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Impact of Pelvic Health Screening on Early Detection of Pelvic Health Problems among Women in Nigeria

Abstract

Pelvic health problems are important women's health concerns that may affect physical functioning, reproductive health, sexual wellbeing, continence, mobility, psychological wellbeing, and quality of life. Women may experience pelvic health problems associated with pregnancy and childbirth, pelvic-floor dysfunction, urinary incontinence, pelvic organ prolapse, chronic pelvic pain, menopause, ageing, obesity, and other health conditions. However, some pelvic health problems may remain undetected because women may be unaware of early symptoms, consider certain symptoms a normal consequence of childbirth or ageing, experience embarrassment or stigma, or have limited access to appropriate pelvic health services. Pelvic health screening provides an opportunity to identify symptoms and potential pelvic health problems at an early stage, facilitate appropriate clinical assessment, provide preventive education, and support timely referral and management. Against this background, this study investigates the impact of pelvic health screening on early detection of pelvic health problems among women 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 pelvic health problems, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence participation in pelvic health screening. Andersen's Behavioral Model explains how predisposing characteristics, enabling resources, and healthcare needs influence women's utilization of screening and healthcare services. The Social Ecological Model emphasizes the interaction between individual, interpersonal, organizational, community, and broader societal factors in determining women's access to pelvic health screening and appropriate healthcare. Collectively, these theoretical perspectives provide a suitable framework for explaining how pelvic health screening may influence early detection of pelvic health problems among women in Nigeria. The study will adopt a quantitative analytical cross-sectional or quasi-experimental research design. The study population will comprise adult women attending selected hospitals, primary healthcare centres, women's health clinics, reproductive health facilities, community health programmes, and other relevant healthcare settings across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, clinics, and eligible women. Pelvic health screening will be assessed using indicators such as availability of screening services, screening coverage, frequency of screening, use of appropriate pelvic health assessment tools, healthcare-provider participation, screening procedures, privacy and confidentiality, health education, referral arrangements, and follow-up systems. Early detection will be assessed using indicators such as identification of previously unrecognized pelvic health symptoms, detection of urinary or faecal incontinence, identification of pelvic-floor dysfunction or pelvic organ prolapse symptoms, recognition of chronic pelvic pain or other relevant pelvic health problems, time between symptom onset and detection, referral for further clinical assessment, confirmed diagnosis where applicable, and initiation of appropriate management or follow-up. Data will be collected using structured questionnaires, validated pelvic health screening or symptom assessment tools where appropriate, healthcare records, screening registers, referral records, and relevant women's health programme documents. Descriptive statistics will be used to summarize participants' characteristics, screening coverage, pelvic health findings, and patterns of early detection. 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 pelvic health screening on early detection. Where a quasi-experimental design is adopted, detection rates before and after implementation of pelvic health screening may be compared, while relevant demographic, reproductive, obstetric, health, 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 pelvic health screening has a significant positive impact on early detection of pelvic health problems among women in Nigeria. Women who participate in appropriate pelvic health screening are expected to have a higher likelihood of previously unrecognized pelvic health symptoms or problems being identified than women without access to screening. Routine screening may encourage women to discuss sensitive symptoms that they might otherwise conceal because of embarrassment, stigma, cultural beliefs, or the assumption that pelvic health problems are unavoidable consequences of childbirth or ageing. Early identification may facilitate appropriate clinical assessment, pelvic-floor rehabilitation, lifestyle counselling, medical management, and referral to physiotherapists, gynaecologists, urologists, or other relevant healthcare professionals when necessary. Screening integrated into accessible primary and women's healthcare services may also reduce barriers to early care. However, limited awareness, inadequate privacy, shortage of trained healthcare personnel, insufficient screening resources, cultural misconceptions, financial barriers, and weak referral and follow-up systems may reduce the effectiveness of pelvic health screening programmes. The study therefore expects accessible, confidential, systematic, and appropriately implemented pelvic health screening to contribute significantly to improved early detection among women in Nigeria. The study is expected to contribute to the literature on pelvic health screening, early detection, pelvic-floor health, women's health, urinary incontinence, pelvic organ prolapse, chronic pelvic pain, preventive healthcare, primary healthcare, reproductive health, 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, hospitals, primary healthcare centres, women's health clinics, healthcare providers, physiotherapists, nurses, midwives, gynaecologists, urologists, community health workers, women's health programmes, development partners, and policymakers regarding strategies for improving pelvic health. The study will also provide evidence-based recommendations for integrating appropriate pelvic health screening into women's healthcare services, training healthcare workers in early identification and referral, improving privacy and confidentiality during screening, strengthening referral and follow-up systems, increasing women's awareness of pelvic health problems, and promoting timely access to appropriate pelvic health services across Nigeria.

Keywords: Pelvic health screening, early detection, pelvic health problems, women, pelvic-floor health, urinary incontinence, pelvic organ prolapse, women's health, preventive healthcare, primary healthcare, Nigeria, public health.