Department of Sociology, Anthropology, and Population Studies (Demography), Faculty of Social Sciences, Kyambogo University, Kampala, Uganda.
Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
BMC Womens Health. 2022 Jul 25;22(1):309. doi: 10.1186/s12905-022-01881-0.
Despite the benefits of cervical cancer (CC) screening to reduce the disease burden, uptake remains limited in developing countries. This study aims to assess the individual and community-level determinants of cervical cancer screening among women of reproductive age in Zimbabwe.
We analyzed data collected from 400 communities from the 2015 Zimbabwe Demographic and Health Survey with a sample size of 9955 women aged 15-49 years. The descriptive statistics and multi-level regression models adjusted for potential covariates were performed to examine the association between individual, household and community-level factors and the uptake of cervical cancer screening in women.
The mean (SD) age of women in Zimbabwe using cervical cancer screening was 27.9 (9.9) years. A relatively small proportion of women, i.e., only 13.4% had ever screened for cervical cancer, with higher screening rates observed in the following sub-groups: middle aged women 31-49 years (odds ratio (OR) = 2.01; 95% confidence intervals (CI) 1.72-2.34), and currently working (OR = 1.35; 95% CI 1.17-1.55), those with health insurance (OR = 1.95; 95% CI 1.63-2.34), used modern contraceptives (OR = 1.51; 95% CI 1.22-1.86), exposed to multiple media (OR = 1.27; 95% CI 1.03-1.58), those living in communities that had a high predominance of women with favorable attitude towards Intimate Partner Violence (IPV) against women (OR = 1.21; 95% CI 1.04-1.41) and a non-poor wealth index (OR = 1.54; 95% CI 1.14-2.05).
Our data shows a significantly low prevalence of cervical cancer screening among reproductive age women in Zimbabwe. To increase the uptake of cervical cancer screening, there is an urgent need both to implement behavioral interventions targeted at women from low socio-economic groups and to advocate for universal health coverage that includes financial risk protection to help all women realize their right to health.
尽管宫颈癌（CC）筛查可降低疾病负担，但在发展中国家，其普及率仍然有限。本研究旨在评估津巴布韦育龄妇女宫颈癌筛查的个体和社区水平决定因素。
我们分析了 2015 年津巴布韦人口与健康调查中来自 400 个社区的数据，样本量为 9955 名 15-49 岁的妇女。采用描述性统计和多水平回归模型调整潜在混杂因素，以检验个体、家庭和社区水平因素与妇女接受宫颈癌筛查之间的关系。
津巴布韦使用宫颈癌筛查的妇女平均（SD）年龄为 27.9（9.9）岁。只有很小比例的妇女，即只有 13.4%曾接受过宫颈癌筛查，以下亚组的筛查率较高：31-49 岁的中年妇女（比值比（OR）=2.01；95%置信区间（CI）1.72-2.34）和目前正在工作的妇女（OR=1.35；95%CI 1.17-1.55）、有健康保险的妇女（OR=1.95；95%CI 1.63-2.34）、使用现代避孕药具的妇女（OR=1.51；95%CI 1.22-1.86）、接触多种媒体的妇女（OR=1.27；95%CI 1.03-1.58）、生活在社区中对针对妇女的亲密伴侣暴力（IPV）持有利态度的妇女占多数的社区的妇女（OR=1.21；95%CI 1.04-1.41）和非贫困财富指数（OR=1.54；95%CI 1.14-2.05）。
我们的数据显示，津巴布韦育龄妇女宫颈癌筛查的普及率明显较低。为了提高宫颈癌筛查的普及率，不仅需要针对社会经济地位较低的妇女实施行为干预措施，还需要倡导全民健康覆盖，包括财务风险保护，以帮助所有妇女实现其健康权。
