Health facility-related barriers associated with cervical cancer screenings in the health districts of Dakar and Kédougou (2023, Senegal)

Abstract

Background: Because of low utilisation of cervical cancer screening (CCS) services, Senegal ranks 17th in the world for cervical cancer incidence. Aim: The aim was to investigate health facility factors associated with CCS. Setting: The study was conducted in six Senegalese health districts (Keur Massar, Yeumbeul, Diamniadio, Kédougou, Saraya and Salémata). Methods: This was a descriptive and analytical cross-sectional study of women aged 25–69 years. A two-stage cluster survey was carried out, with a selection of census districts (CDs) followed by households. The data were collected with collection tools during individual interviews. Data were analysed using R 4.2.3 software. Univariate, bivariate analysis and logistic regression were performed. Results: The study involved 360 women. The average age was 40.2 (± 11.5) years. A proportion of 46.5% (334 individuals) regularly went to the health facility for treatment. 18.8% of women had been screened for cervical cancer. Factors associated with screening were hearing about a CCS or the human papillomavirus vaccine, regular attendance at a traditional healer for care, regular attendance at a healthcare facility to receive care and professionalism of healthcare facility workers. Other significantly related factors were age, marital status and level of education. Conclusion: Improving the uptake of CCS services requires a multifactorial approach, including taking into account obstacles linked to health facilities. It will involve improving attendance at health facilities through information, education and communication strategies aimed at women and health workers to contribute to maternal health. Contribution: This study will help remove the barriers faced by healthcare facilities that limit screening, including a lack of information, reliance on traditional medicine, irregular visits to healthcare facilities, and a lack of professionalism among healthcare workers. As a result, an improvement will be observed in the utilisation of cervical cancer screening services. Policy makers will be able to use the results to implement appropriate strategies that will increase screening rates and ensure adequate care for women who test positive. This study makes a positive contribution to science and opens up avenues for further research, such as on the implementation of cervical cancer screening services.