Towards a cervical cancer-free future: women’s healthcare decision making and cervical cancer screening uptake in sub-Saharan Africa

Okyere, Joshua, Aboagye, Richard Gyan, Seidu, Abdul-Aziz, Asare, Bernard Yeboah-Asiamah, Mwamba, Bupe, and Ahinkorah, Bright Opoku (2022) Towards a cervical cancer-free future: women’s healthcare decision making and cervical cancer screening uptake in sub-Saharan Africa. BMJ Open, 12. e058026.

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Abstract

Objective: We investigated the association between women’s healthcare decision making and cervical cancer screening uptake in sub-Saharan Africa.

Design: Secondary data from the Demographic and Health Surveys of six countries in sub-Saharan Africa were used. We employed multilevel binary logistic regression modelling.

Setting: Sub-Saharan Africa.

Participants: Women aged 15–49 years in Benin (n=5282), Côte d’Ivoire (n=1925), Cameroon (n=7558), Kenya (n=6696), Namibia (n=1990) and Zimbabwe (n=5006).

Primary outcome measures: Cervical cancer screening uptake.

Results: The overall prevalence of cervical cancer screening across the six sub-Saharan African countries was 13.4%. Compared with women whose healthcare decisions were made solely by husbands/partners/someone else, the likelihood of cervical cancer screening uptake was significantly higher among women who took healthcare decisions in consultation with their husbands/partners (aOR=1.38; 95% CI 1.19 to 1.59), but highest among those who made healthcare decisions alone (aOR=1.66; 95% CI 1.44 to 1.91). Women aged between 40 and 45 years (aOR=5.18; 95% CI 3.15 to 8.52), those with higher education (aOR=2.13; 95% CI 1.57 to 2.88), those who had ever heard of cervical cancer (aOR=32.74; 95% CI 20.02 to 53.55), read newspaper or magazine at least once a week (aOR=2.11; 95% CI 1.83 to 2.44), listened to the radio at least once a week (aOR=1.35; 95% CI1.18 to 1.52) and those in households with richest wealth index (aOR=1.55; 95% CI 1.20 to 2.00) had significantly higher odds of screening for cervical cancer compared to their counterparts.

Conclusion: Women who are able to make autonomous healthcare decisions and those who practice shared decision making are more likely to uptake cervical cancer screening. Therefore, policy interventions should focus on empowering women to be able to take autonomous healthcare decisions or shared decision making while targeting subpopulations (ie, multiparous and rural-dwelling women, as well as those in other religious affiliations aside from Christianity) that are less likely to uptake cervical cancer screening. Also, the radio and print media could be leveraged in raising awareness about cervical cancer screening to accelerate cervical cancer screening uptake in sub-Saharan Africa.

Item ID: 75764
Item Type: Article (Research - C1)
ISSN: 2044-6055
Keywords: Cancer pain, Public health, Quality in health care
Copyright Information: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Date Deposited: 17 Aug 2022 09:17
FoR Codes: 42 HEALTH SCIENCES > 4206 Public health > 420603 Health promotion @ 100%
SEO Codes: 20 HEALTH > 2004 Public health (excl. specific population health) > 200401 Behaviour and health @ 100%
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