Details
Category: Volume 06 Issue 12 December 2018
Hits: 1080

Title: Reasons for Low Uptake of Cervical Cancer Preventive Services in Kenya and other Low- Middle Income Countries: A Review Article

Authors: James Mburu Kangethe, Onesmus Wairubi Gachuno, James Gitau Komu, Kenneth Kipyegon Muta, Raphael Mwamtsi Lwembe

 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.169

Abstract

Invasive cervical cancer (ICC) has been documented to be the major cause of cancer-related deaths among women majorly in low and middle income countries such as Kenya. Despite cervical cancer increasingly being a huge national public health problem, uptake of cervical cancer preventive services in health facilities is still as low as 5%. The aim of this review was to identify all documented reasons for the very low utilization of cervical cancer preventive services in Kenya and other low- middle income countries and the proposed interventional strategies to increase the uptake. Using the key words cervical cancer screening, cervical cancer prevention, barriers, low- middle income countries and Kenya, an online search was done for published articles, reviews reports on uptake of cervical cancer preventive services. In total, 48 articles published between 2000 and 2018 were analyzed.

 Three broad reasons identified as main factors hindering women at risk from utilizing cervical cancer preventive services in low- middle income countries include personal or individual, health systems and societal perspectives.

In order to significantly improve the uptake of cervical cancer preventive services in Kenya and other low- middle income countries, there is an urgent need to prioritize and integrate strategies to identify most suitable interventions. This review proposes on the interventions that will focus on health policies, sensitization of the African health care providers and awareness creation targeting women at risk of cervical cancer.

References

  1. Allliance for Cervical Cancer Prevention. (2004). Improving Screening Coverage Rates of Cervical Cancer Prevention Programs: A Focus on Communities. In: Cervical Cancer Prevention Issues in Depth; 4.
  2. Arlene C. (2005). Social construction of cervical cancer screening among women in Panama City, Panama. University of South Florida.
  3. Banura C., Mirembe F., Katahoire A., Namujju P, Mbidde E. (2012).Universal routine HPV vaccination for young girls in Uganda: a review of opportunities and potential obstacles. Infect Agent Cancer; 7(1):2.
  4. Bingham A., Bishop A., Coffey P., Winkler J., Bradley J.et al. (2003). Factors affecting utilization of cervical cancer prevention services in low-resource settings. Salud Publica Mex.; 45 Suppl 3:S408-416.
  5. Bukirwa A., Mutyoba J., Mukasa B., Karamogi Y., Odiit M., et al. (2015). Motivations and barriers to cervical cancer screening among HIV infected women in HIV care: a qualitative study. BMC Women Health; 15: 82
  6. Chidyaonga- Maseko F., Chirwa M., Muula A. (2015). Underutilization of cervical cancer prevention services in low and middle income countries: a review of contributing factors. Pan African Medical Journal; 21:231.
  7. Coleman J., Cespedes M., Cu- Uvin S., Kosgei R., Maloba M., et al. (2016).An insight to cervical cancer screening and treatment in Sub Saharan Africa. J Low Genit Tract Dis. ; 20(1): 31–37.
  8. Cunningham M., Skrastins E., Fitzpatrick R., Jindel P., Oneko O. (2015). Cervical cancer screening and HPV vaccine acceptability among rural and urban women in Kilimanjaro Region, Tanzania. BMC Open; 5.
  9. Gakidou E., Nordhagen S., Obermeyer Z. (2008). Coverage of Cervical Cancer Screening in 57 Countries: Low Average Levels and Large Inequalities. PLoS Med. 2008; 5(6).
  10. Gichangi P., Estambele B., Bwayo J., Rogo K., Ojwang s. (2003). Knowledge and practice about cervical cancer and Pap smear testing among patients at Kenyatta National Hospital, Nairobi, Kenya. International Journal of Gynecological cancer. 13 (16):827-833.
  11. Hawes S., Critchlow C., Faye Niang M., Diouf M., Diop A, Touré P, et al. (2003). Increased Risk of High-Grade Cervical Squamous Intraepithelial Lesions and Invasive Cervical Cancer among African Women with Human Immunodeficiency Virus Type 1 and 2 Infections. J Infect Dis.; 188 (4):555–63.
  12. Huchko M., Maloba M., Nakalembe M., Cohen C. (2015). The time has come to make cervical cancer prevention an essential part of comprehensive sexual and reproductive health services for HIV-positive women in low-income countries. Journal of the International AIDS society; 18 (suppl 5)20282.
  13. International Agency for Research on Cancer (IARC).(2012). International Agency for Research on Cancer (IARC). Available from: http://globocan.iarc.fr/old/FactSheets/cancers/cervix-new.asp. Accessed 31 March 2018.
  14. Kahesa C., Kjaer S., Mwaiselage J., Ngoma T., Tersbol B. et al. (2012). Determinants of acceptance of cervical cancer screening in Dare Salam, Tanzania. BMC Public Health; 12:1093.
  15. Kawonga M., Fonn S. (2008). Achieving effective cervical screening coverage in South Africa through human resources and health systems development. Reproductive Health Matters; 16 (32):32-40.
  16. Kenyan National Cancer Institute (KNCI) - Access accelerated. (2015).

https://accessaccelerated.org/partner_initiative/kenyan-national-cancer-institute-knci/. Accessed 25th Nov 2018.

  1. Kessler S., Wexler C., Maloba M., Mabachi N., Ndikum- Moffor. et al. (2016). Cervical cancer prevention and treatment research in Africa: a systematic review from a public health perspective. BMC public Health; 16: 29
  2. LaMontagne D., Barge S., Le N., Mugisha E., Penny M. et al. (2011). Human papillomavirus vaccine delivery strategies that achieved high coverage in low- and middle-income countries. Bulletin of the World Health Organization; 89 (11):821-830B.
  3. S. LaMontagne, P.J.N. Bloem, J.M.L. Brotherton, K.E. Gallagher, O. Badiane, C. Ndiaye. (2017). Progress in HPV vaccination in low- and lower-middle-income countries Int J Gynaecol Obstet,138, pp. 7-14.
  4. Louie K., Sanjose S., Mayaoud P. (2009). Epidemiology and prevention of human papillomavirus and cervical cancer in sub-Saharan Africa: a comprehensive review. Tropical Medicine and International Health; 14: 1287-1302.
  5. Lukorito J., Wanyoro A, Kimani H. (2017). Uptake of cervical cancer screening among HIV positive women in Comprehensives Care Centers in Kenya. Research in Obstetrics and gynaecology; 5 (1) 1-6.
  6. Mariani L., Pagliusi S. (2008). Vaccination and screening programs: harmonizing prevention strategies for HPV-related diseases. J Exp Clin Cancer Res.; 27(1):84.
  7. Markovic M., Kesic V., Topic L., Matejic B. (2005). Barriers to cervical cancer screening: A qualitative study with women in Serbia. Social Science & Medicine; 61(12):2528-2535.
  8. McFarland D. (2003). Cervical cancer and Pap smear screening in Botswana: knowledge and perceptions. Int Nurs Rev.; 50 (3):167-175.
  9. Morema E., Atieli H., Onyango R., OMondiJ., Ouma C. (2014). Determinants of Cervical screening services uptake among 18–49 year old women seeking services at the Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, Kenya. BMC Health Services Research; 14: 335.
  10. Mupepi S., Sampselle c., Johnson T. (2011). Knowledge, Attitudes, and Demographic Factors Influencing Cervical Cancer Screening Behavior of Zimbabwean Women. Journal of Women’s Health; 20 (6).
  11. Mutyaba T., Mmiro F., Weiderpass E. (2006). Knowledge, attitudes and practices on cervical cancer screening among the medical workers of Mulago Hospital, Uganda. BMC Medical education; 6:13.
  12. Mwaka A., Wabinga H., Mayanja-Kizza H. (2013). Mind the gaps: a qualitative study of perceptions of healthcare professionals on challenges and proposed remedies for cervical cancer help-seeking in post conflict northern Uganda. BMC Family Practice; 14: 193.
  13. Saharabuddhe V., Parham G., Mwanahamtu M., Vermund S. (2012). Cervical Cancer Prevention in Low- and Middle-Income Countries: Feasible, Affordable, Essential. Cancer Prev Res; 5 (1): 11-17.
  14. Sankaranarayanan R., Budukh A., Rajkumar R. (2001). Effective screening programs for cervical cancer in low- and middle income developing countries. Bull World Health Organ; 79(10):954-962.
  15. Sankaranarayanan R., Budukh A., Rajkumar R. (2001). Effective screening programmes for cervical cancer in low- and middle income developing countries. Bull World Health Organ; 79(10):954-962.
  16. Teng F., Mitchelle S., Sekibubo M., Biryabarema C., Byamugisha J. (2014). Understanding the role of embarrassment in gynaecological screening: a qualitative study from the ASPIRE cervical cancer screening project in Uganda. BMJ Open; 4.
  17. Thomas V., Saleem T., Abraham R. (2005). Barriers to effective uptake of cancer screening among black and minority ethnic groups. International Journal of Palliative Nursing; 11(11).
  18. Townsens J., Storma A., Roland K., Bueconsenjo- Lum L., White S. eta l., (2014). Current Cervical Cancer Screening Knowledge, Awareness, and Practices among U.S. Affiliat.ed Pacific Island Providers: Opportunities and Challenges. The oncologist: 19: 383-393.
  19. Twinomujuni C., Nuwaha F., Babirye J. (2015). Understanding the Low Level of Cervical Cancer Screening in Masaka Uganda Using the ASE Model: A Community-Based Survey. PLOS ONE; (6) 10.
  20. Urasa M., Darj E. (2011). Knowledge of cervical cancer and screening practices of nurses at a regional hospital in Tanzania. Afr Health Sci.; 11(1):48-57.
  21. Were E., Nyaberi Z., Buziba N. (2011). Perceptions of risk and barriers to cervical cancer screening at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. African Health Sciences; 11 (1):58 -64.
  22. White H., Mulambia C., Sinkala M., Mwanahamuntu M., Parham G., Moneyham L., Grimley D., Chamot E. (2012). "Worse than HIV" or "not as serious as other diseases?" Conceptualization of cervical cancer among newly screened women in Zambia. Social Science & Medicine.
  23. Wong VS, Kawamoto C. (2010). Understanding cervical cancer prevention and screening in Chuukese women in Hawaii. Hawaii Med J.; 69(6 Suppl 3):13-16.
  24. World Health Organization (WHO). (2009) Human papillomavirus vaccines. WHO position paper; 117–32. Report No 15.
  25. World Health Organization. (2013). Comprehensive cervical cancer prevention and control: a healthier future for girls and women. WHO Guidance Note; Geneva

Corresponding Author

James Mburu Kangethe

Comprehensive Care Center, Kenyatta National Hospital, P.O.BOX 20723- 00202, Nairobi Kenya

Tel: +254726237390. Email: This email address is being protected from spambots. You need JavaScript enabled to view it.