Factors associated with utilization of cervical cancer screening among women accessing family planning services at Kitagata hospital, sheema District, Uganda

Abstract

Background: Cervical cancer is a leading cause of cancer mortality in Uganda, and is attributed to poor utilization of screening services. Screening identifies the precancerous changes which when treated prevents development of the disease. In Uganda however, over 80% of the cases are diagnosed when in inoperable state leading to high rate of premature deaths. The study aimed to establish level of, and factors associated with utilization of cervical cancer screening services among women accessing family planning services at Kitagata hospital, Sheema district. Methods: We conducted a cross-sectional study between April and June, 2014 among 262 women residents of Kitagata Sub County aged 25-49 years using simple random, and systematic sampling methods. Utilization of cervical cancer screening services was determined as a proportion of women screened in the past 3 years, confirmed by verification of client card or exercise book. Associated factors were determined by use of multivariable logistic regression model using STATA version 12.0, and statistical significance determined at p<0.05. Results: The respondents’ mean age was 37.2 years (±7.0), and overall utilization of cervical cancer screening services was only 12.2%. Factors significantly associated with utilization of cervical cancer screening services were; encouragement from a health worker (AOR=3.61; 95%CI 1.45-9.00), partner financial support (AOR=3.44; 95% CI 1.36-8.67), perception of being at risk (AOR=3.01; 95%CI 1.17-7.77), accepting male screener (AOR= 3.96; 95% CI 1.18-13.23), having cancer sensitization programs in the community (AOR= 2.76; 95% CI 1.08-7.06), rude attitude of health worker (AOR=0.27; 95%CI 0.10-0.68), one day screening as inadequate (AOR=0.20; 95%CI 0.07-0.58), and waiting for many hours (AOR= 0.22; 95% CI 0.08-0.59). Conclusion: Utilization of cervical cancer screening services in Sheema district was very low at12.2% compared to 80% target. Factors related to low utilization of screening services were inadequate screening schedule, long waiting time, rude attitude of health worker, as well as insufficient knowledge of clients, lack of adequate staff, logistics and supplies. However, partner financial support, perceiving self at risk of disease, accepting male screener, and having active cancer sensitization programs in the community, facilitated utilization of screening services. The study underscored the need to improve attitude of health workers, waiting time, screening schedule, and ensure adequacy of both human and none human resources.