
41 (70.7)
94 (67.6)
10–30
9 (34.6)
8 (14.6)
6 (10.3)
23 (16.5)
31–50
0 (0)
0 (0)
1(1.7)
1 (0.7)
51 – 70
3 (11.5)
2 (3.6)
3 (5.2)
8 (5.8)
>70
1 (3.9)
2 (3.6)
2 (3.5)
5 (3.6)
How many had Sc eened o CC p io o you in e ac ions
None
2 (7.7)
9 (16.4)
12 (20.7)
23 (16.5)
<10
20 (76.9)
24 (43.6)
41 (70.7)
85 (61.2)
10–30
1 (3.8)
20 (36.4)
3 (5.2)
24 (17.3)
31–50
1 (3.8)
0 (0)
1 (1.7)
2 (1.4)
51 - 70
2 (7.7)
0 (0)
1 (1.7)
3 (2.2)
>70
0 (0 )
2 (3.6)
0 (0)
2(1.4)
Women Consen ed o Sc eening
<10
1 (3.8)
10 (18.2)
22 (37.9)
33 (23.7)
10–50
8 (30.8)
20 (36.3)
17 (29.3)
49(32.4)
51–100
10 (38.5)
15 (27.3)
15 (25.9)
40 (28.8)
>100
7 (26.9)
10 (18.2)
4 (6.9)
21 (15.1)
Women A ended Sc eening
None
0 (0)
6(10.9)
9(15.5)
15(10.8)
<10
5 (19.2)
24 (43.6)
36 (62.1)
65(46.8)
10–30
13 (50)
20(36.4)
11 (19)
44 (31.7)
31–50
7(26.9)
4 (7.3)
2(3.4)
13 (9.4)
51 - 70
1 (3.9)
0 (0)
0 (0)
1 (0.7)
>70
0 (0)
1 (1.8)
0 (0)
1 (0.7)
Reasons o Non-a endance o sc eening
Lack o Awa eness
4(15.4)
6 (10.9)
6 (10.3)
16 (11.5)
Fea o Resul s
7(26.9)
11 (20)
10 (17.2)
28 (20.1)
Cul u al/Religious Belie s
1 (3.8)
0 (0)
2 (3.5)
3 (2.2)
P i acy Conce ns/indecision
2 (7.7)
9 (16.4)
9(15.5)
20 (14.4)
Cos Conce ns/ anspo a ion
12 (46.2)
29 (52.7)
31 (53.5)
72 (51.8)
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Communi y Recep i eness
Ve y Recep i e
23 (18)
54 (28)
51 (23)
128 (92.1)
Mode a ely Recep i e
2(7)
0(0)
3 (23)
5 (3.6)
No Recep i e
1(1)
1 (8)
4(12)
6 (4.3)
3.3.1. Baseline knowledge and a i ude o women eached by Ambassado s acco ding o Loca ion Type
Semi-u ban a eas show he highes a e age numbe o women who had been sc eened be o e he in e en ion by
ambassado s, ollowed by u ban a eas. Ru al a eas consis en ly exhibi he lowes a e age numbe o women wi h p io
sc eening, and he highes pe cen age o ambassado s epo ing "None" p io sc eening (20.7%)
Table 4 Summa y o Baseline knowledge and a i ude o women eached by Ambassado s acco ding o Loca ion Type
Loca ion Type
To al Ambassado s
(N)
Es ima ed To al
Women Reached
Es ima ed To al (%)
Women wi h baseline
Knowledge
Es ima ed To al (%)
Women Sc eened a
baseline
U ban
26
3,580
505(14.1)
289 (8.1%)
Semi-u ban
55
4,350
640(14.7)
620 (14.3%)
Ru al
58
4,580
605(13.2)
365 (8.0%)
To al
139
12,510
1,750 (14)
1,274 (10.2%)
3.3.2. Summa y o Ambassado Reach, Consen , and Sc eening A endance by Loca ion Type
Using he mid-poin s o ge es ima es o numbe s, all he ambassado s eached ou o abou 12,510 women in all he
loca ions, abou 7,035 (56.24%) consen ed o sc eening while only an es ima ed 26.51% (less han 30%) a ended he
sc eening wi h he u al dwelle s lagging behind he mos in sc eening up ake as only 21.59% o hose who consen ed
ac ually p esen ed o sc eening.
Table 5 Summa y o Ambassado Reach, Consen , and Sc eening A endance by Loca ion Type
Loca ion Type
To al Ambassado s (N)
Es ima ed To al
Women Reached
Es ima ed To al
Women Consen ed
% o women consen ed
o sc eening
Es ima ed To al
Women A ended
Sc eening
Consen - o-A endance
Con e sion Ra e (%)
U ban
26
3,580
1,835
51.28
625
34.06
Semi-u ban
55
4,350
2,975
68.39
760
25.55
Ru al
58
4,580
2,225
48.58
480
21.59
To al
139
12,510
7,035
56.24
1865
26.51
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 24(01), 001-017
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3.3.3. Obse ed impac o Ambassado Ac i i ies
The ambassado ’s ac i i ies we e o good impac , as e ealed by imp o ed knowledge acco ding o epo s by 97.8% o
he ambassado s. Inc eased ce ical cance sc eening a es we e also epo ed as obse ed impac by 98(70.5%) o he
ambassado s (Figu e 3). The semi-u ban ambassado s epo ed highes impac on sc eening while 100% o
ambassado s who wo ked in u ban and u al a eas epo ed inc eased knowledge. The end, howe e , ga e a linea
endline showcasing simila i ies ac oss he s udied a eas.
Figu e 3 Obse ed impac o ou each ac i i ies on knowledge o ce ical cance and sc eening up ake epo ed by
Ambassado s
3.4. Sc eening Up ake Imp o emen
U ban A eas eco ded he mos signi ican inc ease, wi h sc eening up ake ising om 289 women (8.1%) a baseline
o 625 women (17.5%) pos -in e en ion (116.27% inc ease). Ru al and Semi-U ban A eas achie ed a modes
imp o emen o 32.51% and 22,58% espec i ely.
O e all, wi hin he 2-mon h ambassado -led in e en ion, he p og amme achie ed a 46.39% o al inc ease in numbe
o women sc eened.
Table 6 Sc eening up ake imp o emen acco ding o Loca ion ype
Loca ion Type
Baseline
Sc eened (No,
%)
Pos -In e en ion
Sc eened (No, %)
Up ake
Imp o emen
Ra e (No)
% Inc ease
U ban
289 (8.1%)
625 (17.5%)
336
116.27%
Semi-U ban
620 (14.3%)
760 (17.5%)
140
22.58%
Ru al
365 (8.0%)
480 (10.5%)
115
31.51%
To al
1,274 (10.2%)
1,865 (14.9%)
591
46.39%
3.4.1. Challenges aced by Ambassado s
The ambassado s epo ed a ying challenges in ca ying ou hei ac i i ies. Challenges seemed o o e lap in he u ban,
semi-u ban and u al a eas as shown in Figu e 4 below.
Gene ally, Lack o app op ia e unding was he mos p ominen (86.3%) challenge o he ambassado s mili a ing agains
hei op imal ou each ac i i ies ac oss all s udy LGAs, peaking a 91.4% in u al a eas. Su p isingly, eligion and
cul u al esis ance posed minimal challenges as no ambassado in u ban a eas epo ed i as a challenge, while semi-
u ban and u al a eas ambassado s aced i a e y low le els, 3 (1.8%) and 7 (12.1%) espec i ely (Figu e 4).
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 24(01), 001-017
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