KNOWLEDGE, ATTITUDINAL DISPOSITION AND WILLINGNESS OF MEN TO SUPPORT CERVICAL CANCER SCREENING IN IBADAN NORTHEAST LOCAL GOVERNMENT AREA, OYO STATE

Abstract

Cervical Cancer (CC) is a major public health challenge in Nigeria. Screening services for detecting the disease in its asymptomatic stage is poorly utilized by women. Although, men are dominant decision makers on women's utilisation of reproductive health services, their knowledge and disposition to CC screening have not been fully explored. This study was therefore aimed at assessing knowledge, attitudinal disposition and willingness of men to CC screening in lbadan North-East Local Government Area (IBNELGA) Oyo state, Nigeria. In this cross-sectional survey, a four-stage sampling procedure was used to select the Local Government Area, wards, communities, and 304 men aged 20-69 years. Four focus group discussion (FGD) sessions, one in each of the four randomly selected wards was conducted. A pretested interviewer-administered questionnaire, which included socio-demographic characteristics, a 20-point knowledge, 16-point attitudinal, 10-point willingness scales, and factors that may enhance men's support for spousal screening was used for data collection. Knowledge scores <10 and ≥10 points were classified as poor and good, attitudinal disposition scores ≤8 and 8> points were categorized as negative and positive scores of <7 and ≥7 points as unwilling and willing respectively. The FGD was analysed using thematic approach and quantitative data using descriptive statistics, Chi-square test and logistic regression model at 5% level of-significance. Age of respondents was 35.9±9.7 years. Few (24.0%) had primary education, 59.9% had secondary education and 16.1% had tertiary education. Most (79.6%), had ever been married. Respondents who were aware of the symptoms of CC, the risk factors and that screening prevents CC were 1.3%, 4.6%, and 42.0% respectively. Some (31.5%) perceived CC as a curse to promiscuous women. 40.5% perceived their spouse not susceptible to CC and yet they believed CC screening is helpful; though felt they lack adequate knowledge. Knowledge score was 6.0±5.0 and many (78.6%) had poor knowledge of CC screening. Attitudinal disposition score was 9.4±4.4 and 45.7% had negative attitudinal disposition, while willingness score was 7.5±2.3 and majority (69.1%) were willing to support CC screening. Major actions recommended that can enhance men's support for CC screening include awareness creation (86.9%) and subsidization of screening fee (40.3%). Respondents with tertiary education were more likely to have good knowledge of CC screening than those with primary education (OR:3.5, CI:1.5-8.1). Men with good knowledge were more Iikely to have positive attitudinal disposition (OR:20, CI:7.0-56.2) than those with poor knowledge. Also, respondents with positive attitudinal disposition (OR: 2.0, CI:1.2-3.3) were willing to support spouse's screening. The FGD participants affirmed willingness to permit spouses to be screened if they have adequate knowledge of the disease, where screening service can be conducted and affordability of screening charges. Good knowledge was associated with positive attitudinal disposition and had positive influence on men's willingness to support CC screening. Therefore, continuous community-based health education is suggested to improve knowledge of men on CC screening.