Cervical Cancer Literacy Among Women Aged 18 to 65 Years in Mayuge District, Eastern Uganda

Abstract

Title: Cervical cancer literacy among women aged 18 to 65 years in Mayuge District, Eastern Uganda.

Introduction:The incidence of cervical cancer in Uganda is on the rise, coupled with high mortality due to late presentation. Health literacy has been shown to influence uptake of screening and adoption other health promoting behaviours and the likelihood of early diagnosis. Health literacy is used to describe an individual’s knowledge and capacity to seek, understand and use health information to make decision on one’s health. Therefore, health communication programming should be linked to the individual and population health literacy level.

However, the functional health literacy level on cervical cancer in Mayuge District in particular and Uganda in general is not known. Mayuge district was selected for this study because the Government of Uganda through Uganda cancer institute proposed Mayuge for operationalization of the first ever rural cancer clinic in Uganda. We assessed the cervical cancer literacy level, risky practices, services availability and factors influencing the cervical cancer literacy among women aged 18 to 65 years in Mayuge District.

Methods:We conducted a cross-sectional concurrent mixed methods study. Structured questionnaire was used to quantitatively assess the cervical cancer literacy levels; awareness (prior knowledge), oral (listening with comprehension-audio clip), print(reading with comprehension), numeracy (understanding numeral health messages) and perceived ehealth interest (mobile phone health message platform) and composite literacy level among 400 women reading ability at least in local language- Lusoga. The questionnaire was also used to assess cervical cancer risky practices, services availability and factors influencing the cervical cancer literacy. Three focus group discussions were conducted among women 18-65 years who attended outpatient services in three health facilities within the sampled counties of Bunya East and Bunya West to qualitatively assess the cervical cancer literacy based on PEN-3 model.

Results:The findings showed overall limited cervical cancer literacy with composite mean percentage score of 42.68(SD: 12.23) except oral literacy that was at basic level (Mean: 74.40). The qualitative data also indicated that the women had limited cervical cancer literacy coupled with limited decisional, social, financial support from the male parners with overall low locus of control. The data also indicated that most of the women had never been screened for Cervical Cancer (76.0%), had no intention to screen (52.5%) yet characterized by multiple lifetime sexual partners (96.3%) and started having their first sexual intercourse at less than 18 years of age (85.8%). On service availability, majority of participants reported there were no routine Cervical Cancer Screening (92.3%) and no cervical Cancer related health education (85.8%) at health facilities in Mayuge district. Higher level of education (p0.004), owning a radio (p0.024) and health facility visits (p0.025) significantly influenced the level of cervical cancer literacy

Conclusion:Both the quantitative and qualitative finding indicated limited cervical cancer literacy among women in Mayuge District, with high prevalence of risky practices. Level of education, radio ownership and health facility visits were positively associated with cervical cancer literacy.

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