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Impact of Fibroid Awareness Education on Healthcare-Seeking Practices among Women of Reproductive Age in Nigeria

Abstract

Uterine fibroids are common benign growths of the uterus that may affect women of reproductive age and can be associated with heavy or prolonged menstrual bleeding, pelvic pain or pressure, abdominal enlargement, frequent urination, painful intercourse, anaemia, and reproductive health challenges. Despite their potential effects on women's physical, reproductive, emotional, and social wellbeing, some women in Nigeria may have limited knowledge of fibroids and may delay seeking professional healthcare when symptoms occur. Misconceptions about the causes of fibroids, fear of surgery, concerns about fertility, financial barriers, cultural beliefs, stigma, and reliance on unverified remedies may contribute to delayed diagnosis and treatment. Fibroid awareness education provides an opportunity to improve women's understanding of fibroid symptoms, risk factors, available diagnostic services, treatment options, and the importance of timely professional assessment. Against this background, this study investigates the impact of fibroid awareness education on healthcare-seeking practices among women of reproductive age in Nigeria. The study will be anchored on the Health Belief Model, Health Literacy Framework, and Social Ecological Model. The Health Belief Model explains how women's perceptions of susceptibility to fibroids, perceived severity of symptoms, perceived benefits of early healthcare-seeking, perceived barriers, self-efficacy, and cues to action may influence healthcare-seeking practices. The Health Literacy Framework emphasizes women's ability to access, understand, evaluate, and apply reliable information about fibroids and available healthcare services. The Social Ecological Model emphasizes the influence of individual, interpersonal, family, community, cultural, socioeconomic, healthcare, and health-system factors on women's decisions to seek care. Collectively, these theoretical perspectives provide a suitable framework for explaining how fibroid awareness education may influence healthcare-seeking practices among women of reproductive age in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise women aged 18–49 years residing in selected urban and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, healthcare facilities, and eligible women. Fibroid awareness education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, information on uterine fibroids, common symptoms, possible risk factors, complications, heavy menstrual bleeding, pelvic pain or pressure, abdominal enlargement, frequent urination, anaemia, fertility concerns, available diagnostic methods, treatment options, misconceptions about fibroids, concerns about surgery and fertility, available healthcare facilities, referral pathways, and reliable sources of reproductive-health information. Healthcare-seeking practices will be assessed using indicators such as seeking professional healthcare for suspected fibroid symptoms, timing of healthcare-seeking after symptom onset, attendance at appropriate healthcare facilities, consultation with qualified healthcare professionals, willingness to undergo recommended diagnostic assessment, compliance with treatment recommendations, follow-up attendance, and avoidance of prolonged reliance on unverified remedies before seeking professional care. Data will be collected using structured questionnaires, standardized fibroid-awareness and healthcare-seeking assessment tools, scenario-based questions, healthcare records where ethically accessible, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize participants' demographic and socioeconomic characteristics, reproductive health history, previous exposure to fibroid information, symptom experiences, sources of health information, and healthcare-seeking patterns. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of fibroid awareness education on healthcare-seeking practices. Where a quasi-experimental design is adopted, healthcare-seeking outcomes before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that fibroid awareness education has a significant positive impact on healthcare-seeking practices among women of reproductive age in Nigeria. Women exposed to structured, evidence-based, culturally appropriate, and sustained fibroid awareness education are expected to demonstrate greater willingness to seek professional healthcare for symptoms suggestive of fibroids than women without comparable education. Education may improve women's ability to recognize heavy or prolonged menstrual bleeding, pelvic pain or pressure, abdominal enlargement, frequent urination, symptoms of anaemia, and other concerns that may require professional assessment. It may also improve understanding of available diagnostic and treatment options and correct misconceptions that fibroids inevitably cause infertility or that surgery is always necessary. Education may reduce fear and encourage women to discuss symptoms with qualified healthcare professionals at an earlier stage. However, financial constraints, cultural beliefs, fear of surgery, concerns about fertility, stigma, geographical barriers, limited access to gynaecological services, misinformation, and reliance on traditional or unverified treatments may reduce the effectiveness of education alone. The study therefore expects accessible, practical, culturally sensitive, and sustained fibroid awareness education, supported by affordable diagnostic and treatment services and effective referral systems, to contribute significantly to improved healthcare-seeking practices among women of reproductive age in Nigeria. The study is expected to contribute to the literature on uterine fibroids, fibroid awareness, healthcare-seeking behaviour, women's reproductive health, gynaecological health, reproductive health education, health literacy, menstrual health, fertility health, health promotion, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, hospitals, gynaecology clinics, healthcare professionals, women's health organizations, community health workers, development partners, and policymakers regarding strategies for improving early recognition and management of uterine fibroids. The study will also provide evidence-based recommendations for integrating fibroid awareness education into reproductive and primary healthcare programmes, strengthening women's health counselling, improving access to appropriate diagnostic and referral services, addressing misconceptions about fibroids and treatment, increasing awareness of available management options, and developing sustainable interventions that promote timely healthcare-seeking among women of reproductive age across Nigeria.

Keywords: Fibroid awareness education, healthcare-seeking practices, uterine fibroids, women of reproductive age, reproductive health, gynaecological health, health education, health literacy, healthcare utilization, women's health, Nigeria, public health.