Determinants of Cervical Cancer Screening Uptake Among Women of Reproductive Age in Hoima Municipality - Hoima District
ABSTRACT Background: Among all the cancers, cervical cancer is by far the one that can be completely prevented if regular screening and treatment of its pre-cancerous lacerations is done. Therefore, cervical screening has helped to reduce cervical cancer rates dramatically through early detection of premalignant lesions. The success of screening depends on access and up-take, quality of screening tests, adequacy of follow-up, and diagnosis and treatment of lesions detected, however, uptake has been mentioned to be low in many settings. Objective: To assess the determinants of the uptake of cervical cancer screening among women of the reproductive age group in Hoima Municipality, Hoima district. Method: A cross sectional study design was used and this design incorporated both quantitative and qualitative data collection methods. The study population was women aged above 30 years who are residents of Hoima municipality. Simple random sampling was used to sample out two of the divisions. In each of the sampled divisions, cluster sampling was used to map out the parishes. Systematic random sampling was used to select households with the eligible respondent who was a woman aged 30 years and above. Structured interviews with close-ended probing questions were used to collect precise data from the respondents. Key informant interviews (Kis) and IDIs were carried out with purposively selected respondents using interview guides that were customized to the different categories of respondents. A structured researcher - administered questionnaire with closed-ended questions was the instrument used to collect quantitative data. Focus group discussion and key informant guides were used to collect qualitative data from the focus group discussions. Collected data was entered into a database created using SPSS Inc 18 statistical software. Results: Only 17.6% (66) had gone for the screening, more than three quarters of them had not by study time 80.4% (309). Four socio demographic characteristics had a significant association with cervical cancer screening uptake, they included; parity of the women with a Chi square value (X2) of 9.291, and a p value of 0.026, ever going for voluntary counseling and testing with a Chi square value (X2) of 9.091 and a p value of 0.003, ever using any form of contraception a Chi square value (X2) of 4.533 and a p value of 0.033 and the residence of the women a Chi square value (X2) of 7.394 and a p value of 0.025.Majority of the women had low knowledge about cervical cancer (n = 278, 74.1%). The level of knowledge did not have a statistically significant influence on the uptake of cervical cancer screening (X2 = 3.370, p = 0.066). Almost all the health facility related factors had a significant influence; they include the presence of cervical cancer screening sites set up in the community (X2 = 8.018, p = 0.005), education about cervical cancer screening by health workers (X2 = 9.803, p = 0.002), ever been referred for cervical cancer screening by health workers working in the municipality (X2 = 10.252, p = 0.006), the ease of getting maternal health services from the health services in the municipal (X2 = 6.307, p = 0.012), provision of cervical screening services by health facilities in the municipal (X2 = 6.265, p = 0.012 ), health workers to the community teaching about cervical cancer (X2 = 6.265, p = 0.012), and waiting time for maternal health services at any of the facilities in this municipality (X2 = 11.979, p = 0.003).