# Improving cervical cancer screening rates among women of reproductive age in rural Kisumu County through dialogue-based community health education

## TL;DR

A dialogue-based health education approach increased cervical cancer screening rates among women in rural Kisumu County.

## Contribution

The study introduces a dialogue-based community health education method to improve cervical cancer screening uptake in rural areas.

## Key findings

- The intervention group showed a significant increase in self-reported screening rates (p = 0.007).
- Barriers like privacy concerns and lack of spousal support were identified as significant obstacles (p < 0.0001).

## Abstract

Low- and middle-income countries continue to bear the burden of cervical cancer partly due to low uptake of screening services. Interventions through the media to increase demand for screening services among women of reproductive age (WRA) have not yielded the desired results mainly due to the unidirectional flow of information. The current study evaluated the use of a dialogue-based approach to community health education to improve the demand for cervical cancer screening services among WRA in rural sub-counties in Kisumu County.

This was a mixed-method longitudinal pre and post-intervention study with a control group. The self-reported screening rates were assessed at baseline in both the intervention and control groups followed by dialogue-based community health education in the intervention arm. This was followed by endline screening rates evaluation. The screening rates at baseline and endline were compared followed by a focused group discussion among the leaders of the community units to discuss the contributors to the observed screening rates. The proportion of change in the screening rates was calculated and statistical significance was assessed at p ≤ 0.05.

There was a significant increase in the number of WRA reporting to have been screened at the endline in the intervention arm (p = 0.007). The number of those being screened due to the health talks conducted by the Community health volunteers also increased significantly at the endline (p = 0.036). The barriers included; not knowing where to get screened (p < 0.0001), violation of ones’ privacy (p < 0.0001), lack of spousal support (p < 0.0001), waiting time at the facility (p = 0.001), attitude of the health providers (p < 0.0001) and cost of transport to the facility (p < 0.0001).

The use of dialogue-based community health education has the potential to improve the uptake of cervical cancer screening services and identify the additional barriers as experienced by the WRA targeted for screening.