Determinants of screening practice for cervical cancer among women in Addis Ababa, Ethiopia

Abstract

Cervical cancer is the second most commonly diagnosed cancer and the third leading cause of cancer death among women in less developed countries. Screening for cervical cancer is the most accepted and successful strategy for cervical cancer control. The purpose of the study was to investigate factors that determine cervical cancer screening practice among women in Addis Ababa, Ethiopia and develop guidelines to improve the utilisation of cervical cancer screening services. The researcher used the health belief model (HMB) as the theoretical foundation of the study and a convergent parallel mixed methods design. Quantitative data was obtained from screened and not screened women attending maternal health services at selected public health centres. Statistical Package for Social Sciences (SPSS) Version 23 was used for entry and analysis of data Qualitative data was obtained in key informant interviews from health service professionals on their perceptions of women‟s cervical cancer screening uptake at the health centres. The study found that higher age >35 years category (X2 =33.618 and p-value <0.001), contraceptive use (X2 value=20.7 and p-value <0.001), having two or more children, and knowledge of cervical cancer and screening (chi-value X2 =51.649, p-value=0.001) were strongly associated with screening practice. In addition, women‟s perception of susceptibility (t-test=3.42 and 3.432, p-value=0.001) was a predictor of screening. Lack of awareness was a serious barrier to cervical cancer screening and health service providers‟ information was a strong promoter of screening. The study recommends promoting and facilitating health education on cervical cancer at all health facilities; organising awareness campaigns, education programmes, and community mobilisation to raise awareness of cervical cancer screening; integrating cervical cancer screening with other reproductive health services, and capacitating the health professionals in order to increase utilisation of cervical cancer screening services. Consequently, the researcher used the findings of the study to develop guidelines to improve the uptake and quality of cervical cancer screening services.