Abstract
BackgroundThere are limited data on awareness of cervical cancer risk factors and symptoms among refugee populations living in Uganda. In this study, we sought to determine the awareness and knowledge of cervical cancer risk factors and symptoms among women in Palabek refugee settlement, northern Uganda.MethodsWe conducted a cross-sectional study. 815 women (aged 18–60 years) were randomly selected using multistage sampling in Palabek refugee settlement. Data were collected using pre-tested, structured questionnaires. Logistic regression models were used to determine magnitudes of association between socio-demographic and health system factors, and knowledge on cervical cancer risk factors and symptoms.ResultsThe majority of participants (53%, n = 433) were young (18–29 years), married (68%, n = 553), and did not have formal employment (93%, n = 759). Less than half (40%, n = 325) had heard of cervical cancer. Of those who had heard, most recognized multiple male sexual partners, early onset of sexual intercourse and HPV infections as risk factors for cervical cancer (93%, n = 295; 89%, n = 283; and 86%, n = 271 respectively). Median knowledge score for risk factor recognition = 7 (IQR: 3–9). Median knowledge score for symptoms recognition = 7 (IQR: 1–10). Half of women (50%, n = 409) correctly recognized 7 to 11 symptoms of cervical cancer, with vaginal bleeding between menstrual periods, pelvic pain, and vaginal bleeding during/after sexual intercourse recognized by 58, 52 and 54% respectively. Single women (OR = 0.59 (95%CI: 0.38–0.94), and women that lived farther than 1 kilo meter from nearest health facility in South Sudan (OR = 0.36–0.49 (95%CI: 0.26–0.84) were less likely to be knowledgeable of symptoms of cervical cancer.ConclusionA significant proportion of women in Palabek refugee settlement had not heard about cervical cancer. Refugee health services providers could increase awareness of cervical cancer risk factors and symptoms through health education in order to promote risk reduction behaviours and guide women during symptoms appraisal. Single women and those who lived more than one kilo metre from nearest health facility in home country could be a priority group for awareness intervention in the settlement.
Highlights
There are limited data on awareness of cervical cancer risk factors and symptoms among refugee populations living in Uganda
Recognition of cervical cancer risk factors Knowledge of cervical cancer risk factors was assessed among the 325 women (40%) who self-reported they had heard of cervical cancer before this study
Upon adjusting for other sociodemographic variables, single women (OR = 0.59 (95%CI: 0.38–0.94), and women that lived farther than 1 kilo meter from nearest health facility in South Sudan (OR = 0.36–0.49 (95%CI: 0.26–0.84) were less likely to be knowledgeable of symptoms of cervical cancer (Table 6)
Summary
There are limited data on awareness of cervical cancer risk factors and symptoms among refugee populations living in Uganda. We sought to determine the awareness and knowledge of cervical cancer risk factors and symptoms among women in Palabek refugee settlement, northern Uganda. Poor access to health information potentially undermines awareness of refugee women regarding cancer risk factors and symptoms. A study among 176 Syrian refugees in Greece revealed low awareness of cervical cancer risk factors and symptoms. Poor access to healthcare services mainly because of low incomes, increased cost of basic services, lack of continuity of care if patients become displaced and limited follow up are some of the challenges to cancer prevention in refugee settings [22]. Understanding the interplay of social determinants of health and health system factors including access to specialized care are critical to appropriate planning for refugee health services in the refugee settlements
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