Cervical cancer knowledge, attitudes, beliefs and practices of women aged at least 25 years in Harare, Zimbabwe

Abstract

BACKGROUND : Cervical cancer is the most common cancer and a major cause of morbidity and mortality among women in Zimbabwe yet it is preventable, early detectable and highly curable. The objective of this study was to investigate knowledge, attitudes, beliefs and practices towards cervical cancer, its prevention and treatment in Harare, Zimbabwe. METHODS : Sequential explanatory mixed methods approach consisting of analytical cross sectional survey and a qualitative inquiry was used. Study population consisted of women with cervical cancer, health workers and other stakeholders who are involved in cancer control programmes. Patient survey data were collected using validated structured questionnaire in Surveytogo software in an android tablet. Qualitative study used key informant interviews to understand survey findings better. Data analyses for the survey involved univariate and multivariate analyses using STATA version 14. For qualitative study, themes in transcripts were coded and analyzed using Dedoose software to generate evidence for the study. RESULTS : Participants reported different levels of knowledge of causes (23%), risk factors (71%), prevention (72%), screening (73%) and treatment (80%) of cervical cancer. Knowledge of causes of cervical cancer were negatively associated with: being aged 45 or more years (OR = 0.02; p = 0.004), having no household income (OR = 0.02;p = 0.007), household income <US$600 per month (OR = 0.02; p = 0.015), middle class wealth (OR = 0.01;p = 0.032), watching TV daily (OR = 0.01;p = 0.007) and 1–6 times per week (OR = 0.02; p=0.045). Knowledge of causes of cervical cancer were also positively associated with listening to radio daily (OR = 394, CI: 11.02–1406) (p = 0.001) and 1–6 times a week (OR = 100, CI: 2.95–3364) (p = 0.010). Knowledge of prevention was only positively associated with listening to the radio daily (OR = 77, CI: 1.89–3114) (p = 0.022) and 1–6 times a week (OR = 174, CI: 2.42–1255) (p = 0.018). Major drivers of lack of knowledge for cervical cancer were: limited awareness programmes, lack of knowledge among health workers, donor prioritization of infectious diseases, infancy of cervical cancer interventions, negative attitudes towards cervical cancer and misconceptions. CONCLUSIONS : This study revealed that knowledge of causes and prevention of cervical cancer was associated with frequent radio listenership. Strengthening of health education through the packaging of messages targeting the wider society using different delivery channels is thus recommended.