Knowledge, Attitude And Practice Of Cervical Cancer Screening Among Women Of Child Bearing Age (15-49) Years

Project and Seminar Material for Nursing (Science)

Knowledge, Attitude And Practice Of Cervical Cancer Screening Among Women Of Child Bearing Age (15-49) Years – Charles

Abstract

This study was carried out to examine the knowledge, attitude and practice of cervical cancer screening among women of child bearing age (15-49) years in Abeokuta, Ogun State. The study was carried out to determine the level of knowledge of cervical cancer screening among women of child bearing age, determine the attitude of women of child bearing age towards the acceptance of cervical cancer screening, determine the extent of women adherence towards practice of cervical cancer screening, and identify the factors influencing women’s attitude and practice of cervical cancer screening. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprised of women of child bearing age (15-49) years in Abeokuta, Ogun State. In determining the sample size, the researcher conveniently selected 147 respondents and 141 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables, and mean scores. While the hypotheses was tested Chi-square statistical tool. The result of the findings reveals that the level of knowledge of cervical cancer screening among women of child bearing age is low. Furthermore, the study revealed that the factors influencing women’s attitude and practice of cervical cancer screening includes: knowledge about cervical cancer, severity of the disease, cultural practices, and accessibility of healthcare facility. Therefore, it is recommended that the government should show greater commitment for cervical cancer control by expediting policy making process and increasing funding for cervical cancer control. To mention but a few.

Table of Content

Title Page
Certification
Dedication
Acknowledgement
Table of Content
List of Tables
Abstract

Chapter One:

Introduction

1.1 Background of the Study
1.2 Statement of the Problem
1.3 Objective of the Study
1.4 Research Questions
1.5 Research Hypothesis
1.6 Significance of the Study
1.7 Scope of the Study
1.8 Limitation of the Study
1.9 Definition of Terms
1.10 Organisations of the Study

Chapter Two:

Review of Literature

2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review

Chapter Three:

Research Methodology

3.1 Research Design
3.2 Population of the Study
3.3 Sample Size Determination
3.4 Sample Size Selection Technique and Procedure
3.5 Research Instrument and Administration
3.6 Method of Data Collection
3.7 Method of Data Analysis
3.8 Validity of the Study
3.9 Reliability of the Study
3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

4.1 Data Presentation
4.2 Analysis of Data
4.3 Answering Research Questions
4.4 Test of Hypotheses

Chapter Five:

Summary, Conclusion and Recommendation

5.1 Summary
5.2 Conclusion
5.3 Recommendation
REFERENCES
APPENDIX
QUESTIONNAIRE

Chapter One

Introduction

1.1 Background of the Study

Cervical cancer is a disease that develops in the female reproductive system where the cells of the cervix become malignant. The primary cause of cervical cancer is infection with human papilloma virus (HPV) (Yang et al., 2004).. Globally, the estimated annual case of cervical cancer is 493,000, with 273,500 annual deaths (Shanta, 2005). In developing countries, it accounts for about 85% of morbidity and mortality(PATH 2000). According to the report from (Shanta, 2005), the incidence of the disease was 25.2%, mortality was 23.2% and 5-year prevalence was 27.6%. As in many developing countries of the world, Nigerian women, especially women of childbearing age, face many challenges: socially, culturally and health-wise. Cervical cancer affects poor, illiterate women mostly living in rural environments which reflect poor access to healthcare as well as gender and economic inequity (Hyacinth 2013). According to [Shrestha 2013], Nigeria has a population of over 50 million women aged 15 years and older who are at risk of developing cervical cancer. Current estimates indicate that 14,943 women each year are diagnosed with cervical cancer and 10,403 women die from the disease(Liu 2017).. Cervical cancer ranks as the second most frequent cancer among women in Nigeria and the second most frequent cancer among women between 15 and 44 years of age (Liu 2017), the age bracket of the high reproductive rate. These findings suggest that this disease is responsible for a disproportionately greater loss of life-years and social cost.

The link between HPV and cervical cancer has been firmly established, thus making it a sexually transmitted malignancy which is preventable. The underlying risk factors of cervical cancer are poverty, choice of lifestyle, engaging in sexual activities early in life and multiple sexual partners (Yang et al., 2004).; these are preventable at the community level through behavioural change, delay in age of initiating sex and promoting safe sex. Yet, lack of knowledge about the disease and risk factors, beliefs about the disease, poor access to preventive services, affordability of the service and current health service system can affect the decision to be screened for cervical cancer (PATH 2000). Knowledge, attitude and practice level of the community regarding the signs and symptoms of cervical cancer, risk factors, benefits of early diagnosis and treatment, availability of health services and prevention methods (HPV vaccination) are very essential(Hyacinth 2013).

Fortunately, some authors have reported that cervical cancer could be prevented, and mortality be reduced through early diagnosis with cervical cancer screening Kyari et al(2004). In Nigeria, a researcher supported this by indicating that cervical cancer can be eradicated through preventive screening and early detection of precancerous lesions (Nwosu & Ana (2014). A similar result was published in China that CCS can be utilized in the bid to dwindle the rate of cervical cancer load apart from the HPV antibodies and HPV DNA testing (Sankaranarayanan et al 2001.)

Despite the availability of cervical screening services in some hospitals in Nigeria, less than 8.9% of the women of child bearing in Nigeria reported having been screened for cervical cancer, even after being aware of the screening services (Shrestha et al 2013]. Even though most studies have identified an appreciable level of knowledge on cervical cancer among women of child bearing the patronage rate in the screening among women of child bearing was reported to be low (Shrestha et al 2013]. Hence, some researchers in Nigeria have suggested that Health Services should develop strategies to help increase women of child bearing’ interest in CCS (Kyari et al(2004). Hence the researchers in this current study aim to explore the knowledge, attitude and practice of cervical cancer screening among women of child bearing age (15-49) years.

1.2 Statement of the Problem

Cancer of the cervix is a major burden on women’s health worldwide (Ibekwe et al., 2011). It is ranked as the second most frequent cancer among women in Africa and the second most frequent cancer among women aged 15 to 44 (WHO/ICO,2010). Although cervical cancer is preventable, many women continue to die because of diagnosis at an advanced stage. Cervical cancer screening is a universally accepted early detection strategy that reduces the morbidity and mortality rates associated with the disease. The long transition period from a premalignant cervical lesion to cancer of the cervix affords possibilities for early detection and effective treatment. (Araoye 2004).

However, Successfully organized, population based cervical cancer screening programmes have not yet been implemented in most tertiary institutions in developing countries, despite the great burden of cervical cancer in these countries. This is largely related to poverty, lack of resources and infrastructure and marginalization of women. (Ibekwe et al., 2011). Due to a lack of an organized screening system in most developing countries for detecting precursor lesions, mortality rates from cervical cancer are used as a measure of its severity.

Additionally, the authors noted that screening practices in Nigeria are considered inadequate, with only 2.4% of the participants in a study having undergone a pap test. It was also discovered that the most prevalent Human papillomavirus (HPV) genotypes among women in Nigeria were HR-HPV 16, 18, 45, 35, and 52 [19]. Although the cost of Pap tests has not been documented, the cost range for visual inspection with acetic acid (VIA) was reported to be between 4.93 US$ and 14.75 US$, while the cost of cryotherapy as a treatment option for cervical cancer ranged from 47.26 US$ to 84.48 US$ [20].

1.3 Objectives of the Study

The primary objective of this study is to examine the knowledge, attitude and practice of cervical cancer screening among women of child bearing age (15-49) years.

Other objectives of this study are:

Determine the level of knowledge of cervical cancer screening among women of child bearing age
Determine the attitude of women of child bearing age towards the acceptance of cervical cancer screening.
Determine the extent of women adherence towards practice of cervical cancer screening
Identify the factors influencing women’s attitude and practice of cervical cancer screening.

1.4 Research Questions

The following questions have been prepared for the study.

What is the level of knowledge of cervical cancer screening among women of child bearing age?
What is the attitude of women of child bearing age towards the acceptance of cervical cancer screening?
What is the extent of women adherence towards practice of cervical cancer screening?
What are the factors influencing women’s attitude and practice of cervical cancer screening?

1.5 Research Hypothesis

Ho: Women of child bearing age do not have adequate knowledge of cervical cancer screening.
Ha: Women of child bearing age do have adequate knowledge of cervical cancer screening.

1.6 Significance of the Study

The information gathered will help policy makers to plan and implement necessary interventions that will enable women of child bearing age to have good knowledge of cervical cancer and provide access to cervical cancer screening services within the communities. Finally, this study will serve as an existing material for future reference and further research.

1.7 Scope of the Study

This study will focus on the knowledge, attitude and practice of cervical cancer screening among women of child bearing age (15-49) years. Hence, the study will be delimited to Abeokuta, Ogun State.

1.8 Limitation of the Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. In addition, there was the element of researcher bias. Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed.

More so, the findings of this study are limited to the sample population in the study area, hence they may not be suitable for use in comparison to other schools, local governments, states, and other countries in the world.

1.9 Definition of Terms

Cancer:

Is a broad term used to describe a class of diseases characterized by the uncontrolled and abnormal growth of cells, often forming tumors or masses (American Cancer Society, 2021).

Cervical Cancer:

A type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.

Cervical Screening:

For the purpose of this study refers to early detection of pre-cancerous lesions through a Papanicolaou (Pap) smear

1.10 Organization of the Study

This research work is organized in five chapters, for easy understanding, as follows.

Chapter one is concern with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study.
Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature.
Chapter three deals on the research design and methodology adopted in the study.
Chapter four concentrate on the data collection and analysis and presentation of finding.
Chapter five gives summary, conclusion, and recommendations made of the study.

Chapter Five

Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings on the knowledge, attitude and practice of cervical cancer screening among women of child bearing age (15-49) years in Abeokuta, Ogun State. The chapter consists of summary of the study, conclusions, and recommendations.

5.2 Summary of the Study

In this study, our focus was to examine the knowledge, attitude and practice of cervical cancer screening among women of child bearing age (15-49) years in Abeokuta, Ogun State. The study specifically was aimed to determine the level of knowledge of cervical cancer screening among women of child bearing age, determine the attitude of women of child bearing age towards the acceptance of cervical cancer screening, determine the extent of women adherence towards practice of cervical cancer screening, and identify the factors influencing women’s attitude and practice of cervical cancer screening.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 141 responses were validated from the enrolled participants where all respondents are women of child bearing age (15-49) years in Abeokuta, Ogun State.

5.3 Conclusions

Based on the findings of this study, the researcher made the following conclusion.

The level of knowledge of cervical cancer screening among women of child bearing age is low.
Women of child bearing age have a negative towards the acceptance of cervical cancer screening.
The extent of women adherence towards practice of cervical cancer screening is low.
The factors influencing women’s attitude and practice of cervical cancer screening includes:knowledge about cervical cancer, severity of the disease, cultural practices, and accessibility of healthcare facility.

5.4 Recommendation

Based on the findings the researcher recommends that;

The government should show greater commitment for cervical cancer control by expediting policy making process and increasing funding for cervical cancer control.
Stake holders for cervical cancer control including women, politicians, heads of medical institutions, MOH officers, NGOs, professional groups including Society for Gynecologists and Obstetricians of Nigeria (SOGON), Nigeria Cancer Society, Society of Oncology and Cancer Research in Nigeria should meet and decide on policy thrust.
Health workers at the level of Health Centre II and above should be supported and trained on the cancer of the cervix and empowered to pass on knowledge to the populations they serve.
Also, the National program on cervical cancer control should be integrated into the existing health system. Thus, it should be community or population based.