Factors Influencing Uptake of Cervical Cancer Screening Services Among Female Health Workers in Wakiso District.

Abstract

Background: This study was carried out to investigate the factors influencing uptake of cervical cancer screening services among female health workers in Wakiso district. Cervical cancer is the second most common cancer in women worldwide, with over 500 000 new cases being diagnosed every year and worldwide cancer deaths are projected to continue rising, with an estimated 13.1 million deaths in 2030. More than 85% of the global burden of cancers occurs in developing countries, where it accounts for 13% of all female cancer deaths. In Uganda, cervical cancer is the commonest malignancy among women with an estimated age standardized incidence rate of 45.6 per 100,000 women, accounting for 40% of all cancers recorded in the Kampala cancer registry. In Uganda Wakiso district, is believed to have one of the highest incidence rates of cervical cancer in Africa and probably in the world at 60% and only 2 % of the female health workers in Wakiso district seek cervical cancer screening services with the greatest percentage reporting for the service when the disease is in advanced stage. However, the factors leading to this low uptake are not known. Objective: We therefore, in this study set out to assess the factors influencing uptake of cervical cancer screening services among female health workers in Wakiso district. Methods: This was a cross sectional study with a sample size of 261 female health workers working in government and private not for profit health facilities in Wakiso district and 15 key informers were interviewed and used as study respondents. We purposively included all the female health workers in Wakiso district but 261 were selected by systematic random sampling. We collected quantitative data and analyzed it using SPSS and Epidata, and presented the results in form of tables, graphs and charts. We also collected the qualitative data which was manually analyzed and presented in form of verbatim as quotations from the respondents. Results: The results reveal that uptake of cervical cancer screening services among female health workers was still low despite the high level of awareness of screening services. The study established that majority 173/261 (66.5%) of the respondents have never screened for cervical cancer with only 87/261(33.5%) of the respondents who had screened. The study revealed that availability of continuous medical education sessions in the working facility of a female health worker was significantly associated with uptake of cervical cancer screening services though less than half of those who said they had continuous medical education sessions had screened due to other factors such as age as the young female health workers felt not susceptible to cervical cancer so felt no need to screen. The study also revealed that lack of the knowledge of the frequency of cervical cancer screening procedure, poor attitudes towards Cervical Cancer screening such as cultural beliefs and lack of a follow up system for clients suspected to have cancer lesions had a significant influence on the uptake of cervical cancer screening services. Conclusion and recommendations: Uptake of cervical cancer screening services is still low among female health workers in Wakiso district so there’s need to increase it by encouraging and conducting continuous medical education sessions related to cervical cancer and its screening services in the working facilities of female health workers in Wakiso district and need to establish more screening and referral centers to improve service accessibility in order to reduce cervical cancer related prevalence, morbidity and mortality among female health workers.