卢旺达城乡人口宫颈癌筛查的障碍。
The barriers to cervical cancer screening for urban and rural populations in Rwanda.
作者信息
Dau Hallie, Vidler Marianne, AboMoslim Maryam, Mutamba Barbra, Nesbitt Zoey, Deodatha John, Byiringiro Schadrack Danson, Niyotwiringiye Charles, Mithani Nadia, Nair Varun, Smith Laurie, Rulisa Stephen, Ogilvie Gina
机构信息
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Women's Health Research Institute, Vancouver, BC, Canada.
出版信息
BMC Glob Public Health. 2023 Jul 31;1(1):4. doi: 10.1186/s44263-023-00005-6.
BACKGROUND
Cervical cancer is the leading cause of cancer mortality in Rwandan women. There is a limited understanding of the barriers that women face to obtain cervical cancer screening in Rwanda. It is important to understand the barriers in order to implement effective screening programs. The goal of this study is to describe the barriers to cervical cancer screening among women in Rwanda and how they differ among women in rural and urban areas.
METHODS
This cross-sectional study recruited women from June 1 to 9, 2022, at Muhima and Nyamata District Hospitals in Rwanda. Women were eligible for the study if they were ≥ 18 years and spoke Kinyarwanda or English. Women completed a 15-min survey which included questions on the participants' demographics, knowledge of cervical cancer, cervical cancer screening history, and barriers to healthcare. Women were stratified by survey location (urban vs rural). Descriptive statistics were reported.
RESULTS
A total of 374 women completed the survey with 169 participants from Muhima and 205 from Nyamata. Most women were in a relationship and had a primary school or less education. The most common barriers to accessing general healthcare services were long wait times at the facility (Muhima 26%; Nyamata 30%), low quality of care (Muhima 15%; Nyamata 12%), and transportation costs (Muhima 13%; Nyamata 9.3%). However, women from Nyamata were significantly more likely to report distance to the health center as a barrier (p-value < 0.001), and women from Muhima were significantly more likely to report transportation method as a barrier (p-value = 0.004). The primary reason reported for not obtaining cervical cancer screening was that women did not know how or where to get tested (Muhima 57%; Nyamata 51%).
CONCLUSIONS
The most common barriers to cervical cancer screening in Rwanda were the quality of clinical care and issues with traveling to the clinic. Implementing a cervical cancer self-collection program could help eliminate many barriers that women face to obtain health services in Rwanda. More research is needed to better understand the acceptability of cervical cancer screening in Rwanda and how it could be integrated into the healthcare system.
背景
宫颈癌是卢旺达女性癌症死亡的主要原因。人们对卢旺达女性在接受宫颈癌筛查时面临的障碍了解有限。了解这些障碍对于实施有效的筛查计划很重要。本研究的目的是描述卢旺达女性宫颈癌筛查的障碍，以及农村和城市女性之间的差异。
方法
这项横断面研究于2022年6月1日至9日在卢旺达的穆希马和尼亚马塔区医院招募女性。年龄≥18岁且会说基尼亚卢旺达语或英语的女性符合研究条件。女性完成了一项15分钟的调查，其中包括关于参与者的人口统计学、宫颈癌知识、宫颈癌筛查史以及医疗保健障碍的问题。女性按调查地点（城市与农村）分层。报告了描述性统计数据。
结果
共有374名女性完成了调查，其中169名来自穆希马，205名来自尼亚马塔。大多数女性处于恋爱关系中，接受过小学及以下教育。获得一般医疗服务的最常见障碍是在医疗机构等待时间长（穆希马26%；尼亚马塔30%）、护理质量低（穆希马15%；尼亚马塔12%）和交通费用（穆希马13%；尼亚马塔9.3%）。然而，尼亚马塔的女性报告距离健康中心远是障碍的可能性显著更高（p值<0.001），穆希马的女性报告交通方式是障碍的可能性显著更高（p值=0.004）。未进行宫颈癌筛查的主要原因是女性不知道如何或在哪里进行检测（穆希马57%；尼亚马塔51%）。
结论
卢旺达宫颈癌筛查最常见的障碍是临床护理质量和前往诊所的问题。实施宫颈癌自我采集计划有助于消除卢旺达女性在获得医疗服务时面临的许多障碍。需要更多研究来更好地了解卢旺达宫颈癌筛查的可接受性以及如何将其纳入医疗保健系统。
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