AWARENESS AND UPTAKE OF CERVICAL CANCER SCREENING AMONG WOMEN OF CHILD BEARING AGE IN ST CAMILLUS HOSPITAL, UROMI,EDO STATE

Abstract

This study investigated the factors influencing the uptake of cervical cancer screening among women of childbearing age at St. Camillus Hospital, Uromi. A quantitative survey research design was adopted to comprehensively assess the level of awareness, socio-economic influences, and barriers related to cervical cancer screening within the community. A structured questionnaire was meticulously designed and administered to a sample of 120 respondents to gather relevant data. The data collected were presented and analyzed using frequency tables and simple percentages to provide an overview of the responses. The study employed a one-sample t-test to test the hypotheses and determine the statistical significance of the relationships between the variables. The hypotheses addressed the level of awareness about cervical cancer and its impact on screening uptake, the influence of socio-economic factors, and the effect of cultural beliefs and misconceptions on screening participation. The findings revealed a high level of awareness among respondents regarding cervical cancer and its screening methods, with 48.1% strongly agreeing that they were aware of various screening methods. However, a significant portion of the sample (36.1%) disagreed with this statement, indicating potential gaps in awareness that could affect screening uptake. The analysis of socio-economic factors indicated that 63.9% of respondents strongly agreed that socio-economic status influenced their decision to undergo screening, underscoring the importance of financial and social considerations in screening participation. Cultural beliefs and misconceptions also emerged as substantial barriers, with 53.7% of respondents strongly agreeing that these factors significantly hindered their participation in cervical cancer screening. The t-test results demonstrated statistically significant differences between the hypothesized values and the observed data. For instance, the mean difference for the level of awareness about cervical cancer and its screening methods was 81.5, with a t-value of 14.351 and a p-value of 0.001, indicating a strong relationship between awareness and screening uptake. Similarly, the factors influencing screening uptake and the barriers to screening were found to be significant, with mean differences of 87.75 and 96.75, respectively, supporting the hypotheses that socio-economic factors and cultural beliefs affect screening participation. In conclusion, the study highlighted critical factors impacting cervical cancer screening uptake among women at St. Camillus Hospital, Uromi. The high level of awareness does not necessarily translate into increased screening rates, suggesting that other barriers, such as socio-economic constraints and cultural beliefs, play a significant role. The study's results emphasize the need for targeted interventions that address these barriers to enhance screening uptake. Recommendations include improving awareness programs, addressing socio-economic barriers, and fostering cultural sensitivity in healthcare outreach efforts. Future research should aim to explore these factors in greater depth and across broader populations to develop more effective strategies for increasing cervical cancer screening participation.

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Cervical cancer is a significant public health concern worldwide, particularly in low- and middle-income countries like Nigeria, where it ranks as the second most frequent cancer among women. The burden of cervical cancer is especially pronounced in Nigeria, contributing to a high rate of cancer-related deaths among women of reproductive age. The primary cause of cervical cancer is persistent infection with high-risk types of human papillomavirus (HPV), which are transmitted through sexual contact. Despite the availability of effective screening methods and preventive vaccines, the prevalence of cervical cancer remains high due to low awareness and inadequate uptake of screening services (Burt et al., 2021).

In many regions of Nigeria, including Edo State, the uptake of cervical cancer screening remains alarmingly low, even when services are readily available. This situation is particularly concerning because early detection through screening is crucial for preventing cervical cancer and improving survival rates. Screening methods such as the Papanicolaou (Pap) smear, HPV testing, and visual inspection with acetic acid (VIA) play a critical role in identifying precancerous lesions and initiating timely treatment. However, the utilization of these life-saving services is hindered by various factors, leading to a persistent high burden of the disease in the country (Zibako et al., 2021).

St. Camillus Hospital in Uromi, Edo State, provides cervical cancer screening services to women of childbearing age. However, anecdotal evidence suggests that awareness and utilization of these services among women in the area are suboptimal. Factors contributing to this low uptake may include a lack of knowledge about cervical cancer and its screening methods, cultural beliefs, fear of the screening process, and socio-economic barriers. These challenges highlight the need for increased public health education and interventions to improve the awareness and uptake of cervical cancer screening in this community (Neji et al., 2019).

Understanding the level of awareness and the factors influencing the uptake of cervical cancer screening is essential for developing targeted interventions to increase screening rates and reduce the incidence and mortality of cervical cancer in Uromi and beyond. This study aims to assess the awareness and uptake of cervical cancer screening among women of childbearing age in St. Camillus Hospital, Uromi, Edo State. Such research is critical in informing public health strategies that can effectively address the barriers to screening and improve the health outcomes of women in the region (Jedy-Agba et al., 2020).

One of the key challenges in addressing cervical cancer in Nigeria is the persistent low level of awareness among women regarding the importance of regular screening. Studies have shown that many women in Nigeria are unaware of the link between HPV and cervical cancer, and even fewer understand the significance of regular screening in preventing the disease. This lack of awareness is a major barrier to the uptake of cervical cancer screening services, as women who are not informed about the risks and benefits are less likely to participate in screening programs (World Health Organization, 2022).

In addition to low awareness, cultural beliefs and practices play a significant role in shaping women's attitudes toward cervical cancer screening in Nigeria. In some communities, there is a strong stigma associated with gynecological examinations, which can deter women from seeking screening services. Additionally, misconceptions about the causes of cervical cancer and the nature of the screening procedures can contribute to fear and reluctance to undergo screening. Addressing these cultural barriers through community engagement and culturally sensitive health education campaigns is crucial for improving the uptake of cervical cancer screening (Anyebe et al., 2023).

Socio-economic factors also significantly impact the uptake of cervical cancer screening in Nigeria. Many women, particularly those in rural areas, face financial barriers that prevent them from accessing screening services. The cost of transportation, the fees associated with the screening itself, and the time required to travel to a health facility can be prohibitive for women with limited resources. Furthermore, healthcare facilities in rural areas may be understaffed or lack the necessary equipment to provide adequate screening services, further limiting access for women in these communities (Landy et al., 2020).

To effectively reduce the incidence and mortality of cervical cancer in Nigeria, it is essential to address the multifaceted barriers to screening. This includes increasing public awareness through targeted education campaigns, addressing cultural and socio-economic barriers, and improving the accessibility and quality of screening services. Interventions should be tailored to the specific needs and circumstances of women in different regions, taking into account the local context and cultural practices (Motavalli et al., 2018).

The role of healthcare providers is also crucial in increasing the uptake of cervical cancer screening. Healthcare professionals, particularly nurses, play a key role in educating women about the importance of regular screening and encouraging them to participate in screening programs. Training and capacity-building for healthcare providers are essential to ensure they have the knowledge and skills necessary to effectively communicate the benefits of cervical cancer screening to their patients. Moreover, healthcare providers should be equipped to address any concerns or misconceptions that women may have about the screening process (Alwahaibi et al., 2018).

In conclusion, cervical cancer remains a significant public health challenge in Nigeria, with low awareness and uptake of screening services contributing to high rates of incidence and mortality. Addressing the barriers to cervical cancer screening requires a comprehensive approach that includes public education, cultural sensitivity, socio-economic support, and capacity-building for healthcare providers. By improving awareness and access to screening services, it is possible to significantly reduce the burden of cervical cancer and improve the health outcomes of women in Nigeria. This study aims to contribute to this effort by assessing the awareness and uptake of cervical cancer screening among women in Uromi, Edo State, and identifying strategies to increase screening rates in this community (Ishola & Omole, 2022).

1.2 Statement of Problem

Cervical cancer is a leading cause of cancer-related deaths among women in Nigeria, particularly in low- and middle-income regions like Edo State. Despite the availability of effective screening methods such as the Pap smear, HPV testing, and visual inspection with acetic acid (VIA), the uptake of these services remains critically low (Motavalli et al., 2018). While several studies have examined the factors influencing cervical cancer screening in various parts of Nigeria, there is a notable gap in research specific to rural communities like Uromi in Edo State, where socio-economic and cultural factors may significantly impact women's health-seeking behaviors (Neji et al., 2019).

Existing research has often focused on urban areas or more generalized populations, overlooking the unique challenges faced by women in rural settings, including limited access to healthcare facilities and cultural stigmas associated with gynecological examinations (Landy et al., 2020). Furthermore, studies have not adequately addressed the role of local health facilities, such as St. Camillus Hospital in Uromi, in promoting awareness and facilitating access to cervical cancer screening services (Anyebe et al., 2023).

Another critical gap is the insufficient exploration of specific barriers to screening uptake, such as the impact of financial constraints, lack of transportation, and inadequate healthcare infrastructure in rural areas (Burt et al., 2021). Additionally, while awareness campaigns have been implemented in some regions, there is a lack of evidence-based strategies tailored to the cultural and socio-economic context of Uromi (Jedy-Agba et al., 2020). Addressing these gaps is crucial for developing targeted interventions that can effectively increase screening rates and reduce cervical cancer incidence and mortality in this underserved community. Therefore, this study aims to fill these gaps by assessing the awareness and uptake of cervical cancer screening among women of childbearing age in St. Camillus Hospital, Uromi, Edo State.

1.3 Purpose of the Study

The purpose of this study is to assess the awareness and uptake of cervical cancer screening among women of childbearing age in St. Camillus Hospital, Uromi, Edo State. The specific objectives of the study are to:

1. Determine the level of awareness about cervical cancer and its screening methods among women of childbearing age in St. Camillus Hospital, Uromi.
2. Identify the factors influencing the uptake of cervical cancer screening among women of childbearing age in this community.
3. Assess the barriers to cervical cancer screening among women of childbearing age in St. Camillus Hospital, Uromi.

1.4 Research Questions

The following research questions will guide this study:

1. What is the level of awareness about cervical cancer and its screening methods among women of childbearing age in St. Camillus Hospital, Uromi?
2. What factors influence the uptake of cervical cancer screening among women of childbearing age in this community?
3. What are the barriers to cervical cancer screening among women of childbearing age in St. Camillus Hospital, Uromi?

1.5 Research Hypotheses

The following hypotheses will be tested in this study:

1. H₁: There is no significant relationship between the level of awareness about cervical cancer and the uptake of cervical cancer screening among women of childbearing age in St. Camillus Hospital, Uromi.
2. H₂: Socio-economic factors do not significantly influence the uptake of cervical cancer screening among women of childbearing age in this community.
3. H₃: Cultural beliefs and misconceptions does not significantly affect the uptake of cervical cancer screening among women of childbearing age in St. Camillus Hospital, Uromi.

1.6 Significance of the Study

The significance of this study lies in its potential to address critical public health challenges related to cervical cancer in Nigeria, particularly in rural areas like Uromi, Edo State. Cervical cancer remains one of the leading causes of cancer-related deaths among women, despite being largely preventable through early detection and treatment. In Nigeria, the low uptake of cervical cancer screening services is a major barrier to reducing the incidence and mortality associated with the disease. This study seeks to provide valuable insights into the factors influencing awareness and uptake of cervical cancer screening among women of childbearing age in a rural setting.

Firstly, the study will contribute to the existing body of knowledge by providing empirical data specific to Uromi, a region that has been underrepresented in cervical cancer research. Most studies on cervical cancer in Nigeria have focused on urban areas, where healthcare access and awareness levels differ significantly from those in rural regions. By focusing on Uromi, this research will highlight the unique challenges and barriers faced by women in rural areas, offering a more comprehensive understanding of the issue within the Nigerian context.

Secondly, the findings of this study have the potential to inform public health policy and intervention programs aimed at increasing cervical cancer screening rates. Understanding the specific barriers that women in Uromi face—such as cultural beliefs, lack of knowledge, fear of the screening process, and socio-economic factors—will enable policymakers and healthcare providers to design targeted interventions that address these challenges effectively. This could lead to the development of culturally sensitive educational campaigns, community outreach programs, and healthcare policies that are tailored to the needs of rural populations.

Additionally, the study will provide critical insights for healthcare providers at St. Camillus Hospital and other similar healthcare facilities in rural Nigeria. By identifying gaps in awareness and utilization of screening services, the study can guide healthcare providers in implementing more effective patient education strategies and improving service delivery. This could result in increased uptake of cervical cancer screening, earlier detection of precancerous lesions, and ultimately, a reduction in cervical cancer mortality rates in the community.

Furthermore, the study has broader implications for the fight against cervical cancer in Nigeria and other low- and middle-income countries. The findings could be used as a reference for similar studies in other rural areas, contributing to a more comprehensive understanding of the factors affecting cervical cancer screening uptake in different cultural and socio-economic contexts. This could enhance the development of global health strategies aimed at reducing cervical cancer incidence and improving women's health outcomes.

Finally, the study will contribute to the empowerment of women in Uromi by increasing their knowledge and awareness of cervical cancer and the importance of screening. By understanding the benefits of early detection and the availability of screening services, women in the community will be better equipped to take proactive steps in managing their health. This empowerment is crucial for improving overall health outcomes and reducing the burden of cervical cancer in the long term.

1.7 Scope of the Study

This study will focus on women of childbearing age (15-49 years) attending St. Camillus Hospital, Uromi, Edo State. The study will assess their awareness of cervical cancer and its screening methods, identify the factors influencing their uptake of screening services, and evaluate the perceived barriers to screening. The study will be limited to women who visit the hospital during the study period, and the findings will be specific to this population in Uromi, which may not be generalizable to other populations.

1.8 Operational Definition of Terms

1. Cervical Cancer: A type of cancer that occurs in the cells of the cervix, the lower part of the uterus that connects to the vagina, primarily caused by persistent infection with high-risk human papillomavirus (HPV).
2. Cervical Cancer Screening: Medical tests, such as the Pap smear, HPV test, and visual inspection with acetic acid (VIA), that detect precancerous changes in the cervix to prevent the development of cervical cancer.
3. Awareness: The knowledge or perception of cervical cancer, its causes, risk factors, symptoms, and the importance of regular screening among women of childbearing age.
4. Uptake: The extent to which women of childbearing age in St. Camillus Hospital, Uromi, utilize cervical cancer screening services.
5. Childbearing Age: Refers to women aged 15-49 years, which is considered the reproductive age range in this study.
6. Perceived Barriers: The subjective obstacles or challenges that women of childbearing age believe hinder their participation in cervical cancer screening, such as fear, cultural beliefs, lack of access, or misconceptions.
7. St. Camillus Hospital: A healthcare facility located in Uromi, Edo State, Nigeria, that provides cervical cancer screening services among other medical services.
8. Socio-Economic Factors: Elements related to the economic and social conditions, such as income, education, and employment status, that may influence a woman's ability to access and utilize cervical cancer screening services.