Optimizing non-communicable disease screening in Ethiopia : development and evaluation of service integration, and behavioral change communication at primary healthcare level

Abstract

The aim of this dissertation is to discuss how to optimize non-communicable disease (NCD) screening in Ethiopia via service integration and behavioral change communication (BCC) at primary healthcare facilities (PHF). Cross-sectional studies among PHF attendees revealed low intention for clinical breast examination (CBE), cervical cancer screening (CCS), and blood pressure checks. Factors like spouse's education, gender, and prior screening experience influenced intention. We then developed BCC materials with high user satisfaction. Finally, a quasi-experimental study evaluated NCD screening service integration (CCS, CBE, blood pressure check, blood glucose check) with/without BCC. Integrating screening services and usage of BCC significantly increased uptake of all four screenings. Service integration without BCC increased CBE and blood glucose check service uptakes only. We recommend integrating NCD screening services and promoting its uptake via BCC at primary healthcare level.