FACTORS INFLUENCING UTILISATION OF CERVICAL CANCER SCREENING SERVICES AMONG WOMEN OF REPRODUCTIVE AGE IN GOMBE LOCAL GOVERNMENT AREA, GOMBE STATE, NIGERIA.

Abstract

Cervical cancer is the second most common female cancer in women aged 15 to 44 years in Nigeria. Screening is one of the most cost-effective control strategies for the disease but its low utilisation has remained an issue of public health concern. Therefore, this study determined factors influencing the utilisation of cervical cancer screening services among women of reproductive age in Gombe Local Government Area, Gombe State, Nigeria. This was a community-based, cross-sectional study design. Multi-stage sampling technique was used to select 230 women between the ages of 15 and 49 years in Gombe Local Government Area, Gombe state. A semi-structured interviewer-administered questionnaire was used to collect information from the respondents. Knowledge on cervical cancer was measured using a 45-point scale; scores between ≤15, >15≤30 and >30≤45 were categorised as poor, fair and good knowledge respectively. Respondents' attitude was measured on a 9-point scale; scores between ≤4 and >5≤9 were categorised as negative and positive attitude respectively. Descriptive statistics, Fishers' exact and Chi-square tests were used to analyze data and the level of statistical significance was set at α ≤ 0.05. The respondents' age ranged from 15-49 years with a mean age of 29.64+8.06 years. More than half 121 (52.2%) of the respondents were Muslims, 130(56.5%) were married and 83 (70.3%) of those married were in a monogamous relationship. Few (4.8%) of the respondents had good knowledge of cervical cancer. Most 199 (86.5%) knew that cervical cancer can lead to death, less than half, 105 (45.7%) knew that HPV infection has been identified as the major cause of cervical cancer. A little more than half (52.2%) had a positive attitude towards cervical cancer screening, while only 9.5% of the respondents aged 25-49 years had undergone cervical cancer screening using Pap smear test. More than half, 128 (55.7%) of the respondents did not have health care facilities where cervical cancer screening is done in their locality. Factors influencing utilisation of cervical screening services was the fact that screening for cervical cancer was not recommended by their doctors or a nurse 95 (41.3%), 80(34.8%) said they were healthy so it is not necessary, almost a quarter of the respondents 56 (24.3%) indicated that fear of the procedure was the reason why they did not go for cervical cancer screening. There was an association between respondents' level of education (p=0.048), level of income (p=0.037), religion (p=0.035), attitude towards cervical cancer screening (p=0.049), availability of health facilities for cervical screening (0.000) and utilisation of cervical cancer screening services. Majority of the respondents had fair knowledge on cervical cancer, a little more than half had a positive attitude towards cervical cancer screening. The utilisation level of cervical cancer screening was low. Therefore, appropriate interventions targeting women, the households, communities and health facilities in Gombe should be planned and implemented by Gombe State health Ministries, Departments and Agencies in order to increase the utilisation of cervical cancer screening services in the state.