Department of Pediatric Hematology and Oncology Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
BMC Health Serv Res. 2024 Jun 14;24(1):731. doi: 10.1186/s12913-024-11169-8.
Cervical cancer remains the second most common cause of death in women and poses a growing public health challenge. It is urgent to increase cervical cancer screening rates in Kenya as per the 2018 Kenya National Cancer Screening Guidelines. Addressing access to care may serve as a target to achieve this goal; however, how individual dimensions of access to care are associated with the utilization of cervical cancer screening services in low- and middle-income countries, including Kenya, remains unclear. This study aimed to examine how different aspects of access to care (affordability, availability, geographical access, and social influence) were associated with cervical cancer screening among Kenyan women of reproductive age.
This cross-sectional study used data from the 2014 Kenya Demographic and Health Survey and the 2010 Kenya Service Provision Assessment. The final sample included 5,563 women aged 25-49 years. Logistic regression models were used to examine the association between different aspects of access to care and the uptake of cervical cancer screening.
Factors such as being in the poorest wealth quintile, lacking health insurance, having difficulty obtaining funds for treatment (affordability), limited availability of screening services at nearby facilities (availability), living in rural areas (geographical access), and having healthcare decisions made solely by husbands/partners or others (social influence) were associated with a decreased likelihood of the uptake of cervical cancer screening.
Increasing health insurance coverage, enhancing the availability of screening services at health facilities, expanding mobile screening health facilities in rural areas, and empowering women to make their own healthcare decisions are crucial steps for increasing cervical cancer screening uptake in Kenya.
宫颈癌仍然是女性死亡的第二大主要原因，也是一个日益严峻的公共卫生挑战。肯尼亚急需根据 2018 年肯尼亚国家癌症筛查指南提高宫颈癌筛查率。解决获得医疗服务的机会问题可能是实现这一目标的一个目标；然而，在肯尼亚等中低收入国家，获得医疗服务的各个方面与宫颈癌筛查服务的利用之间的关系尚不清楚。本研究旨在探讨获得医疗服务的不同方面（可负担性、可及性、地理可及性和社会影响力）如何与肯尼亚育龄妇女的宫颈癌筛查利用相关。
本横断面研究使用了 2014 年肯尼亚人口与健康调查和 2010 年肯尼亚服务提供评估的数据。最终样本包括 5563 名 25-49 岁的妇女。使用逻辑回归模型来检验获得医疗服务的不同方面与宫颈癌筛查利用率之间的关联。
处于最贫穷五分之一的财富阶层、缺乏健康保险、难以获得治疗资金（可负担性）、附近医疗机构的筛查服务有限（可及性）、居住在农村地区（地理可及性）以及由丈夫/伴侣或其他人全权决定医疗保健决策（社会影响力）等因素与宫颈癌筛查利用率降低有关。
增加健康保险覆盖范围、增强卫生设施的筛查服务可用性、扩大农村地区的流动筛查卫生设施以及赋予妇女自主做出医疗保健决策的权力，是肯尼亚提高宫颈癌筛查利用率的关键步骤。
