KNOWLEDGE, ATTITUDE AND PRACTICES IN CERVICAL CANCER SCREENING IN KAKAMEGA COUNTY, KENYA

Authors

  • Gregory Okonya Sakwa Department of Health Promotion and Sports science, Masinde Muliro University of science and technology
  • Peter Bukhala Department of Health Promotion and Sports science, Masinde Muliro University of science and technology
  • Zachary Kwena Kenya Medical Research Institute, Kisumu
  • Mary Kipmerewo Department of Reproductive Health, Child Health and Midwifery, Masinde Muliro University of science and technology.

DOI:

https://doi.org/10.47604/jhmn.1427

Keywords:

Attitudes, Cervical cancer, Knowledge, Screening, Kakamega

Abstract

Purpose: Early cervical cancer screening (CCS) and treatment is effective method of controlling the disease, however its uptake is poor. Women only screen for cervical cancer when they experience symptoms or when advised by healthcare workers. Main objective of the study was to assess knowledge, attitude and practices of cervical cancer screening among women in Kakamega County.

Methodology: The target population was 208,905 women of reproductive age residing in Kakamega County. This was a quantitative research approach utilizing descriptive study design. An interviewer administered questionnaire was used to collect data. Multi-stage sampling was used to select 872 women aged 25-49 from 16 community units of Kakamega County. Participants were assured of confidentiality, voluntary participation and freedom to exit the study at any point. Descriptive statistics were used to analyze knowledge and attitude levels towards cervical cancer screening. Logistic regression along with odds ratios at 95% confidence intervals was used to analyze factors affecting uptake of screening.

Findings: Majority (81%) of participants had heard of cervical cancer screening mainly from media and Health Care workers. Only 16 % and 13% had good knowledge about signs of and risk factors of cervical cancer respectively. More than 78% had positive attitude towards cervical cancer screening. Less than 22% of participants had been screened for cervical cancer previously. Uptake of cervical cancer screening was low, and there was poor knowledge on aspects of cervical cancer. Poor to average knowledge is not sufficient to enable women make decisive actions on CCS.

Unique Contribution to Theory, Practice and Policy: Women should be encouraged to seek for more information about CCS through the various sources of media available to them. Healthcare providers need to be empowered further on delivering key information about CCS. The Ministry of Health should consider and strengthen alternative sources of information on CCS by use of Community Health Volunteers to complement health care providers. The government should further initiate a monitoring and evaluation program to track trends of factors barring uptake of CCS. A qualitative research need to be conducted to establish deeper factors associated with poor knowledge and uptake of CCS despite positive attitude.

Downloads

Download data is not yet available.

References

Ajambo, A., Nawagi, F., Bukenya, D. L., Mukisa, J., Mwaka, A. D., Tumwine, L. K., & Nabirye, R. C. (2017). Awareness and Self-Perceived Risk of Cervical Cancer among Women Living in Namuwongo, an Informal Settlement in Kampala, Uganda. Journal of AIDS & Clinical Research, 8(10). https://doi.org/10.4172/2155-6113.1000741

American Cancer Society. (2014). Cervical Cancer Prevention and Early Detection. In Cervical Cancer Prevention and Early Detection.

Arbyn, M., Weiderpass, E., Bruni, L., de Sanjos, S., Saraiya, M., Ferlay, J., & Bray, F. (2019). Estimates of incidence and mortality of cervical cancer in 2018: A worldwide analysis. The Lancet. Global Health. https://doi.org/10.1016/S2214-109X(19)30482-6

Black, E., Hyslop, F., & Richmond, R. (2019). Barriers and facilitators to uptake of cervical cancer screening among women in Uganda: A systematic review. BMC Women's Health, 19(1), 108. https://doi.org/10.1186/s12905-019-0809-z

Chidyaonga-Maseko, F., Chirwa, M. L., & Muula, A. S. (2015). Underutilization of cervical cancer prevention services in low and middle income countries: A review of contributing factors. Pan African Medical Journal, 21. https://doi.org/10.11604/pamj.2015.21.231.6350

Choi, Y., Oketch, S. Y., Adewumi, K., Bukusi, E., & Huchko, M. J. (2018). A Qualitative Exploration of Women's Experiences with a Community Health Volunteer-Led Cervical Cancer Educational Module in Migori County, Kenya. Journal of Cancer Education. https://doi.org/10.1007/s13187-018-1437-2

Gilbert Wangalwa, Bennett Cudjoe, David Wamalwa, Yvonne Machira, Peter Ofware, Meshack Ndirangu, & Festus Ilako. (2012). Effectiveness of Kenya's Community Health Strategy in delivering community-based maternal and newborn health care in Busia County, Kenya: Non-randomized pre-test post test study. Pan African Medical Journal, 13(Supp 1)(12). http://www.panafrican-med-journal.com/content/series/13/1/12/full

GLOBOCAN. (2020). Cervix uteri fact sheets. WHO.

Han, M. A., Choi, K. S., Lee, H.-Y., Jun, J. K., Jung, K. W., Kang, S., & Park, E.-C. (2012). Performance of Papanicolaou Testing and Detection of Cervical Carcinoma In Situ in Participants of Organized Cervical Cancer Screening in South Korea. PLoS ONE, 7(4), e35469. https://doi.org/10.1371/journal.pone.0035469

Hayes, R. J., & Bennett, S. (1999). Simple sample size calculation for cluster-randomized trials. International Journal of Epidemiology 1999;28:319-326, 319-326.

IARC. (2013). Latest world cancer statistics (Issue December).

ICO/IARC HPV Information Centre. (2018). Kenya Human Papillomavirus and Related Cancers, Fact Sheet 2018.

Joelle I. Rossera,*, Betty Njorogeb, and Megan J. Huchko. (2015). Knowledge about cervical cancer screening and perception of risk among women attending outpatient clinics in rural Kenya. Int J Gynaecol Obstet. 2015 March ; 128(3): 211-215. Doi:10.1016/j.Ijgo.2014.09.006, 3(128), 211-215. https://doi.org/10.1016/j.ijgo.2014.09.006

KDHS. (2014). Kenya Demographic Health Survey , 2014.

Khozaim, K., Orang, E., Christoffersen-deb, A., Itsura, P., Oguda, J., Muliro, H., Ndiema, J., Mwangi, G., Strother, M., Cu-uvin, S., Rosen, B., & Washington, S. (2014). Successes and challenges of establishing a cervical cancer screening and treatment program in western Kenya ☆. International Journal of Gynecology and Obstetrics, 124(1), 12-18. https://doi.org/10.1016/j.ijgo.2013.06.035

KNBS. (2019). 2019 KENYA POPULATION AND HOUSING CENSUS. 1. http://www.knbs.or.ke

Louie, K. S., De Sanjose, S., & Mayaud, P. (2016). Epidemiology and prevention of human papillomavirus and cervical cancer in sub-Saharan Africa: A comprehensive review: Epidemiology of human papillomavirus. Tropical Medicine & International Health, 14(10), 1287-1302. https://doi.org/10.1111/j.1365-3156.2009.02372.x

Louie, K. S., Sanjose, S. De, & Mayaud, P. (2009). Review Epidemiology and prevention of human papillomavirus and cervical cancer in sub-Saharan Africa: A comprehensive review. Tropical Medicine and International Health, 14(10), 1287-1302. https://doi.org/10.1111/j.1365-3156.2009.02372.x

Malhotra, V., Balgir, R., Watts, A., Kaur, S., Nirwan, P., & Cheema, R. (2017). Awareness regarding animal bite management among resident doctors of tertiary care institute of Northern India. Medical Journal of Dr. D.Y. Patil University, 10(4), 359. https://doi.org/10.4103/0975-2870.213928

Ministry of Health. (2018). Kenya National Cancer Screening Guidelines [Guideline]. Ministry of Health.

Mukama, T., Ndejjo, R., Musabyimana, A., Halage, A. A., & Musoke, D. (2017). Women's knowledge and attitudes towards cervical cancer prevention: A cross sectional study in Eastern Uganda. BMC Women's Health, 17(1), 9. https://doi.org/10.1186/s12905-017-0365-3

Ngugi, C. W., Boga, H., Muigai, A. W. T., Wanzala, P., & Mbithi, J. N. (2012). Health Care for Women International Factors Affecting Uptake of Cervical Cancer Early Detection Measures Among Women in Thika , Kenya. October 2014, 37-41. https://doi.org/10.1080/07399332.2011.646367

O'Brien, M. J., Halbert, C. H., Bixby, R., Pimentel, S., & Shea, J. A. (2010). Community health worker intervention to decrease cervical cancer disparities in Hispanic women. Journal of General Internal Medicine, 25(11), 1186-1192. https://doi.org/10.1007/s11606-010-1434-6

Okunowo, A. A., Daramola, E. S., Soibi-Harry, A. P., Ezenwankwo, F. C., Kuku, J. O., Okunade, K. S., & Anorlu, R. I. (2018). Women's knowledge of cervical cancer and uptake of Pap smear testing and the factors influencing it in a Nigerian tertiary hospital. Journal of Cancer Research and Practice, 5(3), 105-111. https://doi.org/10.1016/j.jcrpr.2018.02.001

Rashidul Alam Mahumud1, Syed Afroz Keramat, Gail M Ormsby, Marufa Sultana, Lal B. Rawal, Khorshed Alam, Jeff Gow, & Andre M. N. Renzaho. (2020). Wealth-related inequalities of women's knowledge of cervical cancer screening and service utilisation in 18 resourceconstrained countries: Evidence from a pooled decomposition analysis. BMC Health Services Research, 19(42). https://doi.org/10.1186/s12939-020-01159-7

Rose Olayo, Charles Wafula, Evalyne Aseyo, Constantine Loum, & Dan Kaseje. (2014). A quasi-experimental assessment of the effectiveness of the Community Health Strategy on health outcomes in Kenya. BMC Health Services Research, 14(suppl1). https://doi.org/10.1186/1472-6963-14-S1-S3

Rosser, J. I., Njoroge, B., & Huchko, M. J. (2015). Changing knowledge, attitudes, and behaviors regarding cervical cancer screening: The effects of an educational intervention in rural Kenya. Patient Education and Counseling, 98(7), 884-889. https://doi.org/10.1016/j.pec.2015.03.017

Shimeles Tsegaye, Daniel Mengistu, & Teklemariam Gultie. (2018). Knowledge and attitude towards cervical cancer screening and associated factors among female Hawassa university college of medicine and health sciences students. MOJ Public Health, 7(3). https://doi.org/10.15406/mojph.2018.07.00221

Tadesse Tekle, Eskinder Wolka, Banchialem Nega, Wondimagegn Paulos, Kumma, & Mengistu Meskele Koyira. (2020). Knowledge, Attitude and Practice Towards Cervical Cancer Screening Among Women and Associated Factors in Hospitals of Wolaita Zone, Southern Ethiopia. Cancer Management and Research, 2020(12), 993-1005.

Tapera, O., Dreyer, G., Kadzatsa, W., Nyakabau, A. M., Stray-Pedersen, B., & Sjh, H. (2019). Cervical cancer knowledge, attitudes, beliefs and practices of women aged at least 25 years in Harare, Zimbabwe. BMC Women's Health, 19(1), 91. https://doi.org/10.1186/s12905-019-0790-6

Tapera, R., Manyala, E., Erick, P., Maswabi, T. M., Tumoyagae, T., Mbongwe, B., & Letsholo, B. (2017). Knowledge and Attitudes towards Cervical Cancer Screening amongst University of Botswana Female Students. Asian Pacific Journal of Cancer Prevention, 18(9). https://doi.org/10.22034/APJCP.2017.18.9.2445

Tesfaye, Z. T., Bhagavathula, A. S., Gebreyohannes, E. A., & Tegegn, H. G. (2019). Knowledge and Awareness of Cervical Cancer and Human Papillomavirus among Female Students in an Ethiopian University: A Cross-sectional Study. International Journal of Preventive Medicine, 10, 198. https://doi.org/10.4103/ijpvm.IJPVM_181_17

Tope Olubodun, Oluwakemi Ololade Odukoya, & Mobolanle Rasheedat Balogun. (2019). Knowledge, attitude and practice of cervical cancer prevention, among women residing in an urban slum in Lagos, South West, Nigeria. Pan African Medical Journal. https://doi.org/10.11604/pamj.2019.32.130.14432

UCL. (2011). Cervical Cancer Awareness Measure (Cervical CAM). http://www.data-archive.ac.uk

World Health organization. (2014). Comprehensive Cervical Cancer Control: Aguide to essential practice.

Downloads

Published

2021-12-10

How to Cite

Sakwa, G., Bukhala, P., Kwena, Z., & Kipmerewo, M. (2021). KNOWLEDGE, ATTITUDE AND PRACTICES IN CERVICAL CANCER SCREENING IN KAKAMEGA COUNTY, KENYA. Journal of Health, Medicine and Nursing, 7(3), 51 – 66. https://doi.org/10.47604/jhmn.1427

Issue

Section

Articles