The levels of utilization of visual inspection screening of cervical cancer in Kitui, Kenya

J. Mwangi, A. Gachau, E. Kabiru
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Abstract

Background: Cervical cancer is a disease of public health importance with a high global morbidity and mortality. More than 266,000 women die every year,with 87% of them coming from low and middle-income countries. These are the areas where programmes for screening and treatment are either deficient or underutilized. The morbidity and the mortality rates remain high in Kenya despite the screening and treatment services that the Ministry of Health has rolled out all over the country. Low levels of utilization of the established screening systems leads to increased morbidity and mortality. The problem is more prevalent in the rural Kenya where socioeconomic status of the majority in the population is low. Kitui County is such a rural region in Kenya. Objective: To determine the factors influencing the levels of utilization of the Visual Inspection method (VIA/VILI) for cervical cancer screening services in Kitui County, Kenya. Methodology: This was a descriptive study involving 370 women of reproductive age attending public MCH/FP clinics in Kitui County Kenya. Systematic random sampling method was used to select the participants. Exit interview was the main data collection technique. Key informants were also interviewed and facilities’ preparedness to provide adequate screening services was assessed using a facility survey checklist. Results: A total of 370 women were interviewed, 69.2% of whom were aged below 29 years, 68% were married, 75% had three or fewer children, 19% did not have the basic level of formal education and 61% were earning less than 50 US$per month. The level of awareness on cervical cancer and its prevention was 53.8%, with significant difference in relation to VIA/VILI utilization (OR 3.0675 p=0.000). Significance difference was also observed in cervical cancer testing and level of education (X 2 =21.728, df=3, P= 0.000), the main source of income, (X 2 = 15.030, df=2, P=0.01), average monthly income, (X 2 =27.942, df=4, P=0.0001) and the main decision maker in the family, (X 2 =6.908, df=2, p=0.032). Public health facilities were not adequately equipped and well staffed to provide the VIA/VILI screening services. Conclusion: Low levels (53.8%) of awareness about cervical cancer and its prevention among eligible clients in Kitui Central Sub-county Kenya, which was below the national target of over 70%, low coverage of health facilities and shortage of manpower lead to low levels of VIA/VILI screening. Therefore, there is a need to strengthen the existing services and interventions strategies, and enhance cancer awareness campaigns in order to reduce the incidence of the disease.
肯尼亚基图伊市宫颈癌目视检查筛查的利用水平
背景:宫颈癌是一种具有全球高发病率和高死亡率的重要公共卫生疾病。每年有26.6万多名妇女死亡,其中87%来自低收入和中等收入国家。在这些领域,筛查和治疗方案要么不足,要么利用不足。尽管卫生部在全国各地推出了筛查和治疗服务,但肯尼亚的发病率和死亡率仍然很高。现有筛查系统使用率低导致发病率和死亡率增加。这个问题在肯尼亚农村更为普遍,那里大多数人口的社会经济地位较低。基图伊县就是肯尼亚这样一个农村地区。目的:了解影响肯尼亚基图伊县宫颈癌目视检查方法(VIA/VILI)使用水平的因素。方法:这是一项描述性研究,涉及在肯尼亚基图伊县妇幼保健/计划生育公共诊所就诊的370名育龄妇女。采用系统随机抽样的方法选择研究对象。离职面谈是主要的数据收集方法。还对主要举报人进行了访谈,并使用设施调查清单评估了设施提供适当筛查服务的准备情况。结果:共采访了370名女性,其中69.2%的人年龄在29岁以下,68%的人已婚,75%的人有三个或更少的孩子,19%的人没有接受过基本的正规教育,61%的人每月收入低于50美元。对宫颈癌及其预防的知知率为53.8%,与VIA/VILI使用率有显著性差异(OR 3.0675 p=0.000)。宫颈癌检出率与受教育程度(x2 =21.728, df=3, P=0.000)、主要收入来源(x2 = 15.030, df=2, P=0.01)、平均月收入(x2 =27.942, df=4, P=0.0001)、家庭主要决策者(x2 =6.908, df=2, P= 0.032)也存在显著性差异。公共卫生设施没有足够的设备和人员来提供VIA/VILI筛查服务。结论:肯尼亚基图伊中部副县的合格客户对宫颈癌及其预防的认识水平较低(53.8%),低于70%以上的国家目标,卫生设施覆盖率低和人力短缺导致VIA/VILI筛查水平低。因此,有必要加强现有的服务和干预战略,并加强对癌症的认识运动,以减少该疾病的发病率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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