Determinants of Uptake of Cervical Cancer Screening Services at a No-cost Reproductive Health Clinic Managed by Nurse-Midwives.
BACKGROUND
The incidence of cervical cancer (CC) has been rising in sub-Saharan Africa, and health authorities in this region have responded by increasing the availability of cheap or no-cost CC screening services (CCSS), public health education, and others. However, the efforts have not yet resulted into the expected uptake of CCSS.


OBJECTIVE
The aim of this study was to examine the determinants of uptake of CCSS at a no-cost reproductive health clinic managed by nurse-midwives.


METHODS
A descriptive design and a structured interview questionnaire were used to collect data from 236 women attending the reproductive health clinic. Logistic regression statistics were used to examine the determinants of uptake of CCSS.


RESULTS
The mean age of participants was 28.7 years, and only 29% had received CC screening. The significant determinants of uptake of CCSS were concern about the gender of the healthcare professional (HCP) (odds ratio [OR], 5.03; P = .001), age older than 25 years (OR, 3.09; P = .005), contraceptive use (OR, 0.28; P = .02), encouragement by HCPs (OR, 0.16; P = .00), and perceived quality of CCSS (OR, 0.08; P = .00).


CONCLUSIONS
Gender of the HCP and encouragement or reminders by the HCP influence uptake of CCSS. Because nurse-midwives have successfully led strategies to promote other integrated reproductive health services, they can also play a key role in enhancing uptake of CCSS in resource-poor settings.


CONCLUSIONS
Interventions to enhance service quality and deliberate policies requiring HCP to recommend encourage and remind clients may help to enhance uptake of CCSS in resource-poor settings.
Author Affiliations: School of Health Sciences, College of Health Sciences, Department of Nursing, Makerere University, Kampala, Uganda (Mr Osingada and Ngabirano, Ms Ninsiima, and Dr Chalo); and College of Nursing, Department of Adult Health & Critical Care, Sultan Qaboos University, Muscat, Oman (Dr Muliira).
Charles P
CP
Osingada
Gloria
G
Ninsiima
Rose N
RN
Chalo
Joshua K
JK
Muliira
Tom
T
Ngabirano
D000328:Adult; D000367:Age Factors; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001294:Attitude to Health / Q000208:ethnology*; D016009:Chi-Square Distribution; D003466:Cultural Characteristics; D003906:Developing Countries; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D009721:Nurse Midwives / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014454:Uganda; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D055815:Young Adult