Uptake of Cervical Cancer Screening Services among Women Aged 18 to 59 Years in Laikipia County, Kenya
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Date
2025-06
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Kenyatta University
Abstract
Cervical cancer develops in the cervix and is the fourth most common cancer globally, with over 500,000 cases and 300,000 deaths annually (World Bank, 2020). In Low- and Middle-Income Countries (LMICs), it ranks second despite being preventable, leading the WHO to prioritize it (World Bank, 2020). In Kenya, it is the second most common cancer and the leading cause of cancer deaths (World Bank, 2020). Uptake of cervical cancer screening (CCS) is very low at 17% nationally and 19% in Laikipia (KDHS, 2022). CCS is one of a strategy for detecting Human Papilloma virus (HPV) before this becomes cancerous. HPV causes 99% of cervical cancer (World Health Organization, 2021). Studies have shown that socio-demographic characteristics such as employment status, income, and age influence the acceptability of CCS. This descriptive cross-sectional study, guided by the Andersen and Newman Health Services Utilization Model, examined how personal characteristics, attitude, and health system factors influence CCS uptake. The study targeted 254 women aged 18–59 years in Laikipia County who had lived there for at least six months. Four community units were clustered, and proportionate sampling determined participant numbers per unit. Systematic random sampling was used. Data were collected via surveys and key informant interviews, using semi-structured tools. Bivariate and multivariate analysis was done using STATA version 15. Ethical approvals were obtained. Verbal consent was given by participants. CCS uptake was low at 29.1%. Most respondents were married, unemployed, aged 35–59, with secondary education and earning below Kshs. 5,000/month. Uptake was significantly associated with age (p < 0.001), employment (p = 0.013), income (p < 0.001), and specific knowledge (OR = 6.39; p < 0.001). Positive attitudes (OR = 18.0) and fewer perceived barriers increased uptake, while good self-health perception reduced it (OR = 0.151). Health system barriers included distance (OR = 0.313), cost, service availability, treatment awareness, and insurance. These findings underscore the urgent need for targeted health education, community-based outreach, improved healthcare accessibility, and the expansion of health insurance schemes to address both individual and systemic barriers and ultimately improve screening uptake and outcomes.
Description
A Project Report Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Science in Public Health Systems Management and Application in the School of Public Health and Applied Human Sciences of Kenyatta University, June 2025.
Supervisor
1. Peter Kithuka