Sphindile Magwaza

  • Designation: Social Epidemiology and Health Policy, University of Antwerp
  • Country: South Africa
  • Title: Factors Associated with Willingness to Conduct Colorectal Cancer Screening Among Health Care Workers in Public Sector Primary Health Care Facilities, in Durban, South Africa


Sphindile Magwaza, a public health specialist based in South Africa. She has vast experience in health programs and policy development. She is currently working for a development agency in South Africa. Her interest includes managing health projects, health systems strengthening, and operational health research. She is currently enrolled in doctoral studies at the University of Antwerp. 


Background: In 2018, the age-standardized incidence rate of CRC in South Africa was 18.1 and 12.0 per 100,000 populations of men and women, respectively (Ralwa, 2019). Screening assists with early detection, treatment, and control of CRC. This study sought to identify factors associated with the willingness of healthcare workers to screen for CRC, as part of the broader study on knowledge, attitude, and practices (KAP) in public primary healthcare facilities in Durban, South Africa. 

Methods: A cross-sectional descriptive study was conducted between April and November 2021. Data were collected from 109 nurses, medical doctors, and facility managers at the public primary health care (PHC) facilities. SPSS version 18 for descriptive and association using Chi-Square analysis was conducted identifying factors associated with screening by willingness to conduct screening. 

Results: A total of 109 HCWs participated, with 88% females, 75% under 50 years old, 70% nurses, 44% had more than 10 years work experience;50% worked in the same facility for less than 5 years; 88% worked a 40-hour week; 43% consulted between 51-200 patients per week, with 52% working within facility catchment areas between 200 000 and 400 000 population

There were eight factors significantly (95% confidence level) associated with willingness to conduct CRC screening, including:

  • Type of  preferred colorectal screening program (structured)
  • Perceived the National Cancer Control Guidelines to be influential
  • Perceived colonoscopy to be effective
  • Able to provide CRC Counselling
  • Conducted CRC screening before
  • Prepared to advise on CRC screening
  • Prepared to talk about CRC screening
  • Recommended CRC tests

Conclusion: It is important to identify factors influencing practice at the PHC level, as this is the first entry point to health care. Integration of screening into the routine screening with other cancers at the PHC level reduces opportunity costs. Training and mentorship can assist with provider self-efficacy and confidence to raise awareness about screening with educational materials for patients and providers can in turn lead to service uptake by diverse patients.  The availability of screening guidelines and job aids ensures appropriate screening procedures. Hence, reducing health system barriers can affect the willingness of providers to promote screening from the supply side of health care. 

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