Assessment of Cervical Cancer Screening Service Quality at Comprehensive Health Centres in Niger State

Cervical cancer prevention through structured screening is a national priority in Nigeria, yet the quality of screening service delivery at comprehensive health centres outside tertiary facilities has not been systematically evaluated in Niger State, North Central Nigeria. This study assesses cervical cancer screening service quality at 12 comprehensive health centres in Minna, Bida, and Kontagora LGAs of Niger State. A structured quality assessment covering provider training status, visual inspection with acetic acid technique accuracy, equipment availability, result communication practices, and colposcopy referral pathways was applied. Direct observation of 30 VIA screening procedures supplemented facility assessments. VIA screening providers were trained in only 58 percent of centres. Acetic acid concentration and application technique were correct in 61 percent of observed procedures. Result communication to clients with a written report was achieved in 44 percent of encounters. Positive VIA referral to colposcopy was achievable within the state in only 33 percent of cases, with most positive cases referred to Minna teaching hospital. Quality scores were significantly higher in centres with dedicated screening nurses compared to those relying on general clinic staff. Professional recommendations include standardised VIA training certification, supervisory mentorship visits from Niger State Ministry of Health, and co-location of cryotherapy at district-level centres to provide screen-and-treat services. Keywords: cervical cancer screening, VIA quality, Niger State, comprehensive health centre, colposcopy referral