Factors Influencing Demand For Cervical Cancer Screening Services In Health Facilities In Kenya: Acase Of Yatta Sub-county
Cervical cancer is often the most common cancer among women in developing countries, yet current screening efforts have not been effective in reducing incidence and mortality rates. Over the years, demand for cervical cancer screening services has remained poor and in an effort to increase knowledge about screening participation in low-resource settings, this study sought to identify key factors influencing women's participation in cervical cancer screening in Kenya. This is because strategies for strengthening cervical cancer prevention should focus on ensuring that appropriate, cost-effective services are available and that women who most need the services will, in fact, use them. A number of factors may influence a woman’s ability and desire to participate in screening for cervical cancer, and the impact of decisionmaking process cannot be ignored. This study investigated the factors that influence the demand for cervical cancer screening services among rural women in Kenya. The study objectives included the influence of awareness, social support, women’s income levels and the extent to which women’s education level influences demand for cervical cancer screening services in Yatta sub-county. The study reviewed existing literature and used the socioecological model and identified a knowledge gap to be addressed through a cross-sectional household survey; targeting women aged between 25 to 55 years. This was conducted using a descriptive research design and an interviewer-administered questionnaire was administered to 347 participants on consenting to be part of the research. The findings showed that demand for cervical cancer screening was quite low at 37 (11%), awareness of the screening services was also low at 55 (12%). Among those screened, 65% were married and 95% had at least primary school education. Among the major findings of this study was that screened for cervical cancer, 79% of them live between 5 to 10km away from the nearest health facility; compared to 22% those living less than 5km to the facilities yet had not been screened. Others reported the cost of these services to be too high; yet have been screened. The respondents reported lack of awareness, fear of testing positive for cervical cancer, cost of procedure and practitioners not allowing them to ask questions and clarifications as the major hindrances to cervical cancer screening. Community health workers were reported as the major sources of information; considered trustworthy and motivate women to proactively seek screening; are the ‘interface’ between the formal health care system and the community, they bridge the gap between health needs and provision. It is across this bridge that primary health care may advance understanding individual and community-level barriers to uptake of screening services, improving healthcare worker performance by identifying effective methods for training, supporting and supervising community health care workers, identifying and evaluating strategies to strengthen the links between screening, diagnosis and treatment and identifying the optimal program design, outcomes and costs given the number of competing public health priorities facing the rural Kenyan women. It is hoped that the findings and recommendations of this study will be useful to the Ministry of health and other stakeholders to review its policies to increase the demand for cervical cancer services in health facilities. It is also hoped that the findings may also form a significant reference material to researchers in conducting cervical cancer studies.