Perception of women with ovarian cancer admitted at Kenyatta national hospital towards health care service utilization.
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Problem statement: Ovarian cancer is the third commonest cause of cancer death from gynecologic tumors in Kenya (Cheserem 2013). Globally ovarian cancer is the ninth most common cancer among women. It ranks fifth in cancer death among women. accounting for more deaths than any other cancer of the female reproductive system. It accounts for about 3% of all cancers in women (sterling et al 2012). Considering this challenging health landscape. utilization of health services is a key factor in improving health outcomes for women with ovarian cancer in Kenya. Currently. the level of and access to care varies by region. with the most facilities per person located in Central Province. and the least located in the border provinces of Western Valley and Nyanza. According to recent data. the health care utilization rate in Kenya is approximately 77% for those who arc sick. meaning that a large percentage of the population docs not seek care despite being ill. (WHO 2012) Survival for ovarian cancer is closely related to the stage of disease presentation. The five year survival among women with stage 1 disease ranges between 80-90°/r). but this falls to approximately 40-45% among women with metastatic stage III diseases. The poor prognosis is largely due to the fact that more than 75% of women arc diagnosed when the disease has progressed to stage III or 1V (Elshabrawy ct al 20(6). This calls for a change or ovarian cancer women's perception towards healthcare service utilization for early detection and treatment. Utilization of cancer health care services is important for early detection. treatment and better health outcomes for patients with ovarian cancer. Positive perceptions towards utilization of health care service is therefore necessary for increased early treatment and better prognosis Purpose of the study: The study aimed to establish the perceptions of women with ovarian cancer towards health care service utilization at K. II Study design: This was a descriptive cross-sectional study conducted among women with ovarian cancer admitted at Kenyatta National Hospital. Study objective: The aim of this study was to establish the perceptions of women with: ovarian cancer towards healthcare service utilization. at Kenyatta National Hospital Description of the sample subjects: /\11 women with confirmed diagnosis of Cancer Ovary admitted to KNH oncology ward 1[3 and those previously admitted and on follow up in clinic 18, during the time of the study were recruited as long as they met the inclusion criteria. Thus a total or 36 women with ovarian cancer were enrolled in this study Data collection procedure: Quantitative data was collected using self administered questionnaires. Qualitative data was collected using focused group discussion Data analysis methods: SPSS version 17 was used to analyze quantitative data and Nvivo version 8 was used to analyze qualitative data. Findings: Analyses showed that individual and provider variables were not significant in influencing perception towards health care service utilization. Among the individual-related variables which were found significantly associated with perception towards health care services were income level (p-O.049) and level of education (p-O.037). Majority or the women are of" low income level but this did not influence their perception negatively. Women who had secondary and above level of education had a positive perception towards healthcare service utilization. Healthcare service related variables found to significantly influence patient perception was availability of drugs (p-O.029). Most or the chemotherapy drugs are not available in the hospital forcing the women to buy from elsewhere. this significantly affected the women's perception negatively. Waiting and booking time was too long (p-O.041 ), it also caused a negative perception towards healthcare service utilization. The findings showed that 91% of women with ovarian cancer have a positive perception towards healthcare service utiIization. Benefits of findings: The findings of" this study wiII be used by the health service organization to improve on the quality of" care by ensuring that waiting and hooking time for women with ovarian cancer arc made short in order to improve the women's perception towards health care service utilization. Also the findings will be used to advice the government to improve on chemotherapy drugs availability and at subsidized price for the women