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

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

doi:10.5737/23688076313266274

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

Can Oncol Nurs J. 2021 Jul 1;31(3):266-274. doi: 10.5737/23688076313266274. eCollection 2021 Summer.

Authors

Gaudence Niyonsenga¹, Darius Gishoma², Ruth Sego³, Marie Goretti Uwayezu², Bellancille Nikuze², Margaret Fitch², Pierre Céléstin Igiraneza⁴

Affiliations

¹ King Faisal Hospital, Kigali, Rwanda.
² School of Nursing and Midwifery, University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.
³ Rory Meyer's College of Nursing, New York University, New York, USA and the Bloomberg Faculty of Nursing, University of Toronto, Canada.
⁴ Alight Rwanda, Nyabiheke Refugee Camp, Rwanda.

Abstract

Background: Cervical cancer is the third most common cancer attacking women globally, and the second in Eastern Africa where Rwanda is located. Regular screening is an effective prevention approach for cervical cancer. Despite that, the screening rate for cervical cancer in Africa is estimated between 10% and 70%, with a number of barriers. This is especially the case in sub-Saharan Africa. In Rwanda, there is limited literature on the rate of use of screening services or the barriers to cervical screening.

Objective: To assess knowledge, utilization, and barriers of cervical cancer screening among women attending selected district hospitals in Kigali, Rwanda.

Methods: A descriptive cross-sectional study with a structured questionnaire was used to collect data. Nominal 'yes' or 'no' questions were used to gather data on knowledge and utilisation of cervical cancer and its screening. Likert-type scale questions were used to identify different barriers to screening services. Data were analysed using descriptive and inferential statistics. Respondents were selected by systematic random sampling from the database of women attending gynaecology services at three district hospitals in Kigali, Rwanda.

Results: Three hundred and twenty-nine women responded to the survey. Half of the respondents (n = 165) had high knowledge level scores on cervical cancer screening. The cervical cancer screening rate was 28.3%. Utilization of screening was associated with knowledge (P = 0.000, r = -0.392) and selected demographic factors (P = 0.000). Individual barriers included poor knowledge on availability of screening services, community barriers included living in a rural area, and health provider and systems barriers included lack of awareness campaigns, negative attitudes of healthcare providers toward clients, and long waiting times; all barriers limit the access to screening services.

Conclusion: A low rate of cervical cancer screening was identified for women attending selected district hospitals in Kigali-Rwanda due to various barriers. On-going education on cervical cancer and its screening is highly recommended. It is important that trained health providers encourage their clients to have cervical cancer screening and work to reduce related barriers.

Keywords: barriers to screening; cervical cancer; cervical screening; knowledge about screening; screening in LMIC; utilization of cervical screening.