Facilitators and Barriers to The Access and Utilization of Cervical Cancer Health Services Among Child-Bearing Women in Lusaka District, Zambia
Tinkler Saul Simbeye*, Charity M’samalia Chimwala-Selico, Lee Selico A, Natasha Bwalya, Esnart Tembo and Christine Ngoma
Abstract
Introduction: Cervical cancer is a malignancy that originates in the cervix, the lower part of the uterus that connects to the vagina, and is caused primarily by high-risk types of human papillomavirus (HPV). Globally, cervical cancer is the fourth most common cancer among women, with approximately 660,000 new cases and about 350,000 deaths reported in 2022. This study aimed to assess the facilitators and barriers influencing the utilization of cervical cancer health services among childbearing women aged 15-49 in Lusaka District of Zambia.
Methods: A cross-sectional study design was utilized to investigate the facilitators and barriers that influence the utilization of cervical cancer health services among women of reproductive age. Ethical approval was sought and obtained from Lusaka Apex Medical University Biomedical Research Ethics Committee IRB number 00799-24.
Results: The study disclosed that a large proportion of respondents were Christians (83.8%) and were not employed (45.8%). Research revealed that while 51.4% of respondents have heard about cervical cancer, a significant majority of them (67.6%) are still unaware of risk factors, endorsed frequency (73.2%) and acceptable methods (64.8%) of cervical cancer screening and the importance of early cervical cancer detection and management (73.2%). The study further disclosed that, while 64.8% of women have been encouraged by healthcare professionals, and the convenience of multiple healthcare facilities (64.8%) across the district, a significant proportion of respondents (84.5%) do not attend educational awareness campaigns on cervical cancer. Not only that, the study also disclosed that, many study participants (67.6%) are still unaware of government initiatives about cervical cancer. The study also revealed that, 64.8% of study participants have never received information about cervical cancer health services through community awareness campaigns in Lusaka District. Age, marital status, social class, religion, level of education, occupation and number of children were found to have statistically significant association with respondents’ level of awareness of cervical cancer (P < 0.05). The study also found that, most of the study participants’ significant challenges faced when accessing and utilizing cervical cancer health services include transportation issues and lack of privacy, each affecting 90.3% of study participants, and financial constraints impacting 67.9% of respondents. The study further uncovered that, 67.6% of women feel that the distance to healthcare facilities is another major obstacle to cervical cancer services accessibility and utilization. The study also disclosed that 64.8% of respondents are still unaware of available free cervical cancer health services due to lack of availability of health information and education among women of reproductive age. The study further disclosed that, most of the respondents (73.2%) do not perceive fear or anxiety about cervical cancer screening procedures to affect their willingness to utilize cervical cancer health services in the district.
Conclusion: The study found that utilization of cervical cancer health services among women of childbearing age in Lusaka District remains suboptimal, largely due to low levels of awareness, limited access to health information, and persistent structural barriers such as transportation challenges, financial constraints, distance to health facilities, and concerns regarding privacy. Socio-demographic factors, including age, marital status, education, occupation, religion, and parity, were significantly associated with awareness of cervical cancer services. In response, the study recommends that the Lusaka District
Health Office, in collaboration with the Ministry of Health and the World Health Organization (WHO), strengthen community engagement, social mobilization, and health education campaigns to improve awareness of cervical cancer risk factors, screening services, and HPV vaccination. Additionally, capacity building for healthcare providers in culturally sensitive communication, patient confidentiality, stigma-free care, and the expansion of mobile outreach services is essential to address existing access-related barriers.
