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Research Article
Jean Pierre Gafaranga
University of Rwanda
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Cervical cancer is a global public health problem with marked geographical disparity. There are high morbidity and mortality rates in low- and middle-income countries (LMICs) associated with low screening rates. In 2020, in Rwanda, 3.7 million women aged 15–59 years were at risk of developing cervical cancer. It is the most commonly diagnosed female cancer in Rwanda with an incidence rate of 42 cases per 100,000 women per year. Despite Rwanda being the first African country to vaccinate against human papillomavirus (HPV) with a three-dose regimen, vaccination coverage of nearly 93 % in the target population of girls aged < 15 years, and having an established cervical cancer screening program, recent studies have found low screening rates. Our study sought to determine knowledge, motivators, and barriers to cervical cancer screening.
Methods: This was a qualitative phenomenological study conducted in an urban health facility (Muhima district hospital) and a rural health center (Nyagasambu health center) offering cervical screening services in Rwanda. Focus group discussion (FGD) participants were women seeking these services and other women attending the health facility for any reason, as well as female staff working in these health centers. We also interviewed a key informant (KI) from the national organization. FGD and KI interviews were recorded and transcribed, and the data were analyzed using thematic analysis.
Results: Thirty women were enrolled in the FGDs, with an average age of 39 years. Many FGD women showed knowledge about cervical cancer existence and prevention methods. However, fear for pain, lack of knowledge about screening, how and where the screening was done, and privacy concerns were recurring subthemes. Key-informant and some FGDs participants have also mentioned a lack of health insurance as a possible barrier for cervical cancer screening.
Conclusions: Barriers to the utilization of cervical cancer screening program in Rwanda are related to poor information about cervical cancer and the importance of screening among women, as well non-adherence to medical insurance schemes. Population sensitization through campaign and community outreach activities could have a positive impact on increasing the uptake of cervical cancer screening in Rwanda.
Keywords
cervical cancer, screening, fear for pain, qualitative, acceptance, Rwanda
No competing interests reported.
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Jean Pierre Gafaranga
University of Rwanda
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 27 Sep, 2021
No community comments so far
Reviews received
Received 13 Oct, 2021
Reviewers agreed
On 27 Sep, 2021
Reviewers invited
Invitations sent on 24 Sep, 2021
Editor assigned
On 24 Sep, 2021
Editor invited
On 24 Sep, 2021
Submission checks complete
On 24 Sep, 2021
First submitted
On 16 Sep, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Cervical cancer is a global public health problem with marked geographical disparity. There are high morbidity and mortality rates in low- and middle-income countries (LMICs) associated with low screening rates. In 2020, in Rwanda, 3.7 million women aged 15–59 years were at risk of developing cervical cancer. It is the most commonly diagnosed female cancer in Rwanda with an incidence rate of 42 cases per 100,000 women per year. Despite Rwanda being the first African country to vaccinate against human papillomavirus (HPV) with a three-dose regimen, vaccination coverage of nearly 93 % in the target population of girls aged < 15 years, and having an established cervical cancer screening program, recent studies have found low screening rates. Our study sought to determine knowledge, motivators, and barriers to cervical cancer screening.
Methods: This was a qualitative phenomenological study conducted in an urban health facility (Muhima district hospital) and a rural health center (Nyagasambu health center) offering cervical screening services in Rwanda. Focus group discussion (FGD) participants were women seeking these services and other women attending the health facility for any reason, as well as female staff working in these health centers. We also interviewed a key informant (KI) from the national organization. FGD and KI interviews were recorded and transcribed, and the data were analyzed using thematic analysis.
Results: Thirty women were enrolled in the FGDs, with an average age of 39 years. Many FGD women showed knowledge about cervical cancer existence and prevention methods. However, fear for pain, lack of knowledge about screening, how and where the screening was done, and privacy concerns were recurring subthemes. Key-informant and some FGDs participants have also mentioned a lack of health insurance as a possible barrier for cervical cancer screening.
Conclusions: Barriers to the utilization of cervical cancer screening program in Rwanda are related to poor information about cervical cancer and the importance of screening among women, as well non-adherence to medical insurance schemes. Population sensitization through campaign and community outreach activities could have a positive impact on increasing the uptake of cervical cancer screening in Rwanda.
No competing interests reported.
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