Knowledge, utilization and barriers of cervical cancer screening among women attending selected district hospitals in Kigali - Rwanda

Niyonsenga, Gaudence; Gishoma, Darius; Sego, Ruth; Uwayezu, Marie Goretti; Nikuze, Bellancille; Fitch, Margaret I.; Igiraneza, Pierre Céléstin

doi:10.5737/23688076313266274

Cited by 21 publications

(31 citation statements)

References 32 publications

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“…Other women noted that they waited until they had health insurance before attendance at screening services. Barrier related to health insurance was previously reported in Rwanda by Niyonsenga et al 18 where 54% of women agreed that lack of health insurance was a barrier for uptake of screening. In the same study, 18 16.6% of participant agreed that there is much money needed for treatment although we can not be sure if they were referring to treatment of cancer or referring to screening cost as the item was described under barrier to cervical cancer screening.…”

Section: Discussionmentioning

confidence: 82%

“…Prior studies done in different part of Rwanda, although they used different study design to ours, they have reported varying degree of knowledge related to cervical cancer existence, its prevention and screening methods. 17 , 18 , 23 However, none of them has reported health promotion efforts such as the use of SMS, radio station broadcasts, and other telecommunication tools, as possible motivators or sources of information and knowledge related to cervical cancer screening.…”

Section: Discussionmentioning

confidence: 99%

“…Fear of pain, which can also be coupled with shyness or uncertainty for privacy has been previously reported in our country and in other African countries, especially Tanzania which is a neighbouring country of Rwanda. 30 , 31 Niyonsenga et al 18 in a study done in selected urban hospital of Kigali, Rwanda, reported the barriers for screening to be feeling pain during screening (15.8%), embarrassing to go for screening (34.7) and to feel worry (54.2%). As there is increasing evidence of the effectiveness and acceptability of self-sampling in cervical cancer screening and diagnostic testing of diseases of female genital tract 30 , 32 this might be a remedy for both the concern of lack of privacy, embarrassment and pain as barriers for attending cervical cancer screening.…”

Section: Discussionmentioning

confidence: 99%

“…In focus group interview, we used a semi-structured interview guide 22 with 9 open ended questions with possibility of probing as needed ( Supplementary Material S1 ) and conducted face-to-face interview with recording of voices. The choice for focus group interview was based on the fact that most of existing qualitative research related to cervical cancer screening in Rwanda have used structured questionnaires or questions with yes/no answers 18 , 23 , 24 therefore, to be able to collect in depth subjective opinions 22 , 25 from primordial potential beneficiary of cervical screening we opted for focus group interview. One team of facilitators conducted interview for all five focus groups.…”

Section: Methodsmentioning

confidence: 99%

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Knowledge, Barriers and Motivators to Cervical Cancer Screening in Rwanda: A Qualitative Study

Gafaranga¹,

Manirakiza²,

Ndagijimana³

et al. 2022

IJWH

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Background Cervical cancer is a global public health problem with marked geographical disparity. High morbidity and mortality rates in developing countries are associated with low screening rates. In 2020, in Rwanda, 3.7 million women aged 15–59 years were at risk of developing cervical cancer, the most commonly diagnosed female cancer in Rwanda. Despite Rwanda being the first African country to vaccinate against human papilloma virus with a three-dose regimen vaccination coverage of nearly 93% in the target population of girls aged <15 years, and having established cervical cancer screening program, recent studies have found low screening rates. Our study sought to determine knowledge, motivators and barriers of cervical cancer screening. Methods We conducted a qualitative descriptive study; using focus group interview in an urban health facility (Muhima district hospital) and a rural health center (Nyagasambu health center) offering cervical screening services in Rwanda. Participants were women seeking these services and other women attending the health facility for any reason, and female staff working in these facilities. Interviews were recorded and transcribed, and data were analyzed using content analysis. Results Thirty women participated in focus group interview, with an average age of 39 years. Many of women showed knowledge about cervical cancer existence and prevention methods. However, fear for pain, lack of knowledge about screening, how and where the screening was done, and concern for privacy were recurring subthemes. Some participants also mentioned lack of health insurance as a barrier for cervical cancer screening. Conclusion Barriers to uptake cervical cancer screening services in Rwanda are related to poor information about cervical cancer and the importance of screening as well as non-adherence to medical insurance. Population sensitization through campaign and community outreach activities could have a positive impact on increasing the usage of cervical cancer screening in Rwanda.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Knowledge, Barriers and Motivators to Cervical Cancer Screening in Rwanda: A Qualitative Study

Gafaranga¹,

Manirakiza²,

Ndagijimana³

et al. 2022

IJWH

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“…Evidence supports the nding that inequalities in these underserved cervical pre-cancer screening countries favoured women who were older, resided in urban areas, were more educated and in the highest wealth quintile than younger women, who lived in rural areas, were uneducated and in the lowest wealth quintile [9,17,18]. Studies conducted in Ethiopia, Rwanda, Tanzania, Zambia, and Zimbabwe, also support this nding [10,27,28,12,29,11,12,13,14,15]. A study of 18 resource-constrained countries, of which eight were from sub-Saharan Africa further found that wealth status increased socioeconomic inequalities in cervical pre-cancer screening, whereas being married, unemployed and living in urban communities reduced it [9].…”

Section: Discussionmentioning

confidence: 58%

Socioeconomic inequalities in cervical pre-cancer screening among women in Ethiopia, Malawi, Rwanda, Tanzania, Zambia, and Zimbabwe – Analysis of Population-Based HIV Impact Assessment surveys

Chipanta

Kapambwe

Nyondo-Mipando

et al. 2022

Preprint

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Background: Screening for cervical pre-cancerous lesions may be inequitable among women in sub-Saharan African countries. This study examined age, residence, education and wealth inequalities and their combinations on cervical pre-cancer screening in Ethiopia, Malawi, Rwanda, Tanzania, Zambia, and Zimbabwe. Methods: We used the Population-Based HIV Impact Assessment (PHIA) data, including cervical pre-cancer screening variables and measured the magnitude of inequality between subgroups in percentages points, considering differences of 20%+ as high inequality, 5% to 20% medium, 0 to 5% as low. We described the sample characteristics using descriptive statistics for each country and examined the associations between cervical pre-cancer screening and each inequality. We analysed the differences using multivariable logistic regressions, controlling for covariates. We estimated the inequalities in cervical pre-cancer screening probability for each inequality alone and in combinations using marginal effects models. Results: The sample size of females aged 25–49 years ranged from 5882 in Ethiopia to 9186 in Tanzania. Self-reported cervical pre-cancer screening was low in the surveyed countries ranging from 3.5% (95% Confidence Interval (CI) 3.1%–4.0%) in Rwanda to 17.1% (95% CI 15.8%–18.5%) and 17.4% (95% CI16.1%–18.8%) in Zambia and Zimbabwe. Inequalities in cervical pre-cancer screening were low based on age, residence, education, and wealth. Combining the inequalities led to significant inequalities in self-reported cervical pre-cancer screening between rural dwelling women aged 25–34 years, in the lowest wealth quintile, with a primary education level, and urban dwelling women aged 35–49 years, in the highest quintile, with the highest education level ranging from 4.4% in Rwanda to 44.6% in Zimbabwe. Conclusions: Cervical pre-cancer screening was inequitable and low. None of the countries achieved one-third of the World Health Organisation target of screening 70% of eligible women for cervical pre-cancer by 2030. Inequalities in cervical pre-cancer screening related to age, rural-urban residence, education, and wealth were low. Their combinations led to high inequalities, preventing younger, rural-dwelling, uneducated, women in the lowest wealth quintile from cervical pre-cancer screening. Governments should include and monitor equity in their cervical pre-cancer screening programmes. Research is needed to understand how to scale up equitable cervical pre-cancer screening.

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Understanding the cervical cancer self-collection preferences of women living in urban and rural Rwanda

Nair

Dau

Vidler

et al. 2023

Preprint

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PURPOSE Cervical cancer is a leading cause of cancer among women in low- and middle-income countries. Women in Rwanda have high rates of cervical cancer due to limited access to effective screening methods. Research in other low-resource settings similar to Rwanda has shown that HPV-based self-collection is an effective cervical cancer screening method. This study aims to compare the preferences of Rwandan women in urban and rural settings toward self-collection and to report on factors related to self-collection amenability. METHODS A cross-sectional survey was conducted from June 1-9, 2022. Women were recruited from one urban and one rural clinic in Rwanda. Women were eligible for the study if they were ≥ 18 years and spoke Kinyarwanda or English. The survey consisted of 51 questions investigating demographics and attitudes towards self-collection for cervical cancer screening. We reported descriptive statistics stratified by urban and rural sites. RESULTS In total, 169 urban and 205 rural women completed the survey. The majority of respondents at both sites had a primary school or lower education and were in a relationship. Both urban and rural respondents were open to self-collection; however, rates were higher in the rural site (79.9% urban and 95.6% rural; p-value<0.001). Similarly, women in rural areas were more likely to report feeling unembarrassed about self-collection (65.3% of urban, 76.8% of rural; p-value<0.001). Notably, almost all urban and rural respondents (97.6% urban and 98.5% rural) stated they would go for a cervical cancer pelvic examination to a nearby health center if their self-collected results indicated any concern (p-value=0.731). CONCLUSION Rwandan women in both urban and rural areas largely support self-collection for cervical cancer screening. Further research is needed to better understand how to implement self-collection screening services in Rwanda.

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Knowledge, utilization and barriers of cervical cancer screening among women attending selected district hospitals in Kigali - Rwanda

Cited by 21 publications

References 32 publications

Knowledge, Barriers and Motivators to Cervical Cancer Screening in Rwanda: A Qualitative Study

Knowledge, Barriers and Motivators to Cervical Cancer Screening in Rwanda: A Qualitative Study

Socioeconomic inequalities in cervical pre-cancer screening among women in Ethiopia, Malawi, Rwanda, Tanzania, Zambia, and Zimbabwe – Analysis of Population-Based HIV Impact Assessment surveys

Understanding the cervical cancer self-collection preferences of women living in urban and rural Rwanda

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