Determinants of Utilization of Cervical Cancer Screening Services Among Women Living with Physical Impairements in Highfields, Harare, 2018-19

Abstract

Women living with physical impairments face challenges in accessing cervical cancer screening services. Preventive and health promotion activities like cervical cancer screening have been introduced to reduce morbidity and mortality but exclude women living with physical impairments. In Zimbabwe only 7.2% of women access cervical cancer screening services. The purpose of this study was to determine factors contributing to utilization of cervical cancer screening services by women living with physical impairments in Highfields, Harare from 2018 to 2019. An analytical crosssectional design was used in this study. Purposive sampling method was used to select 60 women living with physical impairments and three nurses working in the VIAC unit. An interviewer-administered questionnaire was used to collect data from the participants. A self-administered questionnaire was used to collect data from the nurses to ascertain the challenges in attending to women living with physical impairments. Epi info version 7 and Microsoft excel were used to analyse data. Descriptive statistics were based on frequencies while logistic regression, odds ratios and p-values were used for analytical statistics. Forty percent were single and 62.0% had children. Eighty percent of participants with physical impairments lived with a family member. Forty four percent had attained advanced level education and above; 48.7% were unemployed and 66.7% had a monthly income of USD200 or less. Source of information on cervical cancer screening was a health worker in 38.1% of the participants. Thirty-one (51.7%) participants had adequate knowledge on cervical cancer screening as they attained a score of more than 60% on knowledge assessment. Thirty three percent of nurses mentioned communication was difficult sometimes with women living with physical impairments and 100% nurses reported that for better service provision beds with side rails were needed. One hundred percent of the nurses reported that their health institution did not have outreach services that targeted women living with physical impairments. Previous pregnancy (COR=1.7; p<0.050) was most significant in determining the utilization of cervical cancer screening services. All these findings reveal that there is need to empower women living with physical impairments with accurate information regarding cervical cancer screening services. Educational and outreach campaigns that target women living with physical impairments are necessary in preventing cervical cancer.