Epidemiology

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Browsing Epidemiology by Subject "Cervical Cancer Screening"

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    Assessment of Ethical Issues Among Women Attending Cervical Cancer Screening in Public Health Facilities, Addis Ababa, Ethiopia: A Cross- Sectional Study
    (Addis Ababa University, 2024-10) Yeelshaday Solomon ; Muluken Gizaw ; Fasil Merawi
    Background: Cervical cancer is the fourth leading cause of cancer deaths among women, resulting in 350,000 deaths worldwide in 2022. In Ethiopia, it is the second most common cancer, with 8,168 cases reported. Screenings like visual inspection with acetic acid (VIA) are essential for early detection, but challenges related to informed consent, privacy, and confidentiality persists. This study aims to assess key ethical issues in cervical cancer screening practices to enhance these programs. Objectives: To assess ethical issues among women attending cervical cancer screening in public health facilities in Addis Ababa. Method: A cross-sectional study was conducted at selected governmental health centers and referral hospitals, involving 422 women undergoing cervical cancer screening. Data analyzed using SPSS Statistics 27. Descriptive analyses assessed frequencies of privacy, confidentiality, and informed consent issues, while chi-square tests examined relationships among variables. Results: Participants reported high satisfaction, with 97.4% noting positive interactions with health workers and 98.6% receiving clear information. However, 5% experienced privacy concerns during examinations, and 3.3% reported unauthorized information disclosure. Significant associations were found: marital status influenced confidentiality assurance (p = .010), facility type affected confidentiality (p < .001), and both age (p = .005) and employment status (p = .022) impacted information clarity. Conclusion: High satisfaction with cervical cancer screening exists in Addis Ababa, but privacy and confidentiality concerns remain. Recommendation: Enhance ethical practices through improved privacy measures, provider training, and patient involvement; use qualitative research to assess impact.
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    Assessment of the Screening Uptake and Health Facility Related Facilitators, and Barriers for Cervical Cancer Screening Uptake at Primary Health Care Facilities in Southeast Oromia, Ethiopia
    (Addis Ababa University, 2024-11) Melat Amberbi; Muluken Gizaw
    Background: Cervical cancer is the second most common cancer-causing morbidity and mortality among women in Ethiopia, yet screening uptake is low despite recommended decentralized approaches and awareness initiatives. The opportunistic screening strategy faces significant health facility barriers, including access issues, financial constraints, and inadequate provider training. These obstacles impede women's participation in screening programs. Consequently, many miss opportunities for early detection and treatment, negatively impacting health outcomes. Therefore, to maximize the uptake and meet the purpose of efforts to enhance cervical cancer screening uptake, it is necessary to know more about health facility related barriers and facilitators for cervical cancer screening uptake. Objectives: To assess cervical cancer screening uptake and health facility related facilitators, and barriers for cervical cancer screening uptake at primary health care facilities in Ethiopia, 2024. Methods: An explanatory sequential mixed study approach of qualitative interviews (n=16) and cross sectional study among 629 women was conducted from January to September 2024 at six health care facilities in southeast Oromia. Systematic random sampling was employed to recruit survey participants from the selected health facilities while purposive sampling was used for key informant interviews. Descriptive statistics were used to summarize the quantitative data and multivariable logistic regression was employed to identified health facility related facilitators, and barriers for cervical cancer screening uptake. Qualitative data were analyzed using thematic analysis approach through preparing themes and subthemes to change raw data to categorized form. Results: Cervical cancer screening uptake among women in this study population was 15.6% (95% CI 12.9, 18.6). TV/Radio was the main source of information about cervical cancer and its screening. age group of 40-44 years (AOR= 3.34; 95% CI (1.27, 8.78)), completed college and above (AOR=4.14, 95% CI (1.1, 15.8)), income level of >7800 (AOR = 8.3; 95% CI (1.86, 35.54)), received CC counseling (AOR=6.52, 95% CI (3.1, 14.1)) and good knowledge (AOR = 6.53; 95% CI (3.2, 13.34)) were significantly associated with cervical cancer screening uptake. The qualitative findings identified feeling healthy, embarrassment, lack of recommendation by HCP, service interruption, availability of traditional treatment as barriers for cervical cancer screening uptake. Furthermore, availability of trained HCP, availability of equipment, and information dissemination through mass media, spousal support, and availability of female provider mentioned as facilitators for CC screening uptake. Conclusions and recommendation: Cervical cancer screening uptake among eligible women was significantly lower in the study area. Age group, women education level, knowledge of women, income level, and availability of CC counselling were factors associated with screening uptake. Furthermore lack of recommendation by HCP and lack of resources including screening room and number of provider were identified as health system related barriers. Therefore, it is necessary to execute planned health education and awareness development at health facilities, particularly in primary health care, in order to increase the adoption of cervical cancer screening services. Additionally, all women who attend the health center for any service should get counselling regarding the advantages of CC screening