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A Mixed Method Study to Assess Women’s Knowledge on Cervical Cancer Screening and Associated Risk Factors in Gakenke District, Rwanda

Gerard Izuwayo, Michael Habtu, Onesmus Marete, Monica Mochama, Erigene Rutayisire, Gabriel O Dida

Purpose: This study aimed to assess women’s knowledge on cervical cancer screening and associated factors in Gakenke district, Rwanda.

Materials and Methods: We conducted a community-based cross section study in rural areas of Gakenke district, north province of Rwanda from December 2020 to February 2021. Multistage and systematic random sampling techniques were used to select 423 women from households in selected villages and cells of each sector of Gakenke District. Level of knowledge was assessed by calculating the overall scores using SPSS score assessment tool. A bivariate and multivariate analysis was used to establish the factors associated with cervical cancer knowledge. By use of interview guide that was provided to the Key Informants (KIIs), we did thematic interpretation of the perceptions of the Key Informant Interviews (KIIs) towards cervical cancer screening by deductive content analysis to enable deeper understanding of the women’s experience of the disease and uptake of screening services.

Results: Most of the respondents (70.7%) were aged between 20-34 years, and almost all of them 396 (93.6%) had attained at least basic level of education. About 61.6% of the respondents were married, while 20.5% of them were either student or unemployed. Less than half (46.0%) of women demonstrated high level of knowledge towards cervical cancer screening. Regardless, women aged between 30 to 34, were notably less knowledgeable, as compared to those aged 45 years and above [AOR=0.316; 95% CI=0.113-0.885; p=0.028]. Students were 6.6 times more knowledgeable than famers [AOR=6.577; 95% CI=2.501-17.291; p=0.001]. The perceived reasons of lack of knowledge were emerged from three themes, namely lack of awareness, fear about outcome of the results, and the issues of affordability. For the perceived solutions, there were 12 codes, which could be grouped into two groups; which were increasing awareness and vaccination.

Conclusion: The overall level of knowledge towards cervical cancer screening was below average in this study. Age and being a student were the main predictors of good knowledge about cervical cancer cancer. Awareness campaigns, personalized encouragements, affordable and friendly health care with subsidized vaccination, and screening facilities are expected to increase awareness and acceptability and thus reduce burden of the disease.