Knowledge, Attitudes and Associated Factors Influencing Utilisation of Cervical Cancer Screening Among Female Health Workers in Gulu Municipality, Gulu District.

Abstract

Background of the study According to the WHO (2010), globally, every year around 500,000 women develop cervical cancer and almost 274,000 of them die from the disease. In Uganda, Katahoire et al (2008) study revealed that the incidence rate for cervical cancer is 45.6 per 100,000 women, which is one of the world‟s highest age-adjusted cervical cancer incidence rates. Objectives The purpose of this study was to determine the proportion of female health workers who had ever done cervical cancer screening, to assess the knowledge of cervical cancer among female health workers in Gulu Municipality, to determine the health workers attitudes towards cervical cancer screening in Gulu Municipality and to identify the health system factors affecting utilization of Cervical Cancer screening services. Methodology This study applied a descriptive-cross sectional survey design that enabled application of both Quantitative and Qualitative methods for collecting data from the respondents. A questionnaire with both closed and open ended questions (semi structured questions) was constructed in English for the female health workers at the hospitals and self administered by the researcher to a sample of 216 respondents. Focus group discussions were also held with the respondents to get an in-depth scenario of cervical cancer screening. Study findings The study findings revealed that despite the fact that majority (53%)of the health workers were aware of the risks involved in not screening for cervical cancer, the proportion of health workers who had screened for cervical cancer were less than half (49%) of the sample of the health workerswho participated in the study. Majority of the health workers on average (65%) were knowledgeable on how to conduct cervical cancer screening on the patients. The findings revealed that majority (74%) of those that had knowledge on how to conduct cervical cancer screening had practically carried out the procedure on the patients and had an idea of factors associated with cervical cancer. There was however variation in knowledge of how to conduct cervical cancer screening across the different specialization of the health workers. The study findings on the attitudes toward cervical cancer screening showed a very high positive willingness to screen for cervical cancer. The results showed that majority of them understood that carcinoma of the cervix was highly preventable in the country, however majority of would screen for cervical cancer only if screening was free. The major health systems factors affecting the uptake of cancer screening services by the women was cost sharing. This however had minimal impact on the screening for cervical cancer given majority of the patients had access to free services and the ability to switch to the hospital with free services. Conclusions and recommendations The researcher therefore recommends that the Government through Ministry of health should intensify general cancer campaign, to intensively carry out community mobilization and education towards the effects of cervical cancer to improve on the level of cervical cancer screening, conduct continuous training of the health workers to increase the level of cervical cancer awareness across the management team; this would also increase their ability to easily extend awareness to the communities and cancer research centers should be established by government and health care provision advocacy organizations in order to conduct research into cervical cancer and improve the level of awareness of its impact. Government should seek to develop a fully fledged professional division in each hospital to specifically manage cervical cancer to reduce on the impact of the factors.