Knowledge and attitudes towards cervical cancer health education and counseling and associated factors among health workers in community drug outlets in Kawempe division in Kampala district; A cross-sectional study

Abstract

Introduction:Cervical cancer is an increasing public health threat worldwide, especially in developing countries. It is the most common cancer among women in Uganda. Despite its high incidence, there is still a low uptake of cervical cancer screening. Increasing the uptake of screening and vaccination services requires awareness of the community about cancer, risk factors, preventive mechanisms, and the availability of such services besides their benefits. Health workers in community drug outlets are in a position to promote healthy behavior and to improve the uptake of those services because they are among the most accessed medical facilities. Objectives: To assess the knowledge and attitudes towards cervical cancer health education and counseling, and associated factors among health workers in community drug outlets in Kawempe division in Kampala district. Methods: A cross-sectional design was used in this study. Interviewer-administered questionnaires with information on knowledge and attitudes toward cervical cancer health education and counseling were used to collect data from health workers in community drug outlets. Descriptive statistics including mean, standard deviation, and median were used to summarize continuous data. Categorical data was summarized using frequency distribution tables and percentages. Modified Poisson regression was used to determine the association between the independent and dependent variables. Results: A total of 410 study participants were included in this study. Of 410 study participants, 51.71% [95% CI: 46.75% – 56.64%] had good knowledge regarding cervical cancer and 38.5% [95% CI: 33.8% – 43.4%] had positive attitudes towards cervical cancer health education and counseling. The factors that were associated with good knowledge of cervical cancer included attendance of cervical cancer training (APR = 1.28, 95%CI: 1.07 – 1.54, p = 0.008), interaction with one or two cervical cancer patients (APR = 1.35, 95%CI: 1.10 – 1.64, p = 0.003), interaction with three or more cervical cancer patients (APR = 1.47, 95%CI: 1.13 – 1.97, p = 0.005), and seeing 41 to 60 clients in a day (APR = 1.53, 95%CI: 1.13 – 2.09, p = 0.006). The factors that were associated with positive attitude towards cervical cancer health education and counseling included; working between 31 to 60 hours a week (APR = 0.47, 95% CI: 0.30 – 0.74, p = 0.001), having 1 or 2 clients seeking knowledge about cervical cancer (APR = 1.33, 95% CI: 1.05 – 1.69, p = 0.019), having 3 or more clients seeking knowledge about cervical cancer (APR = 1.74, 95% CI: 1.18 – 2.59, p = 0.006), and serving between 21 to 40 patients in a day (APR = 0.71, 95% CI: 0.52 – 0.96, p = 0.028). Conclusion: Healthcare workers in community drug outlets ought to play a pivotal role in promoting health practices including providing health education and counseling. This study revealed that healthcare workers in community drug outlets are quite limited in knowledge regarding cervical cancer and few have positive attitudes toward cervical cancer health education and counseling. Improving knowledge and attitudes of healthcare workers in community drug outlets towards cervical cancer health education and counseling through various interventions such as revising policies on cervical cancer prevention and control stipulating vividly their role, offering guidelines in the provision of these services and the necessary trainings, and ensuring their access to various information and education materials on cervical cancer will facilitate their role in promoting cervical cancer prevention and control within their communities.