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Determinants of Uptake of Cervical Cancer Screening Services at a No-Cost Reproductive Health Clinic Managed by Nurse-Midwives

Osingada, Charles P. MPH; Ninsiima, Gloria MSN; Chalo, Rose N. PhD; Muliira, Joshua K. DNP, MA, RN; Ngabirano, Tom MSN

doi: 10.1097/NCC.0000000000000156

Background: The incidence of cervical cancer (CC) has been rising in sub-Saharan Africa, and health authorities in this region have responded by increasing the availability of cheap or no-cost CC screening services (CCSS), public health education, and others. However, the efforts have not yet resulted into the expected uptake of CCSS.

Objective: The aim of this study was to examine the determinants of uptake of CCSS at a no-cost reproductive health clinic managed by nurse-midwives.

Methods: A descriptive design and a structured interview questionnaire were used to collect data from 236 women attending the reproductive health clinic. Logistic regression statistics were used to examine the determinants of uptake of CCSS.

Results: The mean age of participants was 28.7 years, and only 29% had received CC screening. The significant determinants of uptake of CCSS were concern about the gender of the healthcare professional (HCP) (odds ratio [OR], 5.03; P = .001), age older than 25 years (OR, 3.09; P = .005), contraceptive use (OR, 0.28; P = .02), encouragement by HCPs (OR, 0.16; P = .00), and perceived quality of CCSS (OR, 0.08; P = .00).

Conclusions: Gender of the HCP and encouragement or reminders by the HCP influence uptake of CCSS. Because nurse-midwives have successfully led strategies to promote other integrated reproductive health services, they can also play a key role in enhancing uptake of CCSS in resource-poor settings.

Implications for Practice: Interventions to enhance service quality and deliberate policies requiring HCP to recommend encourage and remind clients may help to enhance uptake of CCSS in resource-poor settings.

Author Affiliations: School of Health Sciences, College of Health Sciences, Department of Nursing, Makerere University, Kampala, Uganda (Mr Osingada and Ngabirano, Ms Ninsiima, and Dr Chalo); and College of Nursing, Department of Adult Health & Critical Care, Sultan Qaboos University, Muscat, Oman (Dr Muliira).

Authors’ contributions: C.P.O., G.N., R.N.C., and T.N. were responsible for the study conception, design, and data collection. C.P.O., G.N., and J.K.M. were responsible for data analysis and drafting of the first manuscript. All authors made critical revisions to the final paper for intellectual content.

The authors have no funding or conflicts of interest to disclose.

Correspondence: Joshua K. Muliira, DNP, MA, RN, College of Nursing, Department of Adult Health & Critical Care, Sultan Qaboos University, PO Box 66 Al Khod, PC 123, Muscat, Oman (

Accepted for publication March 4, 2014.

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