Assessing the awareness/knowledge of cervical cancer and screening among rural women, and the health stakeholders’ perception of the relevant strategy implementation in Imo state, South-Eastern Nigeria

Background: Cervical cancer has always been a significant public health issue, mostly in developing countries. The low attendance to screening programs has been evidenced to increase among the rural community due to lack of knowledge. Method: The research was divided into two different studies and adopted a mixed-method research approach. Study 1 assessed the awareness/knowledge and health beliefs of rural women regarding cervical cancer and its impact on screening participation using the Health Belief Model as a theoretical framework. About 436 rural women ≥18 years completed the questionnaire. Study 2 assessed the perception of relevant implementation strategy among health stakeholders, of which 22 of them were recruited and interviewed. Participants involved in both studies were recruited from Imo State, South-East Nigeria. Results: SPSS v.20 was used for study 1 analysis. Findings showed that the awareness of cervical cancer has a significant impact on screening participation. Also, >50% of the women lack knowledge of cervical cancer and believe they are less susceptible to the disease but perceive the disease outcome as highly severe. The main identified barriers to screening were, lack of money (86%), lack of information/awareness (85.8%), screening location is far (74.5%), and lack of knowledge of where screening is done (61.7%). Study 2 adopted thematic analysis using the NVivo software. Strategies to improve awareness have not been effective in reducing cervical cancer disease or increasing screening participation among rural women in Imo State, Nigeria. Conclusion: This research suggests better ways of increasing the awareness/knowledge of cervical cancer and screening among the target population. The benefits of screening ought to be routinely discussed, and policies tailored to women's needs mostly at the community level need to be drafted.