Awareness, willingness, and perceptions of transvaginal ultrasound among african women: A narrative review and recommendations for increased utilization.

INTRODUCTION

While the British Medical Ultrasound Society recommends transvaginal ultrasound (TVUS) as a standard of care, its effective implementation in African contexts requires consideration of women's perspectives alongside clinical efficacy. Unique regional challenges necessitate tailored approaches to TVUS service delivery. This review aimed to narratively explore the current evidence on African women's awareness, willingness, and perceptions of TVUS, and to evaluate how these factors influence their acceptance and utilization of the procedure.

METHODS

A narrative review was conducted in January 2025. Findings were synthesized narratively to explore the themes of awareness, willingness, and perceptions.

RESULTS

Fourteen peer-reviewed studies on African women's awareness, willingness, and perceptions of TVUS were analyzed from various databases, including PubMed and Google Scholar. The quality of these studies was assessed using the Joanna Briggs Institute checklist for bias and validity. Thirteen studies employed a cross-sectional survey approach, while one used a qualitative phenomenological approach. Awareness of TVUS ranged from 16.4% to 56%, with many women expressing anxiety about the procedure, though perceptions improved after examinations. Willingness to undergo TVUS varied significantly, from 28.8% to 98.5%, but the gap between willingness (56.9%) and actual uptake (17.6%) was notable. Common concerns included safety and embarrassment, and preferences for female practitioners were highlighted. Predictors of willingness included demographics, past experiences, and education.

CONCLUSION

Key predictors of acceptance include prior vaginal examinations, higher education, and positive procedural experiences, while barriers include fear of pain, embarrassment, and distrust of male providers. Three critical gaps are identified: awareness-education disconnect, cultural and gender sensitivity, and post-procedure perception shifts. To bridge these gaps, targeted awareness campaigns, mandatory chaperone policies, and training programs for providers are proposed.