Individual Attributes Influencing Cervical Cancer Screening Services in Selected Health Facilities in Machakos County

Agnes Wavinya Nzioka

doi:10.11648/j.jctr.20180601.11

Abstract

In Kenya, 51.2% of estimated women population of 11 million aged 15 years and older are at risk of developing cervical cancer. Research shows that screening a woman even once between the ages of 35 and 40 years reduces her lifetime risk of cervical cancer by 25–36%. However, the effective cervical cancer screening in developing countries is as low as 18.5%. Low levels of utilization of Cervical Cancer Screening Services (CCSS) among health care workers have been documented. This study sought to determine the utilization of cervical cancer screening services by healthcare workers (HCWs) in selected health facilities in Machakos County. It was also thought imperative to determine individual HCW attributes influencing utilization of cervical cancer screening services in selected health care facilities in the county. The study adopted a descriptive cross-sectional study design involving 271 female health workers drawn from all the level 4 and level 5 facilities within the county. Respondents were stratified according to level of facility and according to their cadres. Data was collected via self-administered questionnaires and a facility assessment tool. Data analysis used SPSS version 21. Association was subjected to binary logistic regression. Only 25% of HCWs had utilized cervical cancer screening services. HCWs who had certificate (OR = 0.05, p-value < 0.01), diploma (OR = 0.04, p-value < 0.01) and degrees (OR = 0.09, p-value = 0.01) were less likely to utilize CCSS as compared to HWCs who had attained graduate studies or higher. Also health workers aged 30 years and below (OR = 0.12, p-value = 0.01) and those aged between 31 and 40 years (OR = 0.30, p-value = 0.05) were less likely to utilize CCSS as compared to healthcare workers who were aged more than 50 years. The study recommends establishment of tailor-made sensitization programs on young female health care worker aimed at increasing their uptake of CCSS services among these group.

Highlights

A quarter 69 (25%) of the respondents had previously utilized Cancer Screening Services (CCSS) services while 203 (75%) had never utilized CCSS. This shows that CCSS utilization in the county among health workers were relatively higher as compared to screening prevalence in developing countries which is 18.5% [15, 7]
This proportion was significantly higher compared to the general uptake of CCSS in Kenya which is estimated to be as low as 3.2% [9]
This was similar to other previous studies in several countries that documented low levels of utilization of cervical cancer screening services among health care workers [14, 4, 16, 19]

Summary

Introduction

Cervical cancer (CC) is a slow-onset malignancy found in the interior lining of the cervix, at the junction of the vagina and uterus [1]. CC is has been majorly linked to high- risk HPV types 16 and 18, early sexual debut, high parity, multiple sexual partners and co-infection with HIV [2]. Others include Chlamydia trachomatis, herpes simplex virus type 2, immunosuppressant, diet, smoking [3, 4] This infection results in transformation of the cervical epithelial cells first, to precancerous lesions and to frank cancer [5]. Worldwide CC, is the fourth most common cancer affecting women after breast, colorectal and lung cancers and the second common reproductive tract cancer among women [6]. In sub-Saharan Africa, 34.8 new cases of cervical cancer

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Conclusion