BARRIERS TO UTILIZATION OF CERVICAL CANCER SCREENING SERVICES AMONG WOMEN OF REPRODUCTIVE AGE GROUP IN ONDO TOWN, ONDO STATE

Abstract

Cervical cancer (CC) is the malignant cancer of the cervix area and human papilloma virus infection is the necessary factor for the development of nearly all cases of cervical cancer. CC is the second most commonly diagnosed cancer among women of reproductive age group; yet screening for early detection of the disease among them is not a common practice in Nigeria. Past studies have documented knowledge and perception of cervical cancer screening services practices and its antecedents among Nigerian women but few have indepthly access the perceived factors that have contributed to low utilization of screening services among women in semi-urban areas in Nigeria. This study therefore, investigated the barriers to utilization of cervical cancer screening service among women of reproductive age in Ondo town, Ondo State. A descriptive cross-sectional survey was adopted using a four stage sampling technique to select two hundred and forty four consenting women of reproductive age in Ondo town. A validated semi-structured interviewer administered questionnaire was used to solicit information including a 30 point CC-related knowledge and 12-point perception scales questions on utilization and barriers to utilize the screening service from respondents. Knowledge scores ≤10,>10-≤20,>20-30 were classified poor, fair and good respectively. Perception scores <7 and ≥7 were categorized as negative and positive perception respectively. Data were analyzed using descriptive statistics and Chi-square test at p=0.05. Respondents’ mean age was 30±6.8 years, 75.4% were Yoruba, 81.6% were of Christians faith and 70.9% were married. More than half (58.2%) had tertiary education. Overall mean knowledge score was 17.1±5.3; Respondents with poor, fair and good knowledge of CC were 11.1%, 53.3%, 35.6% respectively. Majority, (73.8%) have heard about CC, 67.8% correctly defined CC with 76.1% reported virus as causes of cervical cancer and 42.6% had positive perception towards CC. More than half (58.9%) were aware of CC screening methods. Only (15.6%) of the respondents have done screening for CC and the decision to do the screening was personal in 78.6% of the respondents. The main barriers

hindering the utilization of CC screening services were: fear of the result (65.1%), negative attitudes of health worker (51.3%) and husband’s influence on decision (51.0%). The knowledge of respondents was not significantly associated with their utilization of cervical screening service. Also, respondents’ perception was not significantly associated with their knowledge about cervical cancer. Low utilization of the screening services based on perceived misconception was noticed among study participants. Health promotion strategies such as social mobilization that will target community leaders, traditional rulers, religious organizations and faith based institutions and not just families. Also, NGOs can partner with health facilities in promoting service availability, affordability and utilization. Health workers should help change perception of non susceptibility of the women. Recruiting and training of health care providers on procedures of the screening and how to educate women on the need to go for the cervical cancer screening services.