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.
