Effectiveness of health education interventions for cervical cancer screening: A quasi-experimental study in Pokhara Metropolitan Slum, Nepal

Cervical cancer remains a major public health challenge in low- and middle-income countries, including Nepal, particularly among marginalized populations such as women living in slum areas. Despite national screening guidelines and awareness campaigns, uptake of cervical cancer screening remains low. The study aimed to assess the effectiveness of a community information channel (CIC) and community health worker (CHW)-led interventions on improving the knowledge and utilization of cervical cancer screening among women of slum areas in Pokhara metropolitan, Nepal. A quasi-experimental study with a pre-test and post-test control group design was conducted in two purposively selected slum areas. Women aged 30-60 years (n = 310) were recruited and divided into intervention and control groups. The intervention group received CHW-led individual health education using flipcharts and brochures, while the control group was exposed to CIC-led awareness through posters. Data were collected at baseline, midterm (3rd week), and endline (6th week) using structured questionnaires and analyzed using SPSS (version 22) and R, where appropriate statistical tests were carried out. Knowledge scores increased significantly in both groups; however, the intervention group showed a greater magnitude of change, with the median knowledge score rising from 2 to 8 compared to an increase from 3 to 5 in the control group. Additionally, screening uptake in the intervention group rose significantly from 36.1% to 52.8% (p-value < 0.001). Improvements were also observed in perceived susceptibility (median difference = 1, 95% CI: 0-2; p < 0.001), perceived severity (median difference = 1, 95% CI: 0-1; p = 0.0011), and behavioral intention (median difference = 15, 95% CI: 0-60; p < 0.001) post-intervention. Community health worker (CHW)-led intervention was effective in enhancing knowledge, perceived susceptibility, perceived severity, behavioral intention, and thereby increasing cervical cancer screening uptake.