Determinants of Cervical Cancer Screening Utilization among Women of Reproductive Age in Choma District, Zambia.

Abstract

Miyoba Hangoma*1,2, Victoria Mwiinga Kalusopa2, Peter Julius3, Christabel Mwiinga3 Marjorie Kabinga Makukula2 1Choma college of Nursing and Midwifery 2University of Zambia, School of Nursing Sciences 3University of Zambia, School of Medicine Corresponding author Miyoba Hangoma Email: miyobahangoma@gmail.com Background: Cervical cancer is a significant global health challenge, ranking as the fourth most prevalent cancer and the fourth leading cause of cancer-related death among women worldwide. Zambia has one of the highest cervical cancer incidence and mortality rates due to under-utilization of cervical cancer screening services (CCSS). Objective: The study aimed to assess the determinants of cervical cancer screening utilization among women of reproductive age in Choma District, Southern Province, Zambia. Methods: A non-interventional, quantitative analytical cross-sectional study was conducted among 384 respondents using systematic random sampling techniques. Data was collected using a structured questionnaire and analyzed with SPSS version 26 using chi-square tests and binary logistic regression. Results: The study indicated the magnitude of CCS utilization at 66.9%. Being employed was significantly associated with lower odds of CCS utilization (aOR = 0.62, 95% CI: 0.39 - 0.98, p = 0.041), while the provision of information by healthcare providers on CCS and prevention was significantly associated with higher odds (aOR = 1.60, 95% CI: 1.02 - 2.50, p = 0.040). Availability of CCS services showed a significant association (uOR = 1.77, 95% CI: 1.05 - 2.99, p = 0.031), but this later became non-significant (aOR = 1.67, 95% CI: 0.97 - 2.89, p = 0.064). Conclusion: The study identified a moderate CCS utilization (66.9%), highlighting areas for improvement, especially among employed individuals. Effective information provision by healthcare providers emerged as a crucial determinant for increasing utilization of CCS. Initial associations with CCS service availability diminished upon adjustment, highlighting the complexity in improving screening rates and the need for targeted strategies. Keywords; Cervical cancer, screening, Utilization, Determinants, women of reproductive age