Facilitators and Barriers to Cervical Cancer Screening among Female Undergraduate Students of Makerere University

Abstract

There is a higher Human Papilloma Virus peak prevalence in younger women (18 -25 years) of university age. The undergraduate university students are more at a risk of acquiring cervical cancer because they are at the stage of exploring which predisposes them to risky behavior like early sexual intercourse and multiple sexual partners among others. This creates a need for cervical cancer screening in the population. The facilitators and barriers to cervical cancer screening have been studied in the Ugandan general population but little is known among University students which this study is taking interest. Objective: This study is aimed at determining the facilitators, barriers and background factors associated to cervical cancer screening among female undergraduate students in Makerere University. Methods: Four hundred twenty-two (422) female undergraduate students of Makerere University who fit the eligibility criteria were recruited in this descriptive cross-sectional quantitative study. A self-administered semi structured questionnaire was administered to these participants chosen by convenient sampling. Data collected was analyzed using SPSS version 23 software and logistic regression models was used. Results: Less than a half of (21.1%) of the participants had ever screened for cervical cancer. At multivariate analysis, only year of study and married status were associated to cervical cancer screening with a P-values were of (0.015) and (0.001) with a (1.173 -4.261) and (1.594 -6.130) 95% CI respectively. The facilitators agreed upon by participants included: Access to free cervical cancer screening services, adequate knowledge about cervical cancer screening and advice from a friend, family or physician among others. The reported barriers to screening were fear of bad result, low risk perception and fear of embarrassment among others. Conclusions and Recommendations: Among the female undergraduate students of Makerere How to cite this paper: Kabiri, L. and Komuhangi, G. (2021) Facilitators and Barriers to Cervical Cancer Screening among Female Undergraduate Students of Makerere Univer-

Female students’ perspectives on cervical cancer screening inclusion in pre-admission university requirements in Ghana

“…Unwillingness to be screened for cervical cancer was identified to stem from the discomfort that participants viewed could arise from the procedure which included showing one’s nakedness to a stranger which paves the way for embarrassment, mistrust about the sterility of the instruments, and perceived vaginal pain due to the insertion of metallic objects into the intimate parts of the woman. Perceived vaginal pain was also identified among 9.4% of the participants in the study in Ghana, out of 140 females who believed that insertion of any objects into the reproductive parts of the female is bound to cause injury and consequently, pain [ 25 ]. This also adds to the fact that their knowledge of the CCS procedure was inadequate, hence, more education should be given on how the screening is performed.…”

“…In this current study, thirty (30) participants were interviewed. The students were between the ages of eighteen (18) and twenty-five (25). All of them were females and stayed across the regions of Ghana.…”

“…In Ghana, the cytology-based test is the most commonly utilized screening strategy [24]. Alongside this, the Visual Inspection with Acetic acid wash (VIA) has been utilized in both rural and urban settings in Ghana and is regarded as an effective screening method for cervical cancer and is available in almost every health care setting [25]. Regardless of the accessibility of these cervical cancer screening instruments, low reports of cervical screening had been recorded to be done for female students in Ghana and Uganda [26][27][28][29].…”

Interpersonal Communication Barriers to Uptake of Cervical Cancer Screening in Uasin Gishu County, Kenya

“…In a study conducted by Kabiri and Komuhangi (2021), an examination of facilitators and obstacles to testing for cervical cancer among female bachelor's students of Makerere University revealed several noteworthy findings. Among the identified barriers were concerns regarding potential negative test results, a diminished perception of personal risk, and apprehension related to potential embarrassment, among other factors.…”

“…Among the identified barriers were concerns regarding potential negative test results, a diminished perception of personal risk, and apprehension related to potential embarrassment, among other factors. The hurdles of fear and humiliation in participating in cervical cancer testing initiatives among African women in various countries have been consistently documented in the literature (Bukirwa et al, 2015;Kabiri & Komuhangi, 2021;Adewumi et al, 2022). The majority of women exhibit a preference for undergoing screening procedures in the presence of a female healthcare professional, such as a doctor or nurse.…”