Cervical Cancer Screening uptake and Associated Factors at Primary Care Facilities in Peripheral Settings of Oromia and SNNP Regions in Ethiopia
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Date
2023-10-11
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Addis Ababa university
Abstract
Background: Cervical cancer is the main cancer-related cause of illness and death globally including Ethiopia. While the incidence and mortality of cervical cancer are decreasing, it remains a major problem for women in developing countries. Cervical cancer screening can help prevent these cancers; nevertheless, its utilization remains far below as not being used as much as it could be, despite numerous initiatives aimed at increasing its uptake, particularly in developing nations. The low rate of cervical cancer screening uptake in primary care settings in rural areas is a significant public health concern. It is important to assess and explore the factors that contribute to this problem so that effective interventions can be developed.
Objective: This study aimed to assess Cervical Cancer Screening uptake and associated factors among age-eligible women at selected health centres in Oromia and SNNP Regions, 2023.
Methods: Facility-based cross-sectional study with concurrent qualitative study was carried out from March 3 to May 5, 2023. A total of 941 women was included to the study using a systematic sampling method. Data were collected by using interview-administered questionnaire by trained nurse. For the qualitative data, in-depth and key-informant interview were done. Descriptive statistics was computed using frequency, percentage, and summary measures. A binary logistic regression was used to identify independent factors for the low uptake of cervical screening. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated in the final model. Statistical significance was declared with p-value of less than 0.05. Thematic content analysis was employed to analyse qualitative data.
Results: A total of 941 women were interviewed with a 100% response rate. The results showed that 235 women 24.97 % (95%CI: 22-28) were screened for cervical cancer. In multi variable logistic regression analysis higher educational level [AOR=3.2, (95%CI: 1.46-7.07)], early age at first sex [AOR=0.49, (95%CI: 0.32-0.75)], knowledgeable about cervical cancer screening [AOR=2.66, 95%CI: 1.82-3.89)], had favourable attitude [AOR=3.91, 95%CI: 2.61-5.84)] and had social support [AOR=2.01, 95%CI: 1.32-3.05)] were associated factors for the low uptake of cervical cancer screening. Insufficient availability of equipments, limited accessibility of services to a specific area, lack of awareness, inadequate competence of providers, and lack of trust and attention from trained providers were additional barriers identified with in depth interview.
Conclusion: Cervical cancer screening uptake were far less common among eligible women in study area. Age at first sex, educational level, knowledge of women, attitude, and social support were factors associated with cervical cancer screening uptake. Therefore, intervention programs that aim to improve cervical cancer screening services for women should prioritize the factors for low uptake; culturally appropriate and accesiable screening methods to meet the national and global elimination targets.
Key words: cervical cancer, screening, Screening uptake, determinant
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Keywords
cervical cancer screening Screening uptake determinant