PREDICTORS OF CERVICAL CANCER SCREENING UPTAKE AMONG HEALTH CARE PROVIDERS IN SIAYA COUNTY, KENYA

Abstract

Cancer remains the second most common cause of death among women globally, with cervical cancer exhibiting the highest mortality rate among all cancer types. In Kenya, cervical cancer is the second most commonly diagnosed cancer in women overall and particularly affects those aged 15 to 44. Alarmingly, a growing number of healthcare professionals are being diagnosed with cervical cancer. Despite being instrumental in delivering cervical cancer screening services, few studies have examined the screening behavior of healthcare workers themselves. This study aimed to determine the proportion of healthcare providers who have undergone cervical cancer screening and to identify individual and systemic factors that influence screening uptake. Conducted across various hospitals in Siaya County—including Ambira, Madiany, Yala, Siaya County Referral, Bondo, and Ukwala—the study employed a cross-sectional analytical approach. A total of 186 healthcare providers, including nurses, clinical officers, and medical officers from level four hospitals, participated in the study. Both qualitative and quantitative data were collected. Statistical analysis was performed using SPSS version 28, incorporating descriptive statistics such as measures of central tendency, dispersion, frequencies, and percentages. To evaluate the determinants of cervical cancer screening uptake, bivariate logistic regression was used, and odds ratios (OR) were calculated to measure the strength of associations between variables. Qualitative responses were analyzed thematically, based on the research objectives. The findings revealed that 77.4% of healthcare providers had undergone cervical cancer screening, with the majority being screened between 2019 and 2022. Age significantly influenced screening behavior: individuals aged 20–29 were 60% less likely to have been screened (OR: 0.4; 95% CI: 0.2–0.8; p = 0.009). Marital status also played a role, with married healthcare providers nearly four times more likely to be screened compared to those who were single or widowed (OR: 3.8; 95% CI: 1.9–7.9; p = 0.0002). Parenthood was another factor, with those having no more than two children being three times less likely to have participated in screening compared to those with more children (OR: 0.3; 95% CI: 0.2–0.7; p = 0.004). Additionally, psychological factors such as perceived risk (OR: 0.2; 95% CI: 0.1–0.6; p = 0.003), confidence in one’s ability to act (self-efficacy) (OR: 0.3; 95% CI: 0.1–0.6; p = 0.0008), and motivation through reminders or encouragement (cue to action) (OR: 0.4; 95% CI: 0.1–1.1; p = 0.09) were linked to screening uptake. From a healthcare system perspective, both the availability of screening services (OR: 4.4; 95% CI: 1.5–13.2; p = 0.004) and the perceived acceptability of these services (OR: 5.0; 95% CI: 1.7–15.0; p = 0.001) significantly influenced participation rates. In conclusion, although healthcare workers are central to the delivery of medical services, a substantial portion have not undergone cervical cancer screening themselves. The study identified key psychological and system-level predictors—such as perceived vulnerability, self-confidence, motivation, service availability, and service acceptability—as crucial to improving screening uptake. The research recommends targeted awareness campaigns and designated sensitization days to increase understanding of cervical cancer risks among healthcare providers and to encourage routine screening.