Does Spousal Engagement Improve Cervical Cancer Screening Discussions and Uptake? Lessons from a Before-After Study in a Rural Nigerian Community

Background. This study determined spousal involvement and the effect of community-based spousal engagement on cervical cancer screening-related discussions and uptake in a rural Nigerian community. Methods. A before-after mixed methods study was conducted among 245 married men in a rural Nigerian community. Spousal engagement involved advocacy to men groups, awareness creation, and monthly meeting-based announcements/reminders about screening. Three months post-intervention, uptake was determined from facility registers. Thematic analysis and SPSS were used for data analysis. Results. A large minority of respondents were aged 29-39 years (95/245, 38.8%). At baseline, respondents generally had poor spousal involvement. Post-intervention, inter-spousal discussion on screening increased from 17.2% to 46.9% (p<.001). There was no significant increase in uptake post-intervention. Having more than 5 children was a predictor of screening discussions (AOR=2.017; CI=1.196–3.403; p=.009). Conclusion. Despite increased inter-spousal discussions on cervical cancer screening, uptake remained low. We recommend community–driven interventions on cervical cancer screening with a gender-transformative perspective.