Uptake of Cervical Cancer Screening and Associated Factors Among Women Attending Outpatient Services in Rwamagana Hospital, Rwanda

Ndateba, Innocent; Kabatsinda, Athanasie; Ndabarora, Eléazar

doi:10.4314/rjmhs.v4i3.8

Cited by 5 publications

(6 citation statements)

References 21 publications

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“…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%

“…14 Different studies about cervical cancer screening in Rwanda reported a participation rate ranging from 2.6% to 28.3%. 15,[17][18][19] For example, Mukanyangezi et al 19 reported that only 7% in HIV-negative women and 27% in HIVpositive women have ever participated in cervical cancer screening. The aim of this study was to elucidate knowledge, barriers and motivators that may affect Rwandan women in using cervical cancer screening services, in order to improve the overall utilization of this program and thus contribute to the prevention of cervical cancer.…”

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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: 99%

mentioning

confidence: 99%

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%

“…The sample size of females aged 25-49 years ranged from 5882 in Ethiopia to 9186 in Tanzania. The median age and interquartile ranges were 32 years (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39) in Ethiopia, 33 years (29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) in Zambia and 34 years (29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) in Malawi, Rwanda, and Tanzania. The rate of self-reported cervical pre-cancer screening was lowest in Rwanda (3.5% [95% CI 3.1%-4.0%]) and highest in Zambia (17.1% [95% CI 15.8%-18.5%]) and Zimbabwe (17.4% [95% CI 16.1%-18.8%]).…”

Section: Resultsmentioning

confidence: 99%

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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“…Evidence supports the finding that inequalities in these underserved cervical precancer screening countries favoured women who were older, resided in urban areas, were more educated and in the highest wealth quintile than women who were younger, 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 finding 10–15 34–36. 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 precancer screening, whereas being married, unemployed and living in urban communities reduced it 9.…”

Section: Discussionmentioning

confidence: 71%

Socioeconomic inequalities in cervical precancer screening among women in Ethiopia, Malawi, Rwanda, Tanzania, Zambia and Zimbabwe: analysis of Population-Based HIV Impact Assessment surveys

et al. 2023

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ObjectivesWe examined age, residence, education and wealth inequalities and their combinations on cervical precancer screening probabilities for women. We hypothesised that inequalities in screening favoured women who were older, lived in urban areas, were more educated and wealthier.DesignCross-sectional study using Population-Based HIV Impact Assessment data.SettingEthiopia, Malawi, Rwanda, Tanzania, Zambia and Zimbabwe. Differences in screening rates were analysed using multivariable logistic regressions, controlling for age, residence, education and wealth. Inequalities in screening probability were estimated using marginal effects models.ParticipantsWomen aged 25–49 years, reporting screening.Outcome measuresSelf-reported screening rates, and their inequalities in percentage points, with differences of 20%+ defined as high inequality, 5%–20% as medium, 0%–5% as low.ResultsThe sample size of participants ranged from 5882 in Ethiopia to 9186 in Tanzania. The screening rates were low in the surveyed countries, ranging from 3.5% (95% CI 3.1% to 4.0%) in Rwanda to 17.1% (95% CI 15.8% to 18.5%) and 17.4% (95% CI 16.1% to 18.8%) in Zambia and Zimbabwe. Inequalities in screening rates were low based on covariates. Combining the inequalities led to significant inequalities in screening probabilities between women living in rural areas aged 25–34 years, with a primary education level, from the lowest wealth quintile, and women living in urban areas aged 35–49 years, with the highest education level, from the highest wealth quintile, ranging from 4.4% in Rwanda to 44.6% in Zimbabwe.ConclusionsCervical precancer screening rates were inequitable and low. No country surveyed achieved one-third of the WHO’s target of screening 70% of eligible women by 2030. Combining inequalities led to high inequalities, preventing women who were younger, lived in rural areas, were uneducated, and from the lowest wealth quintile from screening. Governments should include and monitor equity in their cervical precancer screening programmes.

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Uptake of Cervical Cancer Screening and Associated Factors Among Women Attending Outpatient Services in Rwamagana Hospital, Rwanda

Cited by 5 publications

References 21 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

Socioeconomic inequalities in cervical precancer screening among women in Ethiopia, Malawi, Rwanda, Tanzania, Zambia and Zimbabwe: analysis of Population-Based HIV Impact Assessment surveys

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