Assessment of barriers to cervical cancer screening at primary health care centers in Makurdi, North-Central Nigeria: a mixed-methods study.

Abstract

Background: The major burden of cervical cancer occurs in low income countries in sub-Saharan Africa despite efforts to improve uptake of cervical cancer screening. This study aims to assess the gaps and barriers to cervical cancer screening at primary health care centers in Makurdi, North Central Nigeria.

Methods: This was a convergent parallel mixed method approach involving a cross-sectional study of 288 women aged 25-65 years and 30 key informant interviews (KIIs) with healthcare workers, women and male partners across five primary healthcare centers in Makurdi. Data were collected using an interviewer-guided online questionnaire (Kobo Collect) and a semi-structured interview guide. The quantitative data were analyzed with the Statistical Package for the Social Sciences (SPSS) version 20 (Armonk, NY: IBM Corporation), and the qualitative data were transcribed verbatim using Turboscribe.ai. and analyzed thematically with both inductive and deductive approaches to identify key patterns and themes.

Results: Female participants were mostly between the ages of 25-34 years (76.4%), traders (41%), with secondary education (46.2%) and with an average monthly income of less than 30,000 naira (50.7%). The gaps limiting cervical cancer screening at primary healthcare centers include no routine cervical cancer screening, lack of trained manpower, lack of equipment, lack of training for hospital staff, inadequate knowledge among healthcare workers, and inadequate funding. The barriers to cervical cancer screening include poor knowledge of cervical cancer and cervical cancer screening, the high cost of cervical cancer screening, no knowledge of where to go for cervical cancer screening, low perception of the risk of being susceptible to cervical cancer, fear of cervical cancer, distance to the health facility and lack knowledge of the importance of cervical cancer screening.

Conclusions: This study underscores the need for capacity building among healthcare workers and facility upgrades at primary health care centers as well as awareness creation in the community as keys to improving uptake of cervical cancer screening.