Challenges to Visual Cervical Cancer Screening Service Intergration and Utilization in Imenti South Sub-County Reproductive Health Care System, Meru County, Kenya
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Date
2016-06
Authors
Njiru, Jeremy Murithi
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Cancer is among the leading causes of morbidity and mortality worldwide with
approximately fourteen million new cases and eight million cancer related deaths
annually with an approximated 60 per cent of these new cases and 70 percent of these
deaths occurring in Africa and other developing countries. Cervical cancer in
particular has contributed a fair share of this burden. In Kenya, cervical cancer
incidence and prevalence is second to breast cancer and leading cause of cancer
related deaths among Kenyan women with most cases being diagnosed when it is too
late for any interventions. The solution lies in early screening of women, with visual
cervical cancer screening approach being the most feasible for low resource settings
in developing countries. Kenya, in recognition of this piloted and adopted this
screening approach in the year 2002 in efforts to integrate the screening approach in
all the reproductive health clinics through formation of national cervical cancer
prevention strategic plan with an aim of raising screening coverage to over 70 per
cent. Despite this effort, the population of women screened remains alarmingly low
with an estimated screening prevalence of only 3.2 per cent nationally. This crosssectional
study sought to identify challenges to visual cervical cancer screening
service integration and utilization in Imenti South Sub-County, Kenya with the
specific objectives of determining the proportion of respondents utilizing visual
cervical cancer screening service, how respondents socio-demographic and
reproductive health factors, facility based and system based factors influence
integration and utilization of visual cervical cancer screening service. Six
reproductive clinics were sampled for the study out of the nineteen in the Sub-County
and a total of 354 respondents visiting the sampled reproductive health clinics.
Questionnaires, checklist and key informant interviews were used to collect data. Chisquare and Fisher exact test were used to test significant associations with a P ≤ 0.05 being considered significant while qualitative data was analyzed and discussed in key thematic areas. The sampled reproductive health clinics had the required screening
resources, however only 20 per cent of the respondents had ever been screened for
cervical cancer at the time of this study. The opportunistic screening approach, Low
level of awareness, inexistence of a functional referral system, poor reporting,
monitoring and supervision on visual screening were key screening challenges among
others. The study concluded that, establishing clinical services alone will not achieve
the desired screening target unless critical components are put in place to address the
observed challenges in this study.
Description
A Research Thesis Submitted for the Degree of Master of Science (Reproductive Health) in the School of Public Health of Kenyatta University June, 2016.