The levels of utilization of visual inspection screening of cervical cancer in Kitui, Kenya
Background: Cervical cancer is a disease of public health importance with a high global morbidity and mortality. More than 266,000 women die every year,with 87% of them coming from low and middle-income countries. These are the areas where programmes for screening and treatment are either deficient or underutilized. The morbidity and the mortality rates remain high in Kenya despite the screening and treatment services that the Ministry of Health has rolled out all over the country. Low levels of utilization of the established screening systems leads to increased morbidity and mortality. The problem is more prevalent in the rural Kenya where socioeconomic status of the majority in the population is low. Kitui County is such a rural region in Kenya.
Objective: To determine the factors influencing the levels of utilization of the Visual Inspection method (VIA/VILI) for cervical cancer screening services in Kitui County, Kenya.
Methodology: This was a descriptive study involving 370 women of reproductive age attending public MCH/FP clinics in Kitui County Kenya. Systematic random sampling method was used to select the participants. Exit interview was the main data collection technique. Key informants were also interviewed and facilities’ preparedness to provide adequate screening services was assessed using a facility survey checklist.
Results: A total of 370 women were interviewed, 69.2% of whom were aged below 29 years, 68% were married, 75% had three or fewer children, 19% did not have the basic level of formal education and 61% were earning less than 50 US$per month. The level of awareness on cervical cancer and its prevention was 53.8%, with significant difference in relation to VIA/VILI utilization (OR 3.0675 p=0.000). Significance difference was also observed in cervical cancer testing and level of education (X 2 =21.728, df=3, P= 0.000), the main source of income, (X 2 = 15.030, df=2, P=0.01), average monthly income, (X 2 =27.942, df=4, P=0.0001) and the main decision maker in the family, (X 2 =6.908, df=2, p=0.032). Public health facilities were not adequately equipped and well staffed to provide the VIA/VILI screening services.
Conclusion: Low levels (53.8%) of awareness about cervical cancer and its prevention among eligible clients in Kitui Central Sub-county Kenya, which was below the national target of over 70%, low coverage of health facilities and shortage of manpower lead to low levels of VIA/VILI screening. Therefore, there is a need to strengthen the existing services and interventions strategies, and enhance cancer awareness campaigns in order to reduce the incidence of the disease.