https://orcid.org/0000-0003-4968-2885
Abstract
Background
Cervical cancer is a public health concern worldwide, and is increasing in developing countries. Despite the efforts of governments, demand for cervical cancer screening is low and not well studied. As such, this study was done to figure out the demand for cervical cancer screening in Tigray regional state.
Methods
A cross-sectional study design was conducted, and 1,010 participants were recruited using simple random sampling. Data were collected using an interviewer-administered questionnaire, and analysis was done using multilevel logistic regression.
Results
A total of 1,000 women were included in the final analysis. The mean age of participants was 32.57±8.56 years. Those demandeing cervical cancer screening numbered 480 (48%). Intraclass correlation indicated that 18.9% of the total variance in demand was attributable to differences across the cluster districts (p0.0001). Predictors of demand for cervical cancer screening were age 31–40 years (AOR 2.33, 95% CI 0.42–3.83) and 41–45 years (AOR 3.02, 95% CI 1.64–5.55), tertiary education (AOR 2.81, 95% CI 1.43–5.51), history of sexually transmitted disease (AOR 1.71, 95% CI 1.05–2.79), being knowledgeable about cervical cancer, (AOR 9.21, 95% CI 5.79–14.65), and having a positive attitude toward cervical cancer screening (AOR 8.32, 95% CI 5.53–12.51). Among community level variables, community awareness of cervical cancer and population:health institution ratio were factors associated with demand.
Conclusion
Demand for cervical cancer screening is low compared to the government‘s plan for 2020. Health professionals and leaders need to focus on communit- level demand creation for cervical cancer screening by planning health-promotion strategies.
Abbreviations
AIC, Akaike information criterion; BIC, Bayesian information criterion; ICC, intracluster correlation; LR, likelihood ratio; LROC, log of receiver-operating characteristic curve; PCV, proportional change in variance; STI, sexually transmitted infection;VIF, variance-inflation factor.
Data-Sharing Statement
Most of the relevant information is included in the manuscript, though raw data will be sent upon request.
Ethical Approval and Consent to Participate
Ethical approval was received from the institutional review board of the University of Gondar (registration OIV/P/RCS/05/308/2017). Participants were informed about the purpose of the study, that their participation was voluntary, their right of withdrawal, and the privacy and confidentiality of their information. Finally, written consent was checked before data collection.
Acknowledgments
We would like to acknowledge the University of Gondar, especially the Institute of Public Health, registrar, library, and secretary for creating an enabling environment and for their genuine and friendly facilitation of all research-related activities and legal issues. We would like also to extend our gratitude to the Tigray Regional Health Bureau and district health officers for their provision of support letters and guidance during data collection. Lastly, we express our heartfelt thanks to data collectors and participants for their genuine participation, information provision, and all their input in the development of this paper.
Author Contributions
All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data, took part in drafting the article or revising it critically for important intellectual content, gave final approval to the version to be published, and agree to be accountable for all aspects of the work.
Disclosure
The authors declare that they have no competing interests for this work.