Abstract:
BACKGROUND : Cervical cancer is the most commonly diagnosed cancer among women in Zimbabwe; however;
access to screening and treatment services remain challenged. The objective of this study was to investigate
socio-demographic inequities in cervical cancer screening and utilization of treatment among women in
Harare, Zimbabwe.
METHODS : Two cross sectional surveys were conducted in Harare with a total sample of 277 women aged at least 25
years. In the community survey, stratified random sampling was conducted to select 143 healthy women in Glen View,
Cranborne, Highlands and Hopely communities of Harare to present high, medium, low density suburbs and rural
areas respectively. In the patient survey, 134 histologically confirmed cervical cancer patients were also randomly
selected at Harare hospital, Parirenyatwa Hospital and Island Hospice during their routine visits or while in hospital
admission. All consenting participants were interviewed using a validated structured questionnaire programmed in
Surveytogo software in an android tablet. Data was analyzed using STATA version 14 to yield descriptive statistics,
bivariate and multivariate logistic regression outcomes for the study.
RESULTS : Women who reported ever screening for cervical cancer were only 29%. Cervical cancer screening was less
likely in women affiliated to major religions (p < 0.05) and those who never visited health facilities or doctors or visited
once in previous 6 months (p < 0.05). Ninety-two (69%) of selected patients were on treatment. Women with cervical
cancer affiliated to protestant churches were 68 times [95% CI: 1.22 to 381] more likely to utilize treatment and care
services compared to those in other religions (p = 0.040). Province of residence, education, occupation, marital status,
income (personal and household), wealth, medical aid status, having a regular doctor, frequency of visiting health
facilities, sources of cervical cancer information and knowledge of treatability of cervical cancer were not associated
with cervical cancer screening and treatment respectively.
CONCLUSION : This study revealed few variations in the participation of women in cervical cancer screening and
treatment explained only by religious affiliations and usage of health facilities. Strengthening of health education in
communities including churches and universal healthcare coverage are recommended strategies to improve uptake of
screening and treatment of cervical cancer.
