Reproductive Health and Wellness
Norms and beliefs related to cervical cancer screening amongst women aged 25–49 in Botswana: A pilot study
Cervical cancer is the fourth leading type of cancer in women worldwide (Joshi and Sankaranarayana, 2015; World Health Organization, 2015). According to Bigoni et al. (2015) cervical cancer is a major public health problem with new diagnosed cases at 530,232, and 275,008 deaths annually. It is estimated that around 270,000 women died from cervical cancer in 2012; more than 85% of these deaths occurring in low- and middle-income countries which includes Botswana (McFarland, 2009). According to McFarland (2009) cervical cancer is the most common cancer leading to mortality and mobility among women in Botswana. Ministry of Health in Botswana (2009) noted that cervical cancer incidents continue to rise each year. World Health Organization (WHO) as cited by Ramogola-Masire (2014) “predicted that morbidity and mortality due to cervical cancer will increase by more than 20 per cent by 2025 in women under the age of 65, if no change occurs in the current trends (p. 81)”. It is therefore crucial for developing countries like Botswana to take action just like the developed countries. The United Nations (2018) places Botswana as a developing country. A developing country is a low or a middle income country. Furthermore, Lim and Ojo (2017) noted that all countries in the sub Saharan African region of which Botswana is part are classified as developing countries. The developed countries have less mortality rate of cervical cancer amongst women. This is because they have established and well orga- nized screening programs that allow the early detection of the virus. This allows for the women to get the appropriate treatment hence preventing the development of cervical cancer. The opposite is true for Botswana where screening is opportunistic. About 90% of women presenting with cervical cancer have been observed to have never been screened for cervical cancer in their lifetime (Ramogola-Masire et al., 2012). According to Bano et al. (2007) cervical cancer screening has been observed to be an important diagnostic tool to detect pre-can- cerous and cancerous lesions of the uterine cervix. It is well docu- mented that the evolution of cervical intraepithelial lesion and the implication of persistent infection with the human papillomavirus (HPV), a common sexually transmitted infection (Pitts and Clarke, 2002; Sigurdsson and Sigvaldason, 2007) are closely related. Even though there are over 100 sub-types of HPV, only a few do cause cer- vical cancer. HPV sub-types 16 and 18 have been observed to account for about 70% of cervical cancers (Dodd et al., 2014; Schiffman & Solomon, 2013). In spite of the fact that cervical cancer is the leading cause of women deaths in Botswana (McFarland, 2009; Ramogola-Masire et al., 2012) and the reported benefits of cancer screening uncertainties surrounding cervical cancer screening, very few women go for screening. Inadequate knowledge about the importance of cervical cancer screening and the negative attitude towards cervical cancer amongst women in Botswana has been identified as one of the reasons for low cervical cancer screening rates (McFarland, 2003). Similarly (71%) of women surveyed in Kenya, were not aware of what cervical cancer is. For those who had been screened 6% cited barriers for cervical cancer screening such as fear, lack of time and lack of knowledge about cervical cancer (Sudenga, Rositch, Otieno, & Smith, 2013). Successful cervical cancer screening programs are dependent on informed target populations (Ibekwe, Hoqe & Ntuli-Ngcobo, 2010). In addition, women who had misconceptions about cervical cancer do not feel the need to go for screening (Rosser, Njoroge & Huchko, 2015). Therefore, this study is conducted to find out the norms and beliefs regarding cervical cancer screening among women in Botswana.
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