Barriers and Facilitators to Implementing Cervical Cancer Clinical Practice Guidelines in Nigeria: A Mixed-Methods Study

Across the globe, cervical cancer persists as a frequent contributor to women’s deaths, with Africa bearing a disproportionate share. Nigerian statistics indicate that roughly 7093 women succumb to this illness every year. In response, the Society of Obstetrics and Gynecology of Nigeria (SOGON) formulated clinical practice guidelines to prevent cervical cancer. That said, the extent of these guidelines’ penetration into gynecological practice has not been systematically mapped. The present work was designed to gauge the extent to which Nigerian gynecologists are cognizant of, comprehend, and have embedded the SOGON cervical cancer prevention clinical practice guidelines within their service delivery routines. The investigation followed a convergent parallel mixed methods blueprint. The quantitative strand consisted of a survey administered both electronically and on paper to gynecologists attending the 57th SOGON Annual General Meeting, held in Kano, Nigeria (November 2023). Completed surveys were received from 105 gynecologists, yielding an 80% response rate. Complementary qualitative perspectives were sought through key informant interviews with 12 participants. The quantitative arm was analyzed via descriptive and inferential statistical techniques, including logistic regression (P < .05), while the qualitative dimension underwent thematic analysis. The respondent pool of 105 individuals (mean age 50, SD 8.3 y; mean postresidency practice duration 12, SD 9.4 y) revealed that 98 (93.3%) were acquainted with the SOGON guidelines, and 74 (70.5%) affirmed their significance for cervical cancer prevention. Yet the proportion who had actually operationalized the guidelines within their regular clinical workflow stood at just 58.1% (61/105). Factors obstructing uptake included insufficient training opportunities (71/105, 67.6%), material and resource scarcity (64/105, 60.9%), and deficient institutional reinforcement (57/105, 54.3%). The qualitative strand corroborated appeals for guideline versions better calibrated to at-risk subgroups and remote practice environments. Additionally, 70.5% (74/105) of those surveyed urged a more inclusive, stakeholder-driven guideline revision cycle to safeguard both pertinence and practicability. Recognition of the SOGON guidelines appears widespread, yet systemic barriers hinder their translation into day-to-day clinical practice. Fortifying educational outreach, improving resource availability, and consolidating institutional commitment are indispensable measures to elevate guideline fidelity and advance cervical cancer prevention outcomes in Nigeria.