Visual inspection with acetic-acid (VIA) service utilization and associated factors among women in Hawassa city, southern Ethiopia: a community based cross-sectional study.

Abstract

Background: Reducing cervical cancer mortality and morbidity using visual inspection with acetic acid (VIA) is a primary option, particularly in resource constrained countries. Although VIA screening is a priority program in Ethiopia, there is limited scientific evidence on prevalence of VIA screening service utilization and factors influencing screening practices in the community. This study aimed to assess the magnitude of visual inspection with acetic-acid (VIA) service utilization and associated factors in an urban community among women in Hawassa city, Southern Ethiopia.

Methods: This community-based cross-sectional study was conducted among women aged 30-49 years old who were residents of Hawassa city. The study population (n = 419) was recruited using a multistage random sampling technique. A pretested and structured interviewer-administered questionnaire was used to obtain information on sociodemographic characteristics, reproductive and behavioral variables, awareness of cervical cancer and VIA screening, and VIA screening practices. Multivariate logistic regression models were used to determine factors associated with VIA screening service utilization.

Results: A total of 411 women aged 30-49 were interviewed with a response rate of 98.1%. The visual inspection with acetic-acid (VIA) screening service was utilized by 85 women (20.7%). Multivariable logistic regression analysis showed that use of VIA screening service was significantly associated with older age (adjusted odds ratio (AOR) = 4.64, 95%CI: 2.15-10.01), having a history of sexually transmitted infection (STI), (AOR = 3.90, 95%CI: 2.02-7.53), having awareness about cervical cancer and VIA screening (AOR = 3.67, 95%CI:1.68-8.04), self-perceived susceptibility (AOR = 3.52,95%CI:1.74-7.13),receiving information from health workers (AOR = 4.519, 95%CI: 1.686-12.114) and having received community health education from health extension workers (AOR = 6.251, 95%CI:2.994-13.050).

Conclusion: Self-reported use of VIA screening was low in the study area. Age of participants, history of STI, awareness of cervical cancer and VIA screening, self- perceived susceptibility, receiving information from health workers and community health education from health extension workers were associated with increased prevalence of VIA screening service utilization. These findings suggest that educational and clinical interventions at the community levels and in healthcare facilities should be strengthened to improve cervical cancer risk knowledge, and to encourage women to seek cervical cancer screening in approved settings to order to increase utilization of the service.