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Impact of Reproductive Tract Infection Screening on Early Treatment among Women Attending Primary Healthcare Centres in Nigeria

Abstract

Reproductive tract infections (RTIs) are an important public health concern among women and may result from sexually transmitted infections, endogenous infections, and other infections affecting the reproductive tract. Untreated or inadequately managed RTIs may contribute to pelvic inflammatory disease, infertility, pregnancy-related complications, chronic pelvic pain, and other reproductive health problems. Women attending primary healthcare centres may have opportunities for early identification and management of RTIs, yet several factors may contribute to delayed treatment, including limited awareness, stigma, fear of diagnosis, financial constraints, inadequate diagnostic capacity, and limited access to appropriate treatment and referral services. Reproductive tract infection screening provides an opportunity to identify suspected or confirmed infections before complications develop and facilitate timely treatment. Against this background, this study investigates the impact of reproductive tract infection screening on early treatment among women attending primary healthcare centres in Nigeria. The study will be anchored on the Health Belief Model, Andersen's Behavioral Model of Health Services Use, and the Social Ecological Model. The Health Belief Model explains how women's perceptions of susceptibility to RTIs, perceived severity of untreated infections, perceived benefits of screening and early treatment, perceived barriers, and cues to action may influence screening and treatment behaviours. Andersen's Behavioral Model explains how predisposing characteristics, enabling resources, and healthcare needs influence women's utilization of screening and treatment services. The Social Ecological Model emphasizes the interaction between individual, interpersonal, healthcare, community, and broader societal factors in determining access to and utilization of RTI screening and treatment services. Collectively, these theoretical perspectives provide a suitable framework for explaining how RTI screening may influence early treatment among women attending primary healthcare centres in Nigeria. The study will adopt a quantitative analytical cross-sectional or quasi-experimental research design. The study population will comprise women of reproductive age attending selected primary healthcare centres across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, primary healthcare centres, and eligible women. RTI screening will be assessed using indicators such as availability of screening services, screening coverage, screening frequency, availability of trained healthcare personnel, use of appropriate clinical assessment and laboratory testing where available, screening for relevant sexually transmitted and reproductive tract infections, availability of diagnostic equipment and supplies, counselling, confidentiality, and referral arrangements. Early treatment will be assessed using indicators such as time from screening or diagnosis to treatment initiation, receipt of appropriate treatment, treatment completion, adherence to prescribed treatment, partner management where appropriate, referral compliance, and follow-up attendance. Data will be collected using structured questionnaires, screening registers, clinical records where appropriate, laboratory records, treatment registers, and referral documentation. Descriptive statistics will be used to summarize participants' characteristics, screening coverage, infection findings, and treatment patterns. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of RTI screening on early treatment. Where a quasi-experimental design is adopted, treatment initiation patterns before and after implementation or expansion of screening services may be compared, while relevant demographic, socioeconomic, reproductive, and healthcare-access factors are appropriately controlled. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that reproductive tract infection screening has a significant positive impact on early treatment among women attending primary healthcare centres in Nigeria. Women who participate in appropriate RTI screening are expected to be more likely to have infections identified promptly and commence appropriate treatment within a shorter period than women without access to routine screening. Screening may facilitate early identification of symptomatic and asymptomatic infections, provide opportunities for counselling, reduce delays in seeking care, and support appropriate treatment and referral. Early treatment may also reduce the risk of complications and ongoing transmission of infections. However, inadequate diagnostic capacity, shortages of trained healthcare personnel, limited laboratory services, treatment costs, stigma, fear of diagnosis, poor follow-up systems, and shortages of essential medicines may reduce the effectiveness of screening programmes. The study therefore expects accessible, affordable, confidential, evidence-based, and well-integrated RTI screening services to contribute significantly to improved early treatment among women attending primary healthcare centres in Nigeria. The study is expected to contribute to the literature on reproductive tract infection screening, early treatment, women's reproductive health, sexually transmitted infections, reproductive tract infections, primary healthcare services, disease prevention, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, hospitals, healthcare providers, gynaecologists, nurses, midwives, laboratory personnel, community health workers, development partners, and policymakers regarding strategies for improving early detection and treatment of reproductive tract infections. The study will also provide evidence-based recommendations for strengthening RTI screening at primary healthcare level, improving diagnostic capacity and laboratory services, ensuring availability of appropriate medicines and supplies, training healthcare workers, strengthening referral and follow-up systems, improving community awareness, reducing stigma, and promoting timely treatment among women across Nigeria.

Keywords: Reproductive tract infection screening, early treatment, reproductive tract infections, women of reproductive age, primary healthcare centres, sexually transmitted infections, reproductive health, early detection, disease prevention, healthcare utilization, Nigeria, public health.