Alignment with ambition: knowledge, attitude, and perceived preparedness of undergraduate nursing and paramedical students towards WHO 90-70-90 cervical cancer elimination targets: a comparative study
- 1College of Nursing, Government Medical College Anantnag, Jammu and Kashmir, India
- 2Medical-Surgical Nursing Department, College of Nursing, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671 Saudi Arabia
- 3Department of Medical, Surgical and Critical Care Nursing, College of Nursing, University of Hafr Al Batin, Hafr Al Batin, 39524 Saudi Arabia
Abstract
Background: The World Health Organization (WHO) has launched the ambitious 90-70-90 strategy for cervical cancer elimination, aiming by 2030 to achieve 90% vaccination coverage in girls by age 14, 70% screening coverage in women at ages 35 and 45, and 90% treatment for identified cases. These objectives may remain aspirational without adequate knowledge and preparedness of healthcare trainees, especially nursing and paramedical students. This study compares the knowledge, attitude, and perceived preparedness of undergraduate nursing and paramedical students to implement the WHO’s cervical cancer elimination strategy. Perceived preparedness was assessed as a distinct construct from general attitude, recognizing that positive attitudes do not necessarily translate to confidence in practical implementation.
Methods: A cross-sectional comparative study was conducted among 304 final-year students: Group A (nursing students, n = 152) and Group B (paramedical students, n = 152) across three healthcare institutions in Jammu and Kashmir, India. A 35-item structured questionnaire (25 knowledge items, 10 attitude/perceived preparedness items) was used. Knowledge was assessed across four domains aligned with WHO targets: basic virology and burden, HPV vaccination, screening and triage, and WHO targets. Attitude and perceived preparedness were evaluated on a 5-point Likert scale. Bivariate analysis (chi-square, independent t-test) and multivariate logistic regression were performed.
Results: The mean knowledge score across all participants was 58.7% (SD = 16.2). Nursing students demonstrated significantly higher knowledge (65.3%, SD = 14.1) compared to paramedical students (52.1%, SD = 15.3), with a mean difference of 13.2% and p < 0.001. Significant knowledge gaps were observed regarding WHO recommended strategies in which only 31.6% of nursing and 12.5% of paramedical students were aware of the single-dose HPV vaccine recommendation (p < 0.001), and: 44.1% of nursing vs. 21.7% of paramedical students correctly identified HPV DNA testing as the primary screening method(p < 0.001). Knowledge of WHO 90-70-90 targets was particularly low, with less than 35% of students in either group were able to correct to specify the targets. While as 80% of students in both groups held positive attitude towards cervical cancer elimination, a deficit in perceived preparedness was evident. Only 33.6% of nursing and 14.5% of paramedical students felt prepared to educate patients about WHO strategy. Multivariate analysis confirmed that having a dedicated cervical cancer lecture was the strongest independent predictor of good knowledge (aOR = 5.18, 95% CI 3.02–8.89) and high perceived preparedness (aOR = 3.91, 95% CI 2.23–6.86).
Conclusions: Current health science curricula are misaligned with the competencies required to achieve the WHO’s 90-70-90 elimination targets. The findings suggest an urgent need for standardized interdisciplinary curriculum reform that integrates contemporary elimination strategies and equips future healthcare professionals with the knowledge and practical confidence to act as effective agents of cervical cancer elimination. However, as this is a cross-sectional study, interventional studies are needed to evaluate the effectiveness of specific educational strategies.
Related
- Preparedness of undergraduate health students to provide women-specific epilepsy care: knowledge gaps and stigmatizing attitudes in Saudi Arabia
- LGBTQ+ healthcare preparedness among undergraduate medical students in India: a cross-sectional study of awareness, attitudes, and clinical confidence
- Empathy in dental education: a cross-sectional comparative study among undergraduate and postgraduate students in Iran
- Exploring association of rotating shift work and sleep quality with abdominal obesity among nurses and paramedical healthcare workers: an analytical cross-sectional study
- Comparative benchmarking of three artificial intelligence chatbots (ChatGPT-5.1, Qwen- 3 Max, and Perplexity AI) on faculty validated undergraduate respiratory physiology multiple-choice examinations
BibTeX
@article{habeeb2026alignment,
title = {{Alignment with ambition: knowledge, attitude, and perceived preparedness of undergraduate nursing and paramedical students towards WHO 90-70-90 cervical cancer elimination targets: a comparative study}},
author = {Saima Habeeb and Chandrakala Sankarapandian and Jalal Alharbi and Fares Alshammari and Basim Al shammari and Majed Alamri},
journal = {BMC Nursing},
year = {2026},
month = aug,
doi = {10.1186/s12912-026-05221-7},
url = {https://doi.org/10.1186/s12912-026-05221-7},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Alignment with ambition: knowledge, attitude, and perceived preparedness of undergraduate nursing and paramedical students towards WHO 90-70-90 cervical cancer elimination targets: a comparative study
AU - Saima Habeeb
AU - Chandrakala Sankarapandian
AU - Jalal Alharbi
AU - Fares Alshammari
AU - Basim Al shammari
AU - Majed Alamri
PY - 2026
DA - 2026/08/10
JO - BMC Nursing
DO - 10.1186/s12912-026-05221-7
UR - https://doi.org/10.1186/s12912-026-05221-7
AB - Background: The World Health Organization (WHO) has launched the ambitious 90-70-90 strategy for cervical cancer elimination, aiming by 2030 to achieve 90% vaccination coverage in girls by age 14, 70% screening coverage in women at ages 35 and 45, and 90% treatment for identified cases. These objectives may remain aspirational without adequate knowledge and preparedness of healthcare trainees, especially nursing and paramedical students. This study compares the knowledge, attitude, and perceived preparedness of undergraduate nursing and paramedical students to implement the WHO’s cervical cancer elimination strategy. Perceived preparedness was assessed as a distinct construct from general attitude, recognizing that positive attitudes do not necessarily translate to confidence in practical implementation. Methods: A cross-sectional comparative study was conducted among 304 final-year students: Group A (nursing students, n = 152) and Group B (paramedical students, n = 152) across three healthcare institutions in Jammu and Kashmir, India. A 35-item structured questionnaire (25 knowledge items, 10 attitude/perceived preparedness items) was used. Knowledge was assessed across four domains aligned with WHO targets: basic virology and burden, HPV vaccination, screening and triage, and WHO targets. Attitude and perceived preparedness were evaluated on a 5-point Likert scale. Bivariate analysis (chi-square, independent t-test) and multivariate logistic regression were performed. Results: The mean knowledge score across all participants was 58.7% (SD = 16.2). Nursing students demonstrated significantly higher knowledge (65.3%, SD = 14.1) compared to paramedical students (52.1%, SD = 15.3), with a mean difference of 13.2% and p < 0.001. Significant knowledge gaps were observed regarding WHO recommended strategies in which only 31.6% of nursing and 12.5% of paramedical students were aware of the single-dose HPV vaccine recommendation (p < 0.001), and: 44.1% of nursing vs. 21.7% of paramedical students correctly identified HPV DNA testing as the primary screening method(p < 0.001). Knowledge of WHO 90-70-90 targets was particularly low, with less than 35% of students in either group were able to correct to specify the targets. While as 80% of students in both groups held positive attitude towards cervical cancer elimination, a deficit in perceived preparedness was evident. Only 33.6% of nursing and 14.5% of paramedical students felt prepared to educate patients about WHO strategy. Multivariate analysis confirmed that having a dedicated cervical cancer lecture was the strongest independent predictor of good knowledge (aOR = 5.18, 95% CI 3.02–8.89) and high perceived preparedness (aOR = 3.91, 95% CI 2.23–6.86). Conclusions: Current health science curricula are misaligned with the competencies required to achieve the WHO’s 90-70-90 elimination targets. The findings suggest an urgent need for standardized interdisciplinary curriculum reform that integrates contemporary elimination strategies and equips future healthcare professionals with the knowledge and practical confidence to act as effective agents of cervical cancer elimination. However, as this is a cross-sectional study, interventional studies are needed to evaluate the effectiveness of specific educational strategies.
SN - 1472-6955
ER -