Characteristics of Respondents
A total of 9 study participants (Two health extension workers, four screened women to assess their perception about screening before and after screening, and three health professionals from maternal and child health providing cervical cancer screening service) were included in this study. Of the participants, 8 females and 1 male were interviewed. The demographic characteristics of the participants were summarized in (Table 1).
Table 1: Socio-demographic characteristics of participants
Variables
|
Categories
|
Frequency
|
Percentage
|
Sex
|
Female
|
8
|
88.8
|
Male
|
1
|
11.2
|
Age
|
<30
|
3
|
33.3
|
<30
|
6
|
66.7
|
Marital status
|
Single
|
3
|
33.3
|
Married
|
6
|
66.7
|
Level of education
|
No formal education
|
1
|
11.1
|
Primary education
|
2
|
22.2
|
Secondary education
|
1
|
11.1
|
College and above
|
5
|
55.6
|
Total
|
|
9
|
100
|
Theme: Awareness of cervical cancer and its screening perceptions
This theme was consisted of three categories, “awareness of the cervical cancer screening service”, “awareness of risk factors for cervical cancer”, and “awareness of the symptoms of cervical cancer”. Many of the rural women had no utilize cervical cancer screening service due to misconceptions and inappropriate information provided by friends and relatives.
Awareness of the cervical cancer screening service
Some participants believed that lack of awareness about cervical cancer screening service led to utilization of the cervical cancer screening.
One of the key informant interview raised idea that: “I think women’s in my area don’t have enough information about cervical cancer disease and its screening, but if they know the enough information about the disease and screening service, they would have been screened. Sometimes I heard radio/TV advertisements, but they don’t transfer full information about the benefits, where and when to screen…” (25 years old, female, health extension worker)
Awareness of the risk factors for cervical cancer
One reason for women not to use cervical cancer screening. A rural woman’s who do not screen cervical screening service give their perceived reasons were due to an awareness of the cervical cancer risk factors.
One of the key informant interview raised idea that: “Most women’s think the screening for cervical cancer disease is not essential for healthy women and women of these ages group. They think it is used for those women who are sick or those women found in menopausal age group.” (26 years old, female, maternal and child health care provider)
Another key informant interview raised idea that:
“I was also feared, when my sister died in uterine cancer problem because I have chance of developing cervical cancer; then I decided to do the screening early before the occurrence of the disease.” (41 years old, screened women)
Awareness of the symptoms of cervical cancer
Another awareness of cervical cancer and its screening was a lack awareness of symptoms. The majority of respondents raised the absence of symptoms as perceptions of rural women’s for not undergo cervical cancer screening.
One of the key informant interview raised idea that: “If I think the main cause for many women’s is not screened is due to the natural history of the cervical cancer disease. I mean, at that period they was apparently healthy and had no signs and symptom and complication of the disease. Our women’s are more concerned if there are detectable signs and symptoms of the disease.” (28 years old, female, maternal and child health care provider)
Theme: Health service related perception
Under this theme, three categories emerged, namely “fear of health care provider”, “fear of side effect”, availability, “accessibility and affordability of the service” and “prevention and treatment of cervical cancer perception”.
Gender preferring for screening service
The participants reported different factors for not undergoing cervical cancer screening. From these, the fear of health care providers was identified as factor for not utilizing cervical cancer screening.
“Before five month, I was screened for cancer of cervix by a male doctor and I was so ashamed when he asked me to remove my clothes. It is very difficult to receive and I think this may be due to our culture and religion which is so sensitive to such ideas.” (36 years old, screened women)
Fear of side effects
One category that emerged under the health service related theme is fear of side effects. Most of the women’s and key informants interviewed said that the main factor for women not utilized cervical cancer screening was vaginal bleeding, Painful during screening and infertility.
One of the screened women raised idea that: “Some women told that they had heard that the screening procedure may cause excessive vaginal bleeding, painful …..” (36 year’s old, female, health extension worker)
Another key informant interview raised idea that:
“Most women in our village didn’t screened cervical cancer because if we screened the procedures causes’ health problems like infertility.” (25 years old, female, health extension worker)
Availability, accessibility and affordability of the service
Participants also mentioned other factors related to the health service. The most of respondents said that the availability, accessibility and affordability of the reasonable rural women’s perception which are considered to influence the utilization of the cervical cancer and its screening service. The service is not available at their nearest health facility and it is available only selected hospitals provide the service to clients, so the accessibility issue made it difficult for women to utilize cervical cancer screening according to schedule. They added that not all health professionals offer the service and do not push women’s to screen cervical cancer.
One of the key informant interviews said that: “Most women don’t known that the cervical cancer screening service is given freely in health facility. Most of us think that we have to pay for screening service, but we can’t afford it. We heard that the payment for cervical cancer screening is very expensive…..” (40 years old, screened women)
Another key informant interview raised idea that:
‘‘I think before two years, I treated for vaginal discharge and abdominal pain at health center, then I was wanted to screen for cervical cancer disease after counseling by Doctor, but the service is not avail at that health facility.’’ (45 years old, screened women)
Theme: Prevention and treatment of cervical cancer perception
The third theme is the prevention and treatment perception of rural women’s. The participants believed that prevention and treatment of cervical cancer were the reasons for women’s not undergo screening service.
Most of respondent’s perceived that cervical cancer is not curable and cannot be prevented by screening service; however, the participants perceived that they were not susceptible to this cancer and so that the screening was not required. One respondent said that,
“Many of women’s think the screening for cervical cancer disease is not essential for healthy women and women of these ages group. They think it is used for those women who are sick or those women found in menopausal age group.” (26 years old, female, maternal and child health care provider)
Women are perceived about cervical cancer it’s not prevented by treatment and screening. They linked it with religious and believed. Accordingly, most of women preferred to pray for God instead of screened cervical cancer and treated for the disease. They also heard and believed that the cervical cancer disease treatment outcome is useless even if treated; so, it’s well not to be screen cervical cancer rather than screened and told having the disease.
“Most of women chose to die by the disease rather than utilize the uterus cancer screening and being told having uterus cancer problem…..”(25 years old, female, health extension worker)