Individual Determinants of Cancer Health Service Utilization among Newly Diagnosed Adult Cancer Patients in Garissa County, Kenya
DOI:
https://doi.org/10.47604/jhmn.4038Keywords:
Cancer, Healthcare BehaviorAbstract
Purpose: Cancer remains a major public health challenge in Kenya, particularly in marginalized regions where access to specialized oncology services is limited. Despite increasing investments in cancer prevention, diagnosis, and treatment, utilization of cancer health services remains suboptimal. This study sought to determine the influence of individual factors on utilization of cancer health services among newly diagnosed adult cancer patients attending Garissa County Referral Hospital, Kenya.
Methodology: The study utilized cross sectional study design. Data were collected from 161 newly diagnosed adult cancer patients using structured interviewer-administered questionnaires, Data collection instruments were validated through expert review and pretesting. Quantitative data were analyzed using descriptive statistics, Chi-square tests, and simple linear regression in SPSS version 25.
Findings: The findings revealed that utilization of cancer health services was significantly associated with age (χ²=49.99, p<0.001), marital status (χ²=42.46, p<0.001), education level (χ²=112.94, p<0.001), occupation (χ²=140.55, p<0.001), household income (χ²=131.39, p<0.001), distance from the health facility (χ²=186.08, p<0.001), health insurance status (χ²=55.11, p<0.001), and mode of payment (χ²=57.79, p<0.001). Descriptive analysis showed that respondents perceived cultural beliefs (Mean=4.10), treatment adherence awareness (Mean=4.01), gender-related concerns (Mean=4.00), religious beliefs (Mean=3.98), fear of diagnosis (Mean=3.94), and stigma (Mean=3.94) as important determinants of service utilization. Regression analysis established that individual factors significantly influenced utilization of cancer health services (β=0.604, p<0.001), explaining 24.5% of the variation in utilization (R²=0.245). Qualitative findings corroborated the quantitative results by highlighting the influence of misconceptions about cancer, stigma, cultural beliefs, family decision-making, and trust in healthcare providers on treatment-seeking behaviour.
Unique Contribution to Theory, Policy and Practice: This study found individual factors significantly influenced utilization of cancer health services among adult patients. The findings underscore the need for culturally sensitive cancer awareness programs, strengthened Individual financial protection mechanisms, enhanced patient education, and community-based interventions aimed at reducing stigma and improving timely access to cancer care among vulnerable populations.
Downloads
References
Afaya, A., Ramazanu, S., Bolarinwa, O., Yakong, V., Afaya, R., Aboagye, R., & Alhassan, R. (2022). Health systems barriers influencing timely breast cancer diagnosis and treatment among women in low- and middle-income Asian countries: Evidence from a mixed methods systematic review. BMC Health Services Research, 22(1), 1601. https://doi.org/10.1186/s12913-022-08927-x
Ari, E., Dioso, R., & Sotunsa, J. (2023). Care seeking behavior in cervical cancer screening among Gwafan community women, Jos, Plateau State. The Malaysian Journal of Nursing, 14(4), 83–89. https://doi.org/10.31674/mjn.2023.v14i04.009
Becker, M. H. (1974). The health belief model and sick role behavior. Health Education Monographs, 2(4), 409–419. https://doi.org/10.1177/109019817400200407
Bray, F., Laversanne, M., Sung, H., Ferlay, J., Siegel, R. L., Soerjomataram, I., & Jemal, A. (2024). Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 74(3), 229–263. https://doi.org/10.3322/caac.21834
Deng, P., Fu, Y., Chen, M., & Si, L. (2022). Factors associated with health care utilization and catastrophic health expenditure among cancer patients in China: Evidence from the China Health and Retirement Longitudinal Study. Frontiers in Public Health, 10, 943271. https://doi.org/10.3389/fpubh.2022.943271
Department of Health Garissa County. (2022). County Health Annual Report. Garissa County Government.
Gakunga, R., Kinyanjui, A., Ali, Z., Ochieng, E., Gikaara, N., Maluni, F., & Subramanian, S. (2019). Identifying barriers and facilitators to breast cancer early detection and subsequent treatment engagement in Kenya: A qualitative approach. The Oncologist, 24(12), 1549–1556. https://doi.org/10.1634/theoncologist.2019-0257
Koirala, R., Gurung, N., Dhakal, S., & Karki, S. (2021). Role of cancer literacy in cancer screening behavior among adults of Kaski District, Nepal. PLoS ONE, 16(7), e0254565. https://doi.org/10.1371/journal.pone.0254565
Lauver, D. (1992). A theory of care-seeking behavior. Image: The Journal of Nursing Scholarship, 24(4), 281–288. https://doi.org/10.1111/j.1547-5069.1992.tb00734.x
Macharia, L. W., Mureithi, M. W., & Anzala, O. (2019). Cancer in Kenya: Types and infection-attributable. Data from the adult population of two national referral hospitals (2008–2012). AAS Open Research, 1, 25. https://doi.org/10.17605/OSF.IO/MD2PY
Mensah, A., Mikare, M., Mensah, K., Okyere, J., Ameniampong, E., Poku, A., & Lampley, J. (2023). Impact of cancer diagnosis and treatment: Qualitative analysis of strains, resources and coping strategies among elderly patients in a rural setting in Ghana. BMC Public Health, 23(1), 540. https://doi.org/10.1186/s12877-023-04248-8
Ministry of Health. (2017). National Cancer Control Strategy 2017–2022. Government Printer.
Ministry of Health. (2018). Cancer Management Guidelines. Government Printer.
Myint, W., Aggad, R., Fan, Q., & Mendez, S. (2024). Factors influencing cervical cancer screening uptake among reproductive aged Filipino women: Findings from the 2022 Philippines National Demographic and Health Survey. Women’s Health Reports, 5(1), 485–494. https://doi.org/10.1089/whr.2024.0011
Ngwa, W., Addai, B. W., Adewole, I., Ainsworth, V., Alaro, J., Alatise, O. I., & Kerr, D. (2022). Cancer in sub-Saharan Africa: A Lancet oncology commission. The Lancet Oncology, 23(6), e251–e312. https://doi.org/10.1016/S1470-2045(21)00720-8
Omolo, B. (2022). Factors associated with the uptake of screening services for early detection of cancer among clients visiting Masinga Level Four Hospital Outpatient Department, Masinga Sub-County, Machakos County, Kenya (Doctoral dissertation, Jomo Kenyatta University of Agriculture and Technology).
Rick, T., Aagard, M., Erwin, E., Leintz, C., Danik, E., Serventi, F., & Yeates, K. (2021). Barriers to cancer care in northern Tanzania: Patient and health system predictors for delayed presentation. JCO Global Oncology, 7, 1500–1508. https://doi.org/10.1200/GO.21.00253
Sharma, A., Alatise, O., O’Connell, K., Ogunleye, S., Aderounmu, A., Samson, M., & Du, M. (2021). Healthcare utilisation, cancer screening and potential barriers to accessing cancer care in rural South West Nigeria: A cross-sectional study. BMJ Open, 11(7), e040352. https://bmjopen.bmj.com/content/11/7/e040352
Shimels, T., Gashawbeza, B., & Gedif Fenta, T. (2024). Access to advanced healthcare services and its associated factors among patients with cervical cancer in Addis Ababa, Ethiopia. Frontiers in Oncology, 14, 1342236. https://doi.org/10.3389/fonc.2024.1342236
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Fatuma Abukar, Dr. Dennis Gichobi Magu (PhD), Dr. Joseph Baya Msanzu (PhD), Dr. Mwiti Peter Kirimi (PhD)

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.