Uptake and Barriers to Cervical Cancer Screening among Women Aged 15 Years and above Attending Health Care Facilities in Simanjiro District, Tanzania.

Abstract

Background: Cervical cancer is the most common cancer among women accounting for 250,000 deaths globally each year. Despite the benefits of early detection through screening, only 4% of the targeted women (500,000) were screened. Despite strong evidence that cervical cancer screening reduces mortality, its uptake among women in Tanzania remains low (7.9%).The aim of this study is therefore to identify barriers to the uptake of cervical cancer screening in Simanjiro District health facilities. Objective: To assess the uptake and barriers of cervical cancer screening among women attending different categories of clinics in health facilities of Simanjiro District in Tanzania Methodology: This was a hospital based mixed method cross sectional study which was conducted at the CTC and Reproductive clinics in Simanjiro health facilities in January 2021. The study included a sample size of 352 women and 6 health care workers. Data collection was through face-to-face interviews using validated and adapted questionnaire for the clients and in-depth interviews for the health care worker. The data were entered, processed, and analysed using SPSS version 23.Descriptive statistics were summarized using frequencies while categorical variables were summarized using proportions. Measure of central tendency (median) with respective measure of dispersion (Interquartile range) was used for continuous variables. Logistic regression models were performed to obtain odds ratios (ORs) with 95% confidence interval (CI) for the association between a set of explanatory variables and uptake of cervical cancer screening. A p-value of less than 5% was considered statistically significant. Qualitative data were analysed by using thematic analysis (deductive) approach, whereby a thorough reading and familiarization of the information was done to explore the meanings associated with the concepts from the transcriptions of the participants’ descriptions. Results: Of 352 women the median age of 26.5(IQR: 15-61) years, only 15.1% (53) had ever been screened for cervical cancer .Of these women 43 (81.1%) had Cervical Cancer Screening once and 10 (18.9%) had Cervical Cancer Screening twice. More than three quarters (66.8%) of respondents had ever heard about Cervical Cancer Screening, while 178 (75.7%) heard from health workers. Barriers to cervical cancer screening shows that among 352, more than half 299 (84.9%) had never had cervical cancer screening. However 139 (46.5%) knew nothing about cervical cancer screening, Intriguingly 25 (8.4%) had no time for cervical cancer screening, 28 (9.4%) feared the screening process, Furthermore 71 (23.7%) had no problem requiring cervical cancer screening, from the multivariate analysis; those who were ready for cervical cancer screening were more likely to screen compared to those who were not ready for cervical cancer screening (aOR=8.29, 95% CI: 1.89 – 13.49, p=0.005),majority of health care providers barriers towards cervical cancer screening were, multitasking issues, limited infrastructures ,few trained providers and policy. Conclusion: The study revealed that cervical cancer screening uptake is low in Simanjiro district despite the efforts of providing screening services all over the country. Cervical cancer screening services should be integrated with other health services so that women accessing various health services can also be able to access cervical cancer information and screening services.