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©IDOSR PUBLICATIONS
International Digital Organization for Scientific Research ISSN: 2579-0811
IDOSR JOURNAL OF BIOCHEMISTRY, BIOTECHNOLOGY AND ALLIED FIELDS 8(3): 101-118, 2023.
https://doi.org/10.59298/IDOSR/JBBAF/23/19.476

Examining Prevalence and Influential Factors of Cervical Cancer

Screening Among Women of Reproductive Age at Fort Portal Regional
Referral Hospital in Fort Portal City

Mumere Mutahunga Robert

Faculty of Clinical Medicine and Dentistry Kampala International University Western

Campus Uganda.

ABSTRACT
Globally, cervical cancer stands as a pressing health issue for women, ranking as the
second most common cancer type among females worldwide. A study conducted at Fort
Portal Regional Referral Hospital in Fort Portal City aimed to assess the prevalence and
factors impacting the participation of women of reproductive age in cervical cancer
screening tests. Employing a cross-sectional descriptive design with quantitative methods,
the study utilized a consecutive sampling technique, surveying 96 respondents through
self-administered questionnaires. Data analysis involved coding and entry via SPSS 20.1,
with findings presented through tables, graphs, and pie charts. Results indicated that only
a quarter of respondents (25%) had undergone cervical cancer screening, predominantly
opting for Visual Inspection with Acetic Acid (VIA) (58.3%). Notably, a significant proportion
of screened individuals (66.7%) hailed from rural areas, and the majority (66.7%) had a
parity of 3 or fewer children. Moreover, 58.3% of those screened reported earning more
than 400,000 shs per month. Unexpectedly, reluctance accounted for 44.8% of respondents'
reasons for not undergoing screening. In summary, despite free accessibility to the service,
there's a notably low prevalence of cervical cancer screening. Reluctance and fear
associated with the procedure emerged as significant barriers hindering the uptake of
cervical cancer screening among the surveyed population.

Keywords: Cervical cancer, Reproductive age, Mothers, Women, Human papillomavirus.

INTRODUCTION
Cervical cancer is a cancer that arises Papanicolaou developed a technique that
from the cervix and it is due to the was used for screening. The introduction
abnormal growth of cells that can invade of the Pap test in the clinical setting faced
and spread to other body parts [1]. It is major challenges both in Canada and the
caused by persistent high-risk Human United States, where most Pap smear tests
papillomavirus (HPV) infection. HPV were introduced in Canadian centres as
infection is spread during sexual local trials (Patricia A S, 1999).In 1949,
intercourse. Infection is very common David Boyes and Fidler initiated cervical
following the onset of sexual activity and screening in British Colombia as a project
up to 80% of adults show serological to determine whether screening with Pap
evidence of previous infection [2]. smear could reduce the incidence and
Cervical cancer has been affecting women mortality from invasive cervical
since 400 BC when Hippocrates noted that carcinoma but in 1955, only 3% of the
the disease was incurable. In 1928, British Colombian women had ever been

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screened [3]. Cervical-vaginal screening declining in the developed world. It has
increased greatly in the 1950s when the been estimated that cervical screening
cancer societies in Canada and the United prevents around 5,000 deaths every year
States endorsed the Pap smear test as an in the UK alone. [8, 11]. Evidence shows
effective cancer prevention test, and that early detection through cervical pap
promoted it in their campaigns [4]. In smears has had a significant impact on
1962, only 6.3% of Canadian women over the incidence and mortality associated
the age of 25 were screened in a 12-month with this cancer in many developed
period; by 1967, this had increased to nations including the United Kingdom, the
26%. With the gradual adoption of the United States, and Australia [12].
technique across the country, a reduction Worldwide, over 85% of cervical cancer
in both incidence and mortality from deaths occur every year in developing
cervical carcinoma was documented the countries [13]. This is attributed to
incidence dropped from 21.6 per 100,000 inadequate access to effective screening
women in 1969 to 10.4 per 100,000 in which results in less recognition of the
1990 and mortality dropped from 7.4 per disease during its early stages and higher
100,000 women in 1969 to 2.4 per chances of it developing to advanced
100,000 in 1992 [4]. stages with poor prospects of treatment
Challenges to the provision of effective [14].
care in Uganda include competing health Globally, 570000 new cases of cervical
needs, misconceptions about cervical cancer were registered in 2018 and
cancer screening, and poor prevention, 311000 women died from it in the same
screening, and treatment infrastructure, year [14]. According to a projection by
particularly in rural areas [5]. This study WHO [15], by 2025, about six thousand
provides a cross-section of the prevalence four hundred new cases and four
and the sociodemographic and thousand three hundred deaths will occur
socioeconomic factors that influence the annually if no attempt is made to reduce
uptake of cervical cancer screening tests. the scourge. Uganda ranks 14th among
Cervical cancer is almost entirely countries with the highest incidence of
preventable through vaccination and cervical cancer, and over 65% of those
screening, yet it remains one of the diagnosed with the disease die from it
gravest threats to women’s lives [6]. [16]. Cervical cancer (CC) is the most
Uganda has one of the highest cervical frequent cancer and the leading cause of
cancer incidence rates in the world (54.8 cancer-related deaths in Ugandan women
per 100,000) as a result of limited [17], and the current estimates indicate
screening access and infrastructure [7]. that six thousand four hundred thirteen
Globally, cervical cancer is a health Ugandan women are diagnosed with CC
concern among women, presently ranking annually and four thousand three
as the second to fourth most common hundred one deaths attributed to this
cancer type among women in different disease occur annually [18]. Despite
parts of the world [8]. An estimated cervical cancer screening services being
528,000 new cases of cervical cancer were provided for free at the government
reported globally, with an estimated health facilities, the baseline lifetime
266,000 women dying from this cancer screening rate in Uganda is still very low
[9]. The cancer grows slowly, begins in at 4.8% to 30% among women aged 25 to
the cervix of women, and occurs mostly 49 years [4, 12]. And yet screening by
in women over the age of 30 years [10]. cytology (‘pap smears’) has prevented up
Cervical cancer is an entirely preventable to 80% of cervical cancers in high
disease as the different screening, resource settings [18]. A key goal of
diagnostic, and therapeutic procedures Uganda’s national strategy for CC
are effective. Pap smear has reduced the prevention and control is to have 80% of
incidence of cervical cancer by nearly 80 eligible women aged 25-49 years screened
percent and death by 70 percent. The and treated for cervical precancerous
incidence of cervical cancer is steadily lesions [19]. The prevalence of CC

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screening at Fort Portal RR Hospital is not uptake of cervical cancer screening are
known and the factors influencing the not determined.
METHODOLOGY
Study design literature on P, so P was conventionally
The study was a cross-sectional taken to as 0.5.
descriptive study employing quantitative Q = 1-0.5 =0.5
data collection methods. The researcher d = Precision of the study. A precision of
selected the above method because it 10% (0.1) was used which was the
allowed easy collection of data at a single standard
point in time. 𝑛=
(1.96)2 × 0.5 ×0.5
= 96.4
Area of Study (0.1)2

The place of study was at Fort Portal Therefore, the sample size was 96.
Regional Referral Hospital specifically at Dependent variable
the Department of Obstetrics and To determine the factors influencing the
Gynaecology. It is a government Hospital, uptake of cervical cancer screening tests
located approximately one hundred forty- among women of reproductive age at
eight kilometres, west of Mulago National FPRRH, Fort Portal City
Referral Hospital. The Hospital is along Independent variables
Mugurusi Road in Fort Portal City, i) To assess the socio-demographic
Kabarole District in western Uganda. factors influencing the uptake of cervical
Study population cancer screening tests among women of
The study targeted women coming for reproductive age.
antenatal services and sexually active ii) To assess the socioeconomic factors
women aged 25-49, seeking gynaecology influencing the uptake of cervical cancer
health care services at FPRRH. screening tests among women of
Inclusion criteria reproductive age.
All women between the age of 25-49 years iii) To assess the individual factors
seeking gynaecology health care services influencing the uptake of cervical cancer
and mothers attending antenatal care at screening tests among women of
FPRRH who freely consented and assented reproductive age.
to the study, were eligible to participate Sampling procedure
in the study. Consecutive sampling technique was
Exclusion criteria used, where every participant meeting the
All nulliparous non-pregnant women inclusion criteria was selected until the
below 25 years of age and women above required sample size was achieved which
49 years of age were not eligible for the is a form of non-probability sampling
study. Women aged 25-49 who were method. This was because there was no
unwilling to participate in the study or sampling framework availability for this
were mentally ill did not participate in the type of study design especially for the
study. first-time respondents. The researcher
Sample size determination interviewed all women aged 25 to 49
The sample size was calculated using the years and also women below 25 years who
Kish and Leslie formula [20] for a single had come for antenatal.
proportion as follows; Data Collection Procedures.
2
𝑍 𝑃𝑄 The data was collected by administering a
𝑛= questionnaire to a single participant.
𝑑2
Depending on the situation, the
Where; researcher conducted a one-on-one
n =sample size. interview for respondents who did not
Z = the value that corresponds to the 95% know how to read or write, which made it
confidence interval which is 1.96. an interaction between the interviewer
P = proportion of women attending and the informant. The researcher
antenatal clinic at FPRRH. There was is no explained to the respondent the research
project, the purpose, and the kind of
questions that were asked. Confidentiality

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was assured, consent was sought and a Quality control
consent form was signed. Filling the The researcher trained the research
questionnaire took 10 to 15 minutes. At assistants prior to data collection. The
the end of filling out the questionnaire by research questionnaires were first
the respondent, the researcher thanked administered to 30 respondents prior to
the respondent for their cooperation. the date of data collection for the purpose
Data management of pretesting and ensuring validity.
This involved manual checking for errors Ethical considerations
and omissions in the filled tools to ensure An introductory letter was obtained from
consistency, completeness, validity, KIU-WC and presented to the Executive
relevancy and accuracy of the data that Director of Fort Portal Regional Referral
was collected this was done every day Hospital to seek permission to carry out
after data collection and every respondent my research. All information obtained
was counted once. from the women was not used for any
other purpose apart from this research.
Data analysis Women’s names were not included
Data was analyzed using SPSS version anywhere on the questionnaire; serial
20.1. Data analysis started by allocating numbers were used. The research
codes for each question, tallying, assistants and all the research team
counting frequencies and computing members were fully aware of the fact that
percentages. Tabulation was done and research ethics are part and parcel of the
data was put in their respective figures. research and anything that compromises
This was done to facilitate the process for the adherence to the ethical standards
easy analysis and interpretation of the equally compromises the validity of the
findings. The percentages were further findings. An informed consent was first
analyzed by establishing the relationship requested from the respondents prior to
between the independent and the the interviews. Confidentiality was
dependent variables where the assured to the participants concerning the
information obtained was presented using information they offered. The
the cross-tabulation method (cross- respondents were assured that they could
tabulation analysis) and hence withdraw from participating in the study
appropriate figures, graphs, and pie at any time without consequences.
charts among others.
RESULTS
The prevalence of cervical cancer screening and number of times, the
screening screening methods employed by health
This was determined by the respondents’ workers and the number of other women
awareness about cervical cancer the respondents knew who had performed
screening, participation in cervical cancer cervical cancer screening as follows;

n=96

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0 0

12.50%

87.50%

YES NO

Figure 1: A pie chart showing respondents’ awareness of cervical cancer screening

The figure above shows that the majority of cervical cancer screening and the
84(87.5%) of the respondents were aware minority 12(12.5%) were not.

n=96
0.8 75%

0.7

0.6

0.5

0.4

0.3 25%

0.2

0.1

NO YES

Figure 2: A bar chart showing respondents who ever had cervical cancer screening

The figure above shows that the majority cancer screening and the minority 24(25%)
72(75%) had not performed cervical had done cervical screening tests.

Table 1: Showing how often respondents screened for cervical cancer and methods of
CC screening used
n=96

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Variable Frequency(n) Percentage (%)
Number of times respondents were screened
Once 16 16.6
Twice 04 4.2
Thrice 02 2.1
4 times and above 02 2.1
Zero times 72 75
Total 96 100
Methods of CC screening used Frequency(n=24) Percentage
Pap smear 04 16.7
Visual inspection of acetic acid 14 58.3
Don’t remember 06 25
Total 24 100

The table above shows that the majority also shows that in most 14(58.7%) of the
72 (75%) of respondents had not screened respondents, the visual inspection acetic
for cervical cancer. 16(16.6%) respondents acid method was used, 06(%) of
had screened once and 04 respondents respondents could not remember the
had screened twice. An equal number and method used and in the minority 04(%) of
the minority 02 of respondents had the respondents, Pap smear was used as
screened thrice and 4 times. The table in cervical screening test.

Table 2: Showing women knew had ever screened for cervical cancer
n=96
Variable Frequency (n) Percentage (%)

Number of women reported

None 57 59.4

1-4 25 26.0

5 and above 14 14.6

Total 96 100

The table above shows that the majority Socio-demographic factors influencing
57(59.4%) did not know any other women the uptake of cervical cancer screening
who had screened for cervical cancer, tests among women of reproductive
25(26%) reported a number ranging age.
between 1 and 4, and the minority Respondents were identified by age, place
14(14.6%) of respondents reported 5 plus of residence, parity, level of education,
women who have ever screened for religion, occupation and marital status
cervical cancer. owing to the nature of the study and
interpreting data from the field regarding
the prevalence and factors influencing the
uptake of cervical screening tests.

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Table 3: Showing the parity and the age range of respondents in comparison with
cervical cancer screening

n=96
Variable Frequency (n) Percentage (%)
Age range
15-24 27 28.1
25-35 56 58.3
36-49 13 13.6
Total 96 100
25years and above, ever screened 20 83.3
Below 25 years, ever screened 04 16.7
Total 24 100
Parity
0-3 78 81.3
4 and above 18 18.7
Total 96 100
Parity below 4, ever screened 16 66.7
Parity 4 and above, ever screened 08 33.3
Total 24 100

The table above shows that most years. The table further shows that the
56(58.3%) of the respondents were parity of the majority 78(%) of the
between the ages of 25 and 35, 27(28.1%) respondents was 0-3 and the minority
were in the age range of 15-24 and the 18(18.7%) of the respondents had a parity
minority 13(13.6%) were aged between 36 of 4 and above. And of the 24
and 49. It also shows that of the 24 respondents who had ever screened for
respondents who had ever screened for cervical cancer, the majority had a parity
cervical cancer, the majority 20(83.7%) of below 4 while the minority had a parity
were aged 25 and above while the of 4 and above.
minority 04(16.7%) were aged below 25

Table 4: Showing the place of residence of respondents in comparison with cervical

cancer screening
n=96
Variable Frequency(n) Screened (n=24) Percentage (%)

Place of residence

Rural 57 16 28.1

Urban 39 08 20.5

Total 96 24 48.2

The table above shows that the majority 57(59.4%) of the respondents resided in rural areas
while a significant number 39(40.6%) of respondents resided in urban areas. It also shows
that the majority 16(28.1%) of the respondents who had ever screened for cervical cancer
resided in rural areas while the minority 08 were from urban.

n=96

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60%

49%
50%

40%
32.30%
30%

20%

10.40%
10% 8.30%

0%
PRIMARY SECONDARY INSTITUTION UNIVERSITY

Figure 3: A bar chart showing the Education status of the respondents

The figure above indicates that majority institution (certificate/diploma) and

47(49%) of the respondents studied up to minority 08(%) studied up to bachelor
primary level, 31(32.3%) studied up to level.
secondary level, 10(10.4%) studied up to

n=24
0 0

16.70%

83.30%

High level of Educ Low level of Educ

Figure 4: Showing the level of education of the respondents in comparison with

cervical cancer screening

The figure above shows that the majority education while the minority 04(16.7%) of
20(83.3%) of the respondents who had the respondents were of high education
ever screened had a low level of status.

Table 5: Showing the Occupation and Religion of the respondents

n=96
Variable Frequency (n) Percentage (%)

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Religion
Catholics 45 46.9
Muslims 12 12.5
Protestants 25 26.0
Pentecostal 07 7.3
SDA 07 7.3
Total 96 100
Occupation
Civil servant 06 06.3
Business 51 53.1
Peasant 39 40.6
Total 96 100

The table above indicates majority 45(%) majority of the respondents were doing
of the respondents were Catholics, 12(%) Business, 39(40.6%) were peasant farmers
were Muslims, 25(%) were protestants and the minority 06(6.3%) of the
while the minority 07(7.3%) were SDAs respondents were civil servants.
and Pentecostals. It also shows that the

n=96
0 0

22.90%

77.10%

Single Married

Figure 5: A pie chart showing the marital status of respondents

The figure above shows that the majority married while the minority 22(22.9%) were
74(77.1%) of the respondents were single.

Table 6: Showing marital status versus cervical cancer screening status

n=24
Variable Frequency (n) Percentage (%)
Married
Ever screened 18 32.1
Never screened 56 67.9
Total 74 100
Single
Ever screened 06 27.3

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Never screened 16 72.7
Total 22 100

The table above shows that most finance control, health insurance,
18(32.1%) of the women who had ever transport and cervical cancer screening
screened for cervical cancer were married costs, nearest opportunities for screening
while the minority 06(27.3%) of the and respondents’ opinions on why some
women who had screened for cervical women do come for cervical cancer
cancer were single. screening.
The socioeconomic factors influencing
the uptake of cervical cancer screening
tests among women of reproductive
age.
This covers the respondents’ monthly
income, their monthly household income,

Table 7: Showing monthly income of respondents

n=96
Variable Frequency(n) Percentage (%)
Personal monthly income
<200,000ug shs 46 47.9
200,000-400,000ug shs 30 31.3
400,000-600,000ug shs 13 13.5
>600,000ug shs 07 7.3
Total 96 100
Household monthly income
<400,000ug shs 42 43.8
400,000-1,000,000ug shs 33 34.4
>1,000,000ug shs 21 21.8
Total 96 100
Monthly income >40,000ugx, screened 14 58.3
Monthly income <400,000ugx,screened 10 41.7
Total 24 100

The table above shows that 46(47.9%) of than 400,000ug shillings, a significant
the participants earned less than number of 33(%) of participants’ monthly
200,000ug shillings in a month, 30(31.3%) income was 400,000ug and 1,000,000ug
earned between 200,000 and 400,000ug shillings and the minority 21(21.8%) of
shillings, 13(13.5%) earned between the participants earned more than
400,000 and 600,000ug shillings while the 1,000,000ug shillings. It further shows
minority 07(7.3%) earned more than that the majority 14(58.3%) of the
600,000ug shilling per month. It also participants who had ever screened for
shows that the household of the majority cervical cancer earned a monthly income
42(43.8%) of the respondents was less of more than 400,000ug shillings while

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the minority 10(41.7%) of respondents earned less than 400,000ug shillings.

Table 8: Showing finance control in a home

n=96
Variable Frequency (n) Percentage (%)

Husband 28 29.2

Personal control 31 32.3

Couple 37 38.5

Total 96 100

Personal control, screened 08 33.3

Husband/couple control, ever 16 66.7

screened

Total 24 100

The table above shows that most respondents who had screened for
37(38.5%) respondents planned for cervical cancer were those who planned
finance as a couple, a significant number for their income with their spouses or
31(32.3%) of respondents controlled their control was by their husbands while a
finances and in the minority 28(29.2%) of minority 08(33.3%) of the respondents
the respondents, the finances were who had screened had personal control
controlled by their husbands. It also over their finances.
shows that most 16(66.7%) of the

Table 9: Showing respondents having Health insurance

n=96
Variable Frequency (n) Percentage (%)

Have health insurance

Yes 12 12.5

No 84 87.5

Total 96 100

Insurance covers cervical cancer

screening
Yes 10 83.3
No 02 16.7
Total 12 100

The table above shows that the majority insurance. It also shows that majority
84(87.5%) of the respondents had no 10(83.3%) of the health insurance cover
health insurance while the minority cervical cancer screening while minority
12(12.5%) of the respondents had health 02(16.7%) did not.

Table 10: Showing the costs of cervical cancer screening and transport

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n=96
Variable Frequency (n) Percentage (%)
Screening costs

Expensive 12 12.5

Screening is free 68 72.9

Not sure 14 14.6

Total 96 100

Transport costs

Affordable 49 51

High 47 49

Total 96 100

The table above shows that the majority screening was expensive. It also shows
70(72.9%) of respondents indicated that that 49(51%) of the respondents indicated
cervical cancer screening is for free, that transport costs were affordable while
14(14.6%) were not sure and the minority the minority 47(49%) indicated that
12(12.5%) indicated that cervical cancer transport costs were high.

n=96
70.00%

60.00% 57.30%

50.00%
42.70%
40.00%

30.00%

20.00%

10.00%

0.00%
YES NO

YES NO

Figure 6: Showing respondents’ awareness and utilization of cervical screening

services in lower centres

The figure above shows that the majority heard about screening at their nearby
55(57.3%) of the respondents indicated health centres while a significant number
that they had ever attended, witnessed or 41(42.7%) did not.

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Table 11: Showing limitations to uptake of cervical cancer screening tests

n=96
Variable Frequency (n) Percentage (%)
Long waiting and long line 10 10.4
Absence of equipment 05 5.2
Absence of health workers 00 00
Reluctance 43 44.8
Limited knowledge/information 23 24
Fear of equipment, presumed to cause 15 15.6
pain/trauma
Total 96 100

The table above shows that the majority of the equipment used and that the test is
43(44.8%) of the respondents were painful, 10(10.4%) indicated long waiting
reluctant to do cervical cancer screening, time on long queues and the minority
23(24%) indicated limited knowledge and 5(5.2%) indicated the absence of
information about the cervical cancer equipment to use.
screening tests, 15(15.6%) indicated fear

DISCUSSION
The prevalence of cervical cancer which showed that the proportion of
screening women who had CCS during antenatal was
The research study found that the as low as 11%, far below the WHO
majority 84(87.5%) of the respondents recommended prevalence of 80% of the
were aware of cervical cancer screening. female population aged 25-49 years [22].
This finding agrees with a community- In Europe, however, the screening rates
based survey conducted in central differ between European Union member
Uganda, Masaka district on understanding states with the highest screening achieved
the low levels of CCS, where it was found in the United Kingdom, Norway and
that 85.8% of the respondents had heard Sweden where rates reach as high as 80%
about cervical cancer screening. This [23].The research also showed that in
study also found out that a minority most 14(58.7%) of the respondents, the
24(25%) of mothers had done cervical visual inspection acetic acid method was
screening and the majority 16 (16.6%) of commonly used in the screening exercise.
respondents had screened for cervical This was central to the standard that
cancer once, even when the knowledge cervical cancer screening should begin at
about cervical cancer screening seemed 21 years of age and be done every 3 years
high. The majority 57(59.4%) did not with conventional or liquid-based Pap
know any other women who had screened tests [24].
for cervical cancer, which shows a low The sociodemographic factors
prevalence of CCS. These research influencing the uptake of cervical
findings agree with the study by cancer screening tests among women of
Twinomujuni et al [21] in central Uganda reproductive age.
which found that 7.0% of mothers This research showed that 56(58.3%) of
interviewed had ever screened for CC; respondents were aged 25-35. It also
most of these (79.3%) had screened once. found out that the majority of 20(83.7%)
This low cervical cancer screening rate of the respondents who had ever screened
also agrees with a study done in Brazil for cervical cancer were aged 25 and

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above. This research finding, to some studies conducted by Ebu [28] where
extent agrees with a study in Jordan by employment status and ability to afford
Tekle, et al [25], which indicated that age the cost of cervical cancer screening were
was a predictor for women’s screening not determinants of intention to screen.
practices and the highest incidence of This is because CCS services were done
cervical cancer screening existed among for free. However, this research study did
women aged 35-44 years. It also agrees not relate employment status and cervical
with a study by Lymo and Beran,[24] cancer screening. The study also showed
which found that socio-demographic that the majority 74(77.1%) of the
factors such as age, in sub-Saharan Africa, respondents were married and 18(75%) of
influence cervical cancer screening. This the women who had ever screened for
study also showed that the majority of cervical cancer were married. This result
mothers who had ever screened for was consistent with studies done in
cervical cancer had a parity of below 4. Malaysia [29] and Portland Jamaica [30]
This contradicts the findings of Quido et where married women were 2 times more
al. [26], which found that the utilization likely to take up a Pap smear compared to
of CCS services was directly proportional unmarried ones. Also, studies in Tanzania
to the parity of women. The research [31] found that women who received
revealed that the majority 57(59.4%) of social support from their husbands were
the respondents resided in rural areas and more likely to attend cervical cancer
that the majority 16(28.1%) of the screening.
respondents who had ever screened for The socioeconomic factors influencing
cervical cancer resided in rural areas. This the uptake of cervical cancer screening
contradicted a study by McKinnon B, et al tests among women of reproductive age
(2011) which found that rural residence is The research revealed that most 46(47.9%)
a determinant of non-participation in of the participants earned less than
screening for cervical cancer. The 200,000ug shillings per month. This
research showed a majority 47(49%) of the result disagrees with the findings of
respondents studied up to the primary Suzanne Q.A, et al (2020), where the
level and that most 20(83.3%) of the incidence of CCS was found to be higher
respondents who had ever screened had a among women with high-income levels in
low level of education. This agrees to a study conducted in Jordan.
some extent with the study findings in It also showed that the household income
Ghana, where women with low education of the majority 42(43.8%) of the
were 2.67 times more likely to have the respondents was less than 400,000shs.
intention to screen than those with no This result contradicts a study in India,
formal education, and those with high that women from lower socioeconomic
levels of education were 3.16 times more classes have a higher chance of receiving
likely to have the intention to screen than a Pap smear [31]. It further revealed that
those with no formal education [6, 27]. the majority 14(58.3%) of the participants
This research also indicated that 45(%) of who had ever screened for cervical cancer
the respondents were Catholics. This earned a monthly income of more than
disagrees with the study conducted in 400,000ug shillings. This agrees with
Harare-Zimbabwe which showed that Black et al. [1] who stated that those
cervical cancer screening was less likely whose households earned more than 40
in women affiliated with major religions dollars per month had a significantly
and these religions were Roman Catholic, higher intention to screen for cervical
Protestant, Pentecostal and Apostle [28]. cancer.The research also found out that
This research however did not assess the most 37(38.5%) respondents planned for
relationship between intentions to screen the finances as a couple, and most
and the religious beliefs of respondents 16(66.7%) of the respondents who had
about CCS. The study also found out that screened for cervical cancer were those
the majority 51(53.1%) of the respondents who planned for their income with their
were doing Business. This agrees with spouses. This is contrary to the finding of

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Nyamambi et al. [32] in Zimbabwe, where finding was contrary to the findings by
it was stated that financial independence Black et al. [1] that financial costs related
among women was associated with the to CCS were a barrier for women in four
uptake of cervical cancer screening.The included studies, and related either to
research also revealed that the majority associated transport/food costs.The
84(87.5%) of the respondents had no research also revealed that the majority
health insurance and most 10(83.3%) of 55(57.3%) of the respondents indicated
the health insurance covered cervical that they had ever attended, witnessed or
cancer screening. This in part agrees with heard about screening at their nearby
a study on barriers to the uptake of CCS health centres.This disagrees with the
and treatment among rural women of study findings by Nwabichie et al. [30]
Ghana where the costs of screening where distant health facilities were a
coupled with low levels of income and limitation to the uptake of cervical
lack of funding constrained screening and screening tests.The study revealed that
treatment of cervical cancer [33]. The the majority 43(44.8%) of the respondents
research showed that the majority were reluctant to do cervical cancer
70(72.9%) of respondents indicated that screening.This disagrees with the findings
cervical cancer screening is free. This is by Binka et al. [34] in a study on barriers
consistent with different studies to the uptake of CCS and treatment among
conducted in developing settings which rural women of Ghana, the costs of
showed that the ability to afford cervical screening coupled with low levels of
cancer screening costs did not result in income, lack of funding, and access to
CCS intention [33]. The study also showed screening facilities constrained screening
that 49(51%) of the respondents indicated and treatment of cervical cancer.
that transport costs were affordable. This

CONCLUSIONS
There is adequate awareness of cervical influence the intention to perform CCS.
cancer screening among women of The provision of CCS services for free as
reproductive age. However, there is well as personal control of finances
inadequate knowledge of the purpose of (earnings) does not increase the intention
CCS for improving morbidity and to screen for cervical cancer. Reluctance,
mortality. Sociodemographic factors such transport costs, and fear of the procedure
as age, level of education, marital status, declined the uptake of cervical cancer
parity, place of residence, and religion screening.
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