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Impact of Uterine Fibroid Education on Early Healthcare-Seeking for Fibroid Symptoms among Women in Nigeria

Abstract

Uterine fibroids are common benign growths of the uterus and represent an important women's health concern because they may cause heavy or prolonged menstrual bleeding, pelvic pain or pressure, frequent urination, abdominal enlargement, painful sexual intercourse, reproductive difficulties, and anaemia. Although some women with fibroids may have few or no symptoms, symptomatic fibroids can significantly affect physical health, reproductive wellbeing, daily activities, and quality of life. In Nigeria, delayed healthcare-seeking for fibroid symptoms may occur because of limited awareness, normalization of heavy menstrual bleeding and pelvic symptoms, fear of diagnosis or surgery, financial constraints, cultural beliefs, misinformation, and limited access to appropriate healthcare services. Uterine fibroid education provides an opportunity to improve women's understanding of fibroid symptoms, possible complications, available healthcare services, and the importance of seeking professional assessment at an appropriate time. Against this background, this study investigates the impact of uterine fibroid education on early healthcare-seeking for fibroid symptoms among women in Nigeria. The study will be anchored on the Health Belief Model, Health Literacy Theory, and Social Ecological Model. The Health Belief Model explains how women's perceptions of susceptibility to fibroids, perceived severity of symptoms and complications, perceived benefits of early healthcare-seeking, perceived barriers, self-efficacy, and cues to action may influence their decisions to seek medical care. Health Literacy Theory emphasizes women's ability to obtain, understand, evaluate, and use reliable health information to recognize symptoms and make appropriate healthcare decisions. The Social Ecological Model highlights the influence of individual, interpersonal, community, healthcare-system, and broader socioeconomic factors on women's health-seeking behaviour. Collectively, these theoretical perspectives provide a suitable framework for explaining how uterine fibroid education may influence early healthcare-seeking for fibroid symptoms among women in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise women aged 18 years and above residing in selected urban, semi-urban, and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, and eligible women. Uterine fibroid education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, knowledge of uterine fibroids, awareness of common symptoms, recognition of heavy or prolonged menstrual bleeding, pelvic pain or pressure, abdominal enlargement, frequent urination, painful sexual intercourse, reproductive difficulties, anaemia-related symptoms, awareness of possible complications, available diagnostic services, treatment options, referral pathways, and misconceptions about fibroids. Early healthcare-seeking for fibroid symptoms will be assessed using indicators such as prompt consultation following recognition of concerning symptoms, time between symptom onset and first healthcare contact, willingness to seek professional assessment for persistent or severe symptoms, use of appropriate healthcare facilities, attendance at recommended follow-up appointments, compliance with referral recommendations, avoidance of prolonged self-treatment or unverified remedies, and willingness to seek further evaluation when symptoms persist or worsen. Data will be collected using structured questionnaires, uterine-fibroid knowledge assessment tools, healthcare-seeking behaviour scales, symptom-recognition scenarios, healthcare-utilization records where available, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize participants' demographic and socioeconomic characteristics, reproductive-health experiences, knowledge of fibroid symptoms, sources of health information, and healthcare-seeking patterns. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of uterine fibroid education on early healthcare-seeking. Where a quasi-experimental design is adopted, healthcare-seeking indicators before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that uterine fibroid education has a significant positive impact on early healthcare-seeking for fibroid symptoms among women in Nigeria. Women exposed to structured and evidence-based fibroid education are expected to demonstrate greater knowledge of symptoms and a higher likelihood of seeking professional healthcare promptly when concerning symptoms occur than women without comparable exposure. Education may improve women's ability to recognize heavy menstrual bleeding, persistent pelvic pain or pressure, abdominal enlargement, urinary symptoms, reproductive difficulties, and other symptoms that may require medical evaluation. It may also reduce misconceptions that severe menstrual symptoms are always normal or that fibroids inevitably require surgery. Practical education may encourage women to seek appropriate assessment, follow referral recommendations, and avoid prolonged reliance on unverified treatments. However, financial barriers, fear of medical procedures, cultural beliefs, stigma, misinformation, limited availability of gynaecological services, transportation difficulties, and poor access to diagnostic facilities may reduce the effectiveness of education alone. The study therefore expects accessible, culturally appropriate, practical, and sustained uterine fibroid education, supported by affordable and accessible reproductive-health services, to contribute significantly to improved early healthcare-seeking for fibroid symptoms among women in Nigeria. The study is expected to contribute to the literature on uterine fibroids, women's health, reproductive health, healthcare-seeking behaviour, health education, health literacy, gynaecological health, early healthcare utilization, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, hospitals, primary healthcare centres, healthcare professionals, gynaecological services, women's health organizations, community health workers, public health practitioners, development partners, and policymakers regarding strategies for improving awareness and timely management of uterine fibroids. The study will also provide evidence-based recommendations for expanding community-based fibroid education, integrating fibroid awareness into women's reproductive-health programmes, strengthening recognition of concerning symptoms, reducing misconceptions and stigma, improving referral pathways, increasing access to diagnostic services, and promoting timely healthcare-seeking among women across Nigeria.

Keywords: Uterine fibroid education, early healthcare-seeking, fibroid symptoms, women, uterine fibroids, women's health, reproductive health, health education, health literacy, healthcare-seeking behaviour, Nigeria, public health.