Knowledge, Attitude, and Practice Concerning Cervical Cancer Screening Among Market Women in Ikwerre L.G.A, River State
Chapter One
Objective of the Study
The purpose of this study is to assess the knowledge, attitude, and practice concerning cervical cancer screening among market women in Ikwerre L.G.A, Rivers State. The specific objectives of the study are:
- To evaluate the level of knowledge about cervical cancer and its risk factors among market women in Ikwerre L.G.A.
- To examine the attitude of market women towards cervical cancer screening in Ikwerre L.G.A.
- To determine the practice and frequency of cervical cancer screening among market women in Ikwerre L.G.A.
CHAPTER TWO
LITERATURE REVIEW
Conceptual Review
Cervical Cancer
Cervical cancer is a malignancy that originates in the cervix, the lower part of the uterus connecting to the vagina. It typically arises from pre-cancerous changes in the cervical cells, which can advance to invasive cancer if not detected early (World Health Organization, 2022). This condition is primarily associated with persistent infection by the human papillomavirus (HPV), a sexually transmitted virus. HPV infection is the leading cause of cervical cancer, and its progression to cancer is facilitated by several other risk factors including smoking, oral contraceptive use, multiple sexual partners, and immunosuppression (American Cancer Association, 2021).
Risk factors contributing to cervical cancer include both behavioural and biological elements. Persistent HPV infection is the most significant factor, but other factors like smoking and having a weakened immune system also increase the risk. Additionally, socioeconomic factors such as lack of access to healthcare and education about cervical cancer can exacerbate the risk, particularly among underserved populations (Burt et al., 2021). These factors highlight the importance of accessible screening and preventive measures to combat the disease effectively.
Globally, cervical cancer is a major public health issue, particularly in low- and middle-income countries where screening and treatment services are limited. It is the fourth most common cancer among women worldwide, with an estimated 604,000 new cases and 342,000 deaths in 2020 (Jedy-Agba et al., 2020). In Nigeria, cervical cancer is a significant concern, being the second most common cancer among women. The prevalence of cervical cancer in Nigeria is about 22.2 per 100,000 women, with a mortality rate of 12.4 per 100,000 (Neji et al., 2019). The high incidence and mortality rates in Nigeria reflect the challenges faced in screening and early detection, especially among underserved groups such as market women, who often face barriers to accessing healthcare services (Okolie et al., 2022).
Addressing these disparities requires targeted public health strategies to improve awareness and access to cervical cancer screening, particularly in populations with limited healthcare access (Zibako et al., 2021). By focusing on these underserved groups, public health interventions can better mitigate the impact of cervical cancer and reduce its prevalence and associated mortality.
Cervical Cancer Screening
Cervical cancer screening is crucial for the early detection and prevention of cervical cancer, utilizing various methods to identify pre-cancerous changes and HPV infections that could lead to cancer if left untreated. The primary screening methods include Pap smear and HPV testing. The Pap smear, also known as a Pap test, involves collecting cells from the cervix and examining them for abnormalities that may indicate pre-cancerous or cancerous changes. This test has been a cornerstone in cervical cancer screening for decades and has significantly contributed to the reduction in cervical cancer rates in many developed countries (World Health Organization, 2022).
HPV testing, on the other hand, detects the presence of high-risk HPV types that are known to cause cervical cancer. This test is often used in conjunction with or as an alternative to the Pap smear. HPV testing is particularly effective because it can identify individuals at higher risk of developing cervical cancer before any abnormal cell changes are detected. The combination of these tests can enhance screening effectiveness by providing a more comprehensive assessment of cervical health (Landy et al., 2022).
Regular cervical cancer screening is critical for early detection and prevention of the disease. Early detection through screening allows for timely intervention, which can significantly reduce mortality rates by treating pre-cancerous lesions before they progress to invasive cancer. Regular screening has been shown to decrease cervical cancer incidence and mortality, making it a vital component of public health strategies aimed at controlling the disease (Burt et al., 2021).
The practices and availability of cervical cancer screening vary considerably between developed and developing countries. In developed countries, regular screening programs are well-established and widely accessible, contributing to lower rates of cervical cancer and improved outcomes. For instance, the widespread use of Pap smears and HPV testing in these regions has led to substantial reductions in cervical cancer incidence and mortality (De Vito et al., 2023).
In contrast, developing countries often face significant barriers to effective cervical cancer screening, including limited access to healthcare facilities, lack of trained personnel, and insufficient public awareness about the importance of screening. These challenges contribute to higher cervical cancer rates and poorer outcomes in these regions. For example, in many parts of Sub-Saharan Africa, where resources for screening and treatment are scarce, cervical cancer remains a leading cause of cancer-related deaths among women (Jedy-Agba et al., 2020)
CHAPTER THREE
METHODOLOGY
Research Design
This study utilized a quantitative survey research design to investigate the factors influencing cervical cancer screening among market women. A quantitative approach was selected due to its effectiveness in collecting measurable and comparable data from a large population (Saunders, Lewis, & Thornhill, 2019). The survey design allowed for the systematic collection of data through structured questionnaires, providing a comprehensive view of market women’s knowledge, attitudes, and practices related to cervical cancer screening. The use of a quantitative design was justified as it enabled the collection of numerical data that could be statistically analyzed to identify patterns and correlations in screening behaviors.
Population of the Study
The target population for this study comprised 1,200 market women from various markets within the region. This population was selected due to its significant role in the local economy and its potential vulnerability to health disparities (Bell, Bryman, & Harley, 2019). Market women, often juggling multiple responsibilities, are a key demographic for public health interventions. The choice of a large population size aimed to ensure a representative sample that could provide reliable insights into the prevalence and factors affecting cervical cancer screening within this group.
CHAPTER FOUR
DATA PRESENTATION, ANALYSIS AND DISCUSSION
Data Presentation
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATIONS
Summary of Findings
The study aimed to assess the level of knowledge, attitudes, and practices regarding cervical cancer screening among market women in Ikwerre Local Government Area. The results offer a comprehensive view of the current state of cervical cancer awareness and screening practices within this community, providing valuable insights for public health interventions.
The first major finding of the study is that the majority of market women in Ikwerre L.G.A. possess a substantial level of knowledge about cervical cancer and its risk factors. This is evident from the high mean scores and t-values observed in the analysis. The data suggests that these women have been exposed to sufficient educational information about the disease, including its potential impacts on health. Such knowledge is crucial as it forms the foundation upon which informed health decisions are made. The elevated awareness levels are indicative of successful educational efforts and public health campaigns aimed at increasing understanding of cervical cancer within the community. However, despite the overall high knowledge levels, there are nuances in the data indicating that certain aspects of cervical cancer, particularly less commonly discussed risk factors, are not as well understood. This highlights an opportunity for further targeted education to cover these gaps and ensure comprehensive awareness.
The study also uncovered a generally positive attitude towards cervical cancer screening among the respondents. This is supported by a significant mean difference and high t-values, which reflect that the market women recognize the importance of screening as a preventive measure. Positive attitudes towards screening are a critical factor in encouraging participation, as they suggest a readiness to engage with health services. However, the data indicates that while attitudes towards screening are favorable, this does not always correlate with actual screening practices. This disconnection between positive attitudes and screening behavior points to potential barriers that may be preventing regular participation. It underscores the need for a deeper understanding of these barriers, which could include financial constraints, lack of access to healthcare facilities, or logistical issues related to scheduling and attending screenings.
In terms of actual screening practices, the study found that the frequency and regularity of cervical cancer screening among market women were lower than expected given their level of knowledge and positive attitudes. This discrepancy highlights a critical issue: despite being informed and having a positive view of screening, many women are not participating in regular screening programs. The data reveals a significant difference in screening practices, which suggests that there are factors beyond awareness and attitude that are influencing participation rates. Identifying and addressing these barriers is essential for improving screening uptake. Potential strategies could involve increasing accessibility to screening services, reducing associated costs, and implementing community-based initiatives that offer screenings at convenient locations and times.
Another important finding is the relationship between screening participation and knowledge about cervical cancer. The study indicates that women who have undergone cervical cancer screening generally have a higher level of knowledge about the disease compared to those who have not. This suggests that participating in screening programs often correlates with better understanding and awareness. This relationship underscores the importance of integrating educational components into screening programs. By combining screening with educational efforts, healthcare providers can enhance both knowledge and participation, creating a more effective approach to cancer prevention.
Additionally, the study found that discussions about cervical cancer screening with friends or family members are prevalent among the respondents. This reflects a community-oriented approach to health promotion, where individuals share information and encourage one another to participate in preventive measures. The positive aspect of this finding is that it indicates a supportive social environment that can be leveraged for further health promotion efforts. By encouraging discussions and peer support, public health initiatives can harness this community dynamic to increase awareness and promote regular screening practices.
In summary, the study provides a detailed overview of the state of cervical cancer awareness, attitudes, and practices among market women in Ikwerre L.G.A. The findings highlight that while there is a strong foundation of knowledge and positive attitudes towards cervical cancer and screening, there is a noticeable gap in actual screening practices. Addressing this gap requires a multifaceted approach that includes enhancing accessibility to screening services, reducing barriers, and integrating educational efforts with screening programs. By focusing on these areas, public health interventions can improve screening rates and ultimately contribute to better health outcomes for women in the community.
Conclusion
The results of the hypotheses tested reveal significant insights into the cervical cancer awareness and screening practices among market women in Ikwerre L.G.A. The analysis confirmed that there is a substantial relationship between the level of knowledge about cervical cancer and the practice of screening, highlighting that increased awareness is linked to better screening practices. Similarly, the study found a significant relationship between attitudes towards cervical cancer screening and actual screening practices, suggesting that while positive attitudes are prevalent, they do not always translate into consistent screening behavior.
Furthermore, the comparison between women who have undergone screening and those who have not indicated that knowledge levels are generally higher among those who participate in screening. This underscores the importance of integrating educational components into screening programs to enhance both knowledge and participation.
Overall, the study concludes that while knowledge and positive attitudes towards cervical cancer are high, these factors alone are insufficient to ensure regular screening. Addressing barriers to screening and improving accessibility are crucial for increasing participation rates. Effective public health strategies must focus on overcoming these barriers to bridge the gap between awareness and practice, ultimately improving cervical cancer prevention and health outcomes.
Recommendations
In line with the research objectives, the following recommendations are proposed to enhance cervical cancer awareness and screening practices among market women in Ikwerre L.G.A.:
- Enhance Educational Campaigns:Implement targeted educational campaigns that focus on increasing awareness about cervical cancer and its risk factors. These campaigns should utilize various media, including community gatherings, local radio, and social media, to ensure wide reach and engagement. Providing clear, accessible information can bridge the gap between knowledge and practice.
- Promote Regular Screening:Develop and promote programs that encourage regular cervical cancer screening. Community health workers and local clinics should offer reminders and incentives for regular screenings, making it easier for women to participate. Emphasizing the importance of early detection and making screenings more accessible can help increase participation rates.
- Address Attitudinal Barriers:Conduct workshops and discussions to address and correct any misconceptions or negative attitudes towards cervical cancer screening. Engaging influential community leaders and peers in these discussions can help shift attitudes and promote a more positive view of screening practices.
- Improve Accessibility:Ensure that cervical cancer screening services are accessible and affordable for all market women. Establish mobile clinics or partnerships with local health centers to provide screenings in convenient locations. Additionally, subsidize or provide free screenings for those who cannot afford them.
- Strengthen Healthcare Provider Engagement:Train healthcare providers to effectively communicate with patients about cervical cancer and its prevention. Providers should be equipped with the skills to discuss screening benefits, address concerns, and encourage regular check-ups. Building strong patient-provider relationships can increase trust and adherence to screening recommendations.
- Foster Community Support Networks:Create support networks within the community where women can share experiences and encourage one another regarding cervical cancer prevention and screening. Support groups can provide emotional encouragement and practical advice, enhancing overall community engagement in health practices.
Implications of the Findings
The findings of this study have several significant implications for cervical cancer prevention and screening efforts among market women in Ikwerre L.G.A. Understanding these implications can guide future interventions and policy decisions aimed at improving health outcomes in this population.
Firstly, the study reveals a high level of awareness about cervical cancer among the respondents, but this awareness does not always translate into regular screening practices. This disconnect underscores the need for more effective strategies that bridge the gap between knowledge and action. Public health campaigns must be designed not only to inform but also to motivate individuals to act on their knowledge. This can involve creating targeted messaging that highlights the personal and communal benefits of regular screening, as well as addressing any psychological or logistical barriers that may prevent women from participating in these screenings.
The high level of knowledge about cervical cancer among the respondents suggests that educational initiatives have been somewhat successful. However, the varying levels of attitude towards screening and the reported practices indicate that knowledge alone is insufficient to change behavior. This calls for a multifaceted approach that includes not only educational outreach but also interventions that address attitudinal and systemic barriers. For instance, community-based health education programs could be complemented by practical support, such as free or subsidized screening services, to make it easier for women to act on their knowledge.
Furthermore, the findings on attitudes towards cervical cancer screening reveal a mixed response. While some women strongly agree on the importance of screening, others remain uncertain or disagree. This variation highlights the need for tailored interventions that consider diverse attitudes and beliefs. Tailoring messages to address specific concerns and misconceptions about screening can help shift attitudes in a more positive direction. Engaging community leaders and influencers who can advocate for the benefits of screening may also play a crucial role in changing perceptions and encouraging more widespread participation.
The implications extend to the healthcare system as well. The study indicates that while many women recognize the importance of screening, the actual practice of regular screenings is less prevalent. This suggests that healthcare providers need to play a more proactive role in encouraging and facilitating screening. Training for healthcare professionals should focus on effective communication strategies to help them better educate patients about the importance of regular screenings, address fears or misconceptions, and ensure that patients follow through with their appointments. Additionally, integrating reminders and follow-up systems into healthcare services can help ensure that women keep up with their screening schedules.
Another important implication is related to the accessibility of screening services. The study underscores that while knowledge and positive attitudes towards screening are present, barriers related to accessibility and affordability still exist. There is a clear need for interventions that make screening services more accessible. This could involve establishing more convenient screening locations, such as mobile clinics that visit markets or community centers, and providing financial assistance or incentives to reduce the cost burden on individuals. By improving access to screening, the healthcare system can better support women in taking preventive actions against cervical cancer.
Additionally, the study’s findings have implications for policy development. Policymakers should consider incorporating cervical cancer prevention and screening into broader health initiatives. This includes allocating resources for public health campaigns, supporting local healthcare facilities in offering affordable screening services, and developing policies that address health disparities among different population groups. Policies that integrate cervical cancer prevention into routine healthcare services and emphasize the importance of regular screenings can contribute to improved health outcomes and reduced incidence of cervical cancer.
Contribution to Knowledge
The study’s contribution to knowledge primarily lies in its detailed examination of the relationship between awareness, attitudes, and practices regarding cervical cancer screening among market women in Ikwerre L.G.A. This research adds significant value by highlighting the discrepancies between the high level of knowledge about cervical cancer and the actual screening behaviors observed. While existing literature has explored cervical cancer awareness and screening practices in various contexts, this study provides a nuanced understanding of how knowledge alone is insufficient to drive preventive health behaviors. By illustrating that awareness does not always translate into practice, the study underscores the need for targeted interventions that address both knowledge and behavioral barriers.
Additionally, this study contributes to the understanding of the complex interplay between attitudes towards cervical cancer screening and actual screening practices. The findings reveal that although a significant portion of the respondents recognize the importance of screening, there remains a diverse range of attitudes, from strong agreement to uncertainty or disagreement. This detailed breakdown of attitudes offers new insights into how personal beliefs and perceptions influence health behaviors, providing a basis for developing more effective educational and motivational strategies tailored to various attitudinal profiles.
Another notable contribution is the study’s identification of specific barriers to cervical cancer screening that affect market women. The research highlights that despite a good level of awareness and positive attitudes towards screening, practical issues such as accessibility and affordability remain significant challenges. By identifying these barriers, the study provides valuable information for designing interventions that are not only educational but also address logistical and financial obstacles. This contributes to the body of knowledge by emphasizing the importance of integrating practical support into public health strategies to improve screening rates.
Finally, the study’s findings have implications for policy development and healthcare practices. By demonstrating the gap between knowledge, attitude, and practice, the research advocates for a more comprehensive approach to cervical cancer prevention. It suggests that policy interventions should not only focus on raising awareness but also include measures to improve access to screening services and address financial constraints. This contribution is crucial for shaping future health policies and practices, ensuring that they are informed by evidence on the factors influencing both the knowledge and behavior of target populations.
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