Attitudes and knowledge gaps of the communities about cervical carcinoma and it’s detection in four selected districts of Uganda

Abstract

The main objective of the study was to determine the attitudes and knowledge gaps about cervical carcinoma in the urban and rural women and health workers. A cross sectional study survey was done on four districts of Sironko in the eastern part of Uganda, Kawempe in the central, Ntungamo in the south-west and Arua in the north. Focus group discussions were held and structured questionnaires was administered 288 rural and urban women and 29 health workers in all the four districts. The study revealed that less than 10% of rural and urban women had claimed to know what cancer of the cervix was and how it was prevented compared to 96% of the health workers. Thirteen percent (n=4) of the health workers knew Pap screening procedures. Regarding the causes of cancer of the cervix, less than 35% of both urban and rural women believed that cancer of the cervix is caused by early coitus, family planning, having many partners and prolonged painful bleeding. While 3.4% rural and 1.4% urban women linked cancer of the cervix to witchcraft, only 0.7% of rural women associating it with “curse from GOD”. Although more than 60% of rural and urban women had a positive attitude towards going to health centers when sick, less than 10% preferred visiting a witchdoctor while less than 30% wanted home medication. None had had a Pap smear done. Eleven percent (n=2) of the female health workers had Pap smear despite the fact that they were near health facilities. Although urban and rural women had different education backgrounds, they had the same low understanding of cancer of the cervix and its prevention. The difference in their beliefs and attitudes on the causes of cancer of the cervix and health seeking behaviour was insignificant. Most of the health workers lacked skills on Pap screening and female health workers were found to have low opinion towards going for Pap screening. There is therefore a need to sensitise rural and urban women, and female health workers about cancer of the cervix and on the relevance of Pap screening. There is equally a great need for health workers to be trained and have Pap screening services introduced at health centers. If the above measures are put in place, then prevention and early detection of cervical carcinoma will be done with good prognosis upon treatment.