Influence of the Knowledge and Attitude towards Cervical Screening Services on the Uptake of Cervical Screening Services among Antenatal Attendees in Rural and Urban Health Facilities in Ebonyi State, Nigeria
Amuchechukwu Veronica Nwafor
Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakalilki, Ebonyi State, Nigeria and Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Ndufu Alike Ikwo, Ndufu-Alike Ikwo, Nigeria.
Callistus Obinna Elegbua
*
Department of Obstetrics and Gynaecology, David Umahi Federal University of Health Sciences Uburu, Ebonyi State, Nigeria.
Emmanuel Okechukwu Ndukwe
Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakalilki, Ebonyi State, Nigeria and Department of Obstetrics and Gynaecology, Ebonyi State University, Isieke, Nigeria.
Moses Ikenna Ekuma
Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Ndufu Alike Ikwo, Ndufu-Alike Ikwo, Nigeria and Department of Obstetrics and Gynaecology, David Umahi Federal University of Health Sciences Uburu, Ebonyi State, Nigeria.
Chinwendu Precious Eugene-Abah
Department of Paediatrics, Alex Ekwueme Federal University Teaching Hospital, Abakalilki, Ebonyi State, Nigeria and Department of Paediatrics, Alex Ekwueme Federal, University Ndufu Alike Ikwo, Ndufu-Alike Ikwo, Nigeria.
Hyacinth Okwe Ebenyi
Department of Public Health and Disease Control, Ministry of Health, Ebonyi State, Nigeria.
Benedict Ndubueze Azuogu
Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakalilki, Ebonyi State, Nigeria and Department of Community Medicine, Ebonyi State University, Isieke, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Cervical cancer remains a major public health challenge in Nigeria, accounting for substantial morbidity and mortality among women of reproductive age. Despite being largely preventable through early detection and vaccination against human papillomavirus (HPV), the uptake of cervical cancer screening remains low, particularly in rural areas. Knowledge, attitude, and access to screening services significantly influence utilisation.
Objectives: To compare the influence of knowledge and attitudes towards cervical screening services on the uptake of cervical screening services among antenatal attendees in rural and urban health facilities in Ebonyi State, Nigeria.
Study Design: A comparative cross-sectional study involving eligible antenatal attendees from selected rural and urban health facilities in Ebonyi State, Nigeria.
Methodology: A total of 440 women attending antenatal clinics at selected urban and rural health facilities in Ebonyi State were recruited using a systematic sampling technique. Data were collected using a structured, pretested questionnaire covering socio-demographic characteristics, knowledge, attitudes, and cervical cancer screening uptake. The results were analysed using SPSS version 26, and appropriate tables were generated.
Results: The mean knowledge score among urban respondents was higher (M = 60.64) than that among rural respondents (M = 27.27) (p < 0.01). Attitudes towards cervical cancer screening were significantly more positive among urban women (M = 58.86) than among rural women (M = 24.66) (p < 0.01). Despite this attitudinal advantage, screening uptake was low among both urban respondents, 97 (44.1%), and rural respondents, 52 (23.6%).
Conclusion: Despite the higher knowledge of cervical cancer and its screening services and the significantly more positive attitudes among urban antenatal attendees, the uptake of cervical cancer screening remained low in both groups.
Recommendation: Cervical cancer screening should be integrated into the routine antenatal care services.
Keywords: Cervical cancer, cervical cancer screening, knowledge, attitudes, screening uptake, antenatal care, rural health facilities, urban health facilities, pregnant women