Uptake and factors associated with cervical cancer screening among female health workers at Makerere University teaching hospitals. .

Abstract

Background World Health Organization estimated 342,000 deaths and 570,000 new cases of cervical cancer in 2020. In Uganda cervical cancer is the leading cause of cancer related death accounting for 40% cases and over 4000 deaths annually. Despite the target of 80% screening uptake, community uptake remains very low at 4.8% in Eastern Uganda and screening among medical worker is also very low at 19%. This study assessed uptake of cervical cancer screening among health workers. This study was set to determine uptake and factors associated with cervical cancer screening services among female health workers at Makerere University teaching hospitals. Methods: A cross-sectional survey using pretested self-administered structured questionnaire was carried out among female health workers in four of Makerere University teaching hospitals in Kampala. We sampled 303 female health workers proportionate to size in each of the various professional cadres. Data were entered in Epidata version 4.4 and analyzed using Stata version 14 statistical software. Univariate, bivariate, and multivariate analyses were performed to determine factors that were independently associated with cervical cancer screening. Factors with a p-value of ≤ 0.05 were considered factors associated with uptake of cervical cancer screening. Results: We surveyed 303 female health workers, 291(96%) were considered for analysis. Uptake of cervical cancer screening was 118/291(40.5 %), the majority of the participants preferred female health workers 220/291(75.6%) with only 10/291(3.4%) preferring male providers. The majority respondents had appropriate knowledge on cervical cancer screening (87.3%). The most commonly mentioned method of cervical cancer screening was visual inspection with acetic acid (VIA) 276/291(94.3%) and the most commonly mentioned symptom was abnormal vaginal bleeding 268(92.1%). Factors significantly associated with cervical cancer screening included: working at either Mulago specialized women and neonatal hospital (aOR = 5.1, 95 % CI:1.85-14.05) or Kawempe National referral hospital (aOR = 4.71, 95 % CI 1.85-12.02), being a midwife (aOR = 2.78, 95 % CI 0.81-9.48) and being staff at OPD (aOR = 2.24, 95 % CI 1.17-4.28). Conclusions: The uptake of cervical cancer screening among health workers was low. Health promotional activities need to target health workers to take up cervical cancer screening in order to increase community uptake so as to achieve the WHO target of 90–70–90 by 2030 for global elimination of cervical cancer as a public health problem.