Barriers of Utilization of Cervical Precancerous Lesions Screening Services Among Women of Child Bearing Age in Lupane District, Zimbabwe

Abstract

Cervical cancer is one of the most common malignancies globally and ranking fourth amongst cancers, 530 000 new cervical cancer cases and 270 000 deaths are recorded annually. In Zimbabwe the burden of cervical cancer is about 35/100000, and a mortality rate of 60%, and could be higher as statistics are not accurate due to poor reporting, at most 2270 cases and 1450 deaths are recorded annually. Lupane District had the highest statistics of cervical precancerous lesions diagnosed through VIAC in the province in 2019, 95, when compared with other districts which offer the service, Bubi 53 and Nkayi 40 respectively. Lupane District has a total number of 20799 women of child bearing age, and only a fraction of them, 992 were screened, and that is (5%) utilization. This clearly indicated under utilization of the service in the District. The World Health Organization recommends (80%) screening for cervical precancerous lesions. An assessment into the barriers of utilization of cervical precancerous lesions screening services among women of child bearing age in Lupane District Matabeleland North Province, in Zimbabwe was undertaken. An analytic cross-sectional study, using interviewer administered questionnaire in 293 women was undertaken. A univariate, bivariate as well as multivariate analysis of data was done, using Epi Info 7.2. The following variables were found to be statistically significant barriers to the utilization of the cervical precancerous lesions screening service in Lupane District, grand multi parous [AOR= 20, p=0.000], marital status [AOR = 13, p=0.037] knowledge, [AOR= 11, p=0.041], primary level of education, [AOR = 8.0, p=0.03], income [AOR= 6, p=0.028]. Protective factors were, age [AOR= 1, p=0.132] and, religion [AOR= 2, p=0.321]. Awareness campaigns on cervical cancer and availability of cervical precancerous screening services need to be intensified. Integration of cervical cancer screening with other reproductive health services like family planning has to be advocated for. Women empowerment to enable them to make independent decisions in matters related to their health to enable them to undertake cervical cancer screening.