Mathewos Assefa

Effect of Health Education on Cervical Cancer Screening Uptake and Knowledge among Target Women in Addis Ababa: A Randomized Controlled Trial

Abstract Health education can improve cervical cancer screening uptake; however, evidence from randomized controlled trials in the general population of Addis Ababa is limited. The aim of this study is to assess the effect of health education on screening uptake and knowledge among women aged 30 to 49 years in Addis Ababa, Ethiopia. A randomized controlled trial was conducted involving 1,300 women who had never been screened before. The intervention group received home-based health education about cervical cancer, supplemented by brochures. The χ2 test, independent sample t test, and paired t tests were used to assess pre- and pos-tintervention differences. The impact of the intervention was measured using the differences-in-differences approach. Three months after the intervention, 1,154 (88.8%) were interviewed. Screening uptake was significantly higher in the intervention group, with 241 (41.8%) of women screened compared with 93 (16.1%) in the control group. After the intervention, awareness increased by 42.2%, knowledge of symptoms increased by 23.1%, knowledge of risk factors increased by 15.2%, positive attitudes improved by 26.7%, and overall knowledge increased by 19.5% among the intervention group, indicating that the change is statistically significant. The differences-in-differences analysis indicated that 51% of the change in overall knowledge was due to the intervention. Age, occupation, and income were significantly associated with the uptake of screening, whereas the lack of time was a common barrier. Structured home-based education significantly increases cervical cancer knowledge and screening uptake. Scaling up home-based health education can significantly improve screening uptake. Prevention Relevance: Cervical cancer is the second leading cause of cancer-related morbidity and mortality among women in Ethiopia. Increasing awareness, improving access to screening, and promoting timely preventive interventions are critical to reducing the disease burden and increases life saving among women.

Cervical Cancer Screening Uptake and Sociocultural Barriers among Women in Addis Ababa, Ethiopia: Population-Based Study

Abstract Background: Cervical cancer is the second leading cause of cancer death among women in Addis Ababa and other parts of Ethiopia. Yet, there are limited age-eligible city-wide data on cervical cancer screening prevalence in Addis Ababa to inform public policy. Methods: A population-based cross-sectional study was conducted among 1881 screening eligible women aged 30 to 49 years, who were selected from 63 enumeration areas in Addis Ababa based on multistage sampling and proportional sample size allocation. Logistic regression was used to identify barriers to screening. All statistical tests were two-sided, P < 0.05. Results: Overall, 30.8% [95% confidence interval (CI), 28.8%–33.0%] of study participants reported receipt of screening in the past 5 years. Less than half (45.7%) of women reported that they received healthcare provider recommendation for screening, and only 15% of married women reported that they had spousal support for it. In the multivariable adjusted model, the odd of being screened was considerably higher in women with healthcare provider recommendation, with spousal support, and with good cervical cancer screening awareness and knowledge of risk factors for the disease. Factors associated with not seeking screening service included feeling healthy and perception of low risk for cervical cancer. Conclusions: Cervical cancer screening uptake is low in Addis Ababa, and less than half received healthcare provider recommendation. Future studies should identify barriers to provider recommendations. Impact: The findings underscore the need for a coordinated effort to enhance healthcare provider recommendations for cervical cancer screening and to raise awareness about the benefits of screening in the general population.