International Journal of Women's Health (Sep 2022)
Knowledge, Barriers and Motivators to Cervical Cancer Screening in Rwanda: A Qualitative Study
Abstract
Jean Pierre Gafaranga,1,2 Felix Manirakiza,3,4 Emmanuel Ndagijimana,5 Jean Christian Urimubabo,6 Irénée David Karenzi,7 Esperance Muhawenayo,6 Phophina Muhimpundu Gashugi,8 Dancilla Nyirasebura,6 Belson Rugwizangoga3,4 1Department of Psychiatry, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda; 2Department of Psychiatry, University Teaching Hospital of Kigali, Kigali, Rwanda; 3Department of Clinical Biology, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda; 4Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda; 5Department of Epidemiology and Biostatistics, School of Public Health, University of Rwanda, Kigali, Rwanda; 6Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda; 7Department of Surgery, Ruhengeri Referral Hospital, Musanze, Rwanda; 8Department of Physical Rehabilitation, University Teaching Hospital of Kigali, Kigali, RwandaCorrespondence: Jean Pierre Gafaranga, Department of Psychiatry, University of Rwanda, Kigali, Rwanda, Department of Psychiatry, University Teaching Hospital of Kigali, Kigali, Rwanda, Tel +250788224864, Email [email protected]; [email protected]: Cervical cancer is a global public health problem with marked geographical disparity. High morbidity and mortality rates in developing countries are associated with low screening rates. In 2020, in Rwanda, 3.7 million women aged 15– 59 years were at risk of developing cervical cancer, the most commonly diagnosed female cancer in Rwanda. Despite Rwanda being the first African country to vaccinate against human papilloma virus with a three-dose regimen vaccination coverage of nearly 93% in the target population of girls aged < 15 years, and having established cervical cancer screening program, recent studies have found low screening rates. Our study sought to determine knowledge, motivators and barriers of cervical cancer screening.Methods: We conducted a qualitative descriptive study; using focus group interview in an urban health facility (Muhima district hospital) and a rural health center (Nyagasambu health center) offering cervical screening services in Rwanda. Participants were women seeking these services and other women attending the health facility for any reason, and female staff working in these facilities. Interviews were recorded and transcribed, and data were analyzed using content analysis.Results: Thirty women participated in focus group interview, with an average age of 39 years. Many of women showed knowledge about cervical cancer existence and prevention methods. However, fear for pain, lack of knowledge about screening, how and where the screening was done, and concern for privacy were recurring subthemes. Some participants also mentioned lack of health insurance as a barrier for cervical cancer screening.Conclusion: Barriers to uptake cervical cancer screening services in Rwanda are related to poor information about cervical cancer and the importance of screening as well as non-adherence to medical insurance. Population sensitization through campaign and community outreach activities could have a positive impact on increasing the usage of cervical cancer screening in Rwanda.Keywords: cervical cancer, screening, fear for pain, qualitative, acceptance, Rwanda
