Determinants of Cervical Cancer Screening Service Utilization Among Women Aged 25-49 Years Attending Kitengela Sub-county Hospital- Kajiado County

Abstract

Background: Cervical Cancer has been established as the fourth most common cancer among women all over the world, with an estimation of 570 000 new cases in 2018. Kenya cervical cancer statistics have shown that the disease contributes 5 250 (12.9%) of the new cancer cases every year, consequently contributes to 3 286 (11.84%) of all the cancer deaths every year. The World Health Organization (WHO) reports have shown that cervical cancer screening for early detection of precancerous cells, is one path to elimination of cervical cancer among the women population. Methodology: This was a descriptive cross-sectional study carried out at Kitengela Sub-county Hospital Maternal Child Health FP clinic. Women aged 25-49 years seeking services FP were assessed. Semi-structured researcher administered questionnaires were used to assess bio-sociocultural, economical, level of knowledge and healthcare system factors influencing cervical cancer screening services utilization. Sample size was determined by use of Fishers’ formula and 194 participants were selected through systematic random technique. Quantitative data was analyzed using descriptive statistics consisting of frequencies, percentages and means. Logistic regression models was run to check the relationships between the variables and tested using Pearson’s correlation test with the help of Statistical package for social sciences (SPSS). Results: Age group of 26-30 years had the highest number of participants of 82(42.3%). There was a significant relationship (p value=0.000) between age of the respondent and utilization of cervical cancer screening service. The study showed 69(35.6%) and 63(32.5%) of the respondents were moderately and highly knowledgeable respectively. There was a significant relationship (p value=0.000) between knowledge on cervical cancer risk factors and the utilization of cervical cancer screening service. Similarly there was a significant relationship (p=0.001) between awareness of the misinformation and misconception and utilization of cervical cancer screening service. There was no significant relationship between education level and monthly income to the utilization of cervical cancer screening. However, study results revealed a statistical significance (p value=0.003), between awareness on the availability of free cervical cancer screening and utilization of the service. Majority of the respondents 105(54.1%) would engage any healthcare worker to discuss their reproductive system health needs. However, a significant number of them 77 (39.7%) preferred a female healthcare worker. A vast number of women 149 (76.8%) missed the screening during data collection period and majorly tied this to the service being unnecessary at the moment because they didn’t have symptoms (51%) and the long waiting hours to be screened (50%). Conclusion: The study concludes that utilization of the cervical cancer screening was way below average with only 43(22.2%) of the respondents reporting to have utilized the service in the past. Bio-sociocultural, level of knowledge and healthcare factors are the major factors influencing the utilization of the cervical cancer screening service.