Facilitators and Barriers to Cervical Cancer Screening Among Women in a Rural District of Northeastern Uganda, a Qualitative Study

Abstract

Introduction: Cervical cancer screening in Uganda has remained relatively low, with fewer than one in 10 of eligible women screened, despite the availability of cervical cancer screening services in most health facilities. The barriers and facilitators of cervical cancer screening in remote rural settings of Northeastern Uganda like Ngora are not yet well understood. This study therefore aimed to assess the barriers and facilitators to cervical cancer screening among women of reproductive age in a remote rural district Ngora, Northeastern Uganda. Methods: This study employed a qualitative approach to gather in-depth insight into the barriers and facilitators of cervical cancer screening. We conducted six focused group discussions (FGDs) (4 females and 2 males) with the community members and nine key informant interviews (KIIs) with the health workers in Ngora district. The participants for FGDs were chosen through convenient sampling while those for KIIs were chosen through purposive sampling methods. The interviews were audio-recorded and subse quently transcribed for analysis. Data was analyzed using thematic analysis techniques to identify significant patterns and themes related to cervical cancer screening behaviors, while inductive coding was conducted to identify codes and create meaning around the texts. Results: The facilitators of cervical cancer screening were active community sensitization, availability of screening services at designated facilities, supportive national policies, and integration with other health services, while the barriers included myths and misconceptions about cervical cancer screening, stock-outs of essential commodities for screening, long distances to the health facilities, limited human resources, and informal costs charged by the health facilities. Conclusion: Improving cervical cancer screening uptake requires a multi-pronged approach that strengthens health systems, addresses myths and misinformation, reduces financial and logistical burdens, and mobilizes community support. Keywords: cervical cancer, facilitators, barriers, community sensitization