Abstract:
While cervical cancer screening is key for early diagnosis and treatment, its uptake is often
sub-optimal and may be adversely affected by fatalism. The study aimed to establish the
factors associated with fatalism and its influence on cervical cancer screening among
women aged 15-54 years in Kiambu sub-county. This was because the sub-county is more
representative of the larger Kiambu County in terms study population characteristics. A
cross-sectional study design, involving a sample size of 400 obtained through simple
random sampling was employed. A standard in-person administered structured
questionnaire was initially pre-tested (Cronbach’s alpha 0.7) among 10 women and later
used for data collection from among selected households across Kiambu sub-county.
Before the actual data collection, consent was taken from eligible participants. Data
collected involved socio-demographic and socio-economic factors, knowledge, fatalism
and cervical cancer screening practices. After data collection, the questionnaires were
checked for completeness, and respective data entered into a standard excel data sheet.
This was followed by data cleaning, and coding for analysis. Descriptive statistics
generated cervical cancer screening, knowledge, and fatalism levels. Binary logistic
regression was used for all bivariable, and multivariable analyses to identify factors
associated with fatalism, knowledge on cervical cancer and cervical cancer uptake. To
establish the influence of fatalism on cervical cancer screening, a univariable and
multivariable logistic regression analysis was done adjusting for fatalism. A slightly above
a third 134 (34.5%) of the study participants were aged between 25-34 years, with almost
half being married 179(45.8%). A majority 267(70.1%) of the participants had no
substantial income, with slightly above half 203(52.2%) of them being protestants. The
prevalence of cervical cancer screening was 25.8%, whereas that of fatalism was 14.3%.
Only age of 35-44 years (AOR 2.1; 95% CI; 1.1-3.9; P=0.02) and being a Muslim (AOR
9.9; 95% CI 1.6-61.7; P=0.02) were significantly associated with fatalism. A majority
(80.6%) of the study participants had good knowledge on cervical cancer and screening.
Only the age of 45-54 years, (AOR 1.6; 95% CI 0.8-3.3; p=0.02), having attained a tertiary
level of education (AOR 0.45; 95% CI 0.3-0.8; p=0.01), and being a Muslim (AOR 0.13;
95% 0.02-0.8; p=0.03) were significantly associated with knowledge of cervical cancer
and screening. On adjusting for fatalism, there were no factors that significantly
influenced fatalism among the study participants. Conclusively, 25.8% uptake of cervical
cancer screening is low at 25.8%. A majority (80.6%) of women aged 15-54 years have
good knowledge of cervical cancer and screening in Kiambu Sub-County. While the level
of fatalism was low at 14.3%, more public health awareness campaigns should be focused
to women aged 35-44 years and the Muslims who constitute the factors significantly
associated with fatalism. While fatalism had no significant influence on cervical cancer
and screening, there is still the need to dispel any existing related fatalistic beliefs among
women aged 15-54 years in Kiambu Sub-County. The study recommends more public
health sensitization, and awareness campaigns to reach as many women aged 15-54 years
of age as possible with cervical cancer screening and linkage of those infected in care and
follow-up.
