Women's Perceptions of Utilisation of Cervical Cancer Prevention Services in Southwestern Nigeria: A Qualitative Study

Purpose: Cervical cancer is one of the gravest threats to women’s lives that are of public health significance (World Health Organization [WHO], 2014). According to Africa Cervical Cancer Multi-Indicator Incidence and Mortality Scorecard (2014), Nigeria, the most populous country in Africa is ranked among the top 10 African countries with the highest cervical cancer mortality. It ranks second to breast cancer and about 14,089 new cervical cancer cases are diagnosed annually. Sexually active women are at risk of cervical cancer (WHO, 2014). However, several studies show that there has been a low utilisation of cervical cancer prevention services. Thus, it is important to understand women’s perceptions of utilisation of cervical cancer prevention services, as this will provide useful information for designing interventions aimed at improving utilisation of cervical cancer prevention services. This is with the view of providing empirical evidence for improving cervical cancer prevention services in Southwestern Nigeria.

Methods: The study was conducted in two states in southwestern Nigeria; Osun and Lagos States. The exploratory research design was used, using Anderson and Newman’s utilisation model which employs a deductive approach. Two communities in each state which had at least one secondary health facility offering cervical cancer prevention services were selected. Sixty-four women in the reproductive age group (30-49 years) were purposively selected to participate in the study from the communities. Focus Group Discussion guide was used for data collection. Eight Focus Group Discussions; 4 FGDs in each state were conducted. Data were recorded, transcribed, coded and organised into themes using NVivo 10.

Results: The emerged themes situate the three contextual factors of women’s perception of utilisation of cervical cancer prevention services; the commonest predisposing factor which made the women utilise the cervical cancer prevention services were their level of awareness and knowledge of cervical cancer, while the cost of service was the most stated individual enabling factor to utilise the cervical cancer prevention services. Quality of cervical cancer prevention services delivery was conveyed as the health system factor that influences their utilisation of cervical cancer prevention services by the participants. Being sexually active was reported as the health need factor for utilisation of cervical cancer prevention services.

Conclusion: Women’s perspectives of the contextual factors are vital towards effective strategies to improve utilisation of cervical cancer prevention services.