Thesis:

Determinants of cervical pre-cancer screening uptake among women attending Mbagathi level four hospital in Nairobi, Kenya

Cervical cancer poses a significant global health challenge, causing around 340,000 deaths annually and ranking as the fourth most frequent cancer worldwide. This study aimed to determine the factors influencing the uptake of cervical pre-cancer screening among women at Mbagathi Level Four Hospital in Nairobi, Kenya. The specific objectives were to determine screening rates, assess awareness levels, and identify socio-cultural and psychological factors affecting screening uptake. The Health Belief Model provided the theoretical framework for this study. An analytical cross-sectional design was employed, targeting women aged 25-49 years attending Mbagathi Level Four Hospital. Systematic random sampling was used to select 213 participants. Data collection involved semi-structured questionnaires, which were pre-tested for validity and reliability, achieving a Cronbach's alpha of 0.78. Data management and analysis were conducted using SPSS version 26. Descriptive statistics summarized demographic data, while inferential statistics, including Chi-Square tests and logistic regression, identified associations and predictors of screening uptake. The study found that the cervical pre-cancer screening rate among the participants was 39.6%. Awareness levels were high, with 80.8% of women having heard about cervical pre-cancer screening. However, significant socio-cultural and psychological barriers influenced screening uptake. Marital status, educational attainment, and psychological factors such as fear and perceived susceptibility were significant determinants (p < 0.05). Younger women, particularly those aged 25-29 years, exhibited higher screening rates compared to older age groups. Married women were more likely to participate in screening than single women, indicating the influence of marital support on health behaviors. The logistic regression analysis revealed that higher educational attainment significantly predicted increased screening uptake (OR = 2.3, p = 0.01). Women with a higher perceived susceptibility to cervical cancer were also more likely to undergo screening. The Chi-Square test demonstrated a significant association between awareness and screening uptake (χ² = 10.24, p = 0.001). Despite high awareness, psychological barriers such as fear of a positive result and socio-cultural factors like stigma and support from spouses and community members remained substantial obstacles. In conclusion, while awareness of cervical pre-cancer screening is high among women at Mbagathi Level Four Hospital, socio-cultural and psychological barriers continue to impede screening uptake. To improve screening rates, it is recommended that targeted educational campaigns be enhanced, addressing specific socio-cultural barriers and providing psychological support to alleviate fears associated with screening. These interventions could significantly contribute to increasing cervical pre-cancer screening rates and ultimately reduce the burden of cervical cancer in this population.