Sociocultural factors influencing cervical pre-cancer screening among women attending Mbagathi level four hospital, Nairobi, Kenya

Abstract

Cervical cancer poses a significant global health challenge, causing around 340,000 deaths annually and ranking as the fourth most frequent cancer worldwide. The burden is heaviest in low- and middle-income countries (LMICs), where more than 90% of cervical cancer deaths occur, largely due to inadequate screening. In Kenya, cervical cancer is the second most frequent cancer among women after breast cancer, with 5,236 new cases and 3,211 deaths annually. Kenya’s cervical cancer mortality rates are expected to increase by 50% by 2030. Cervical pre-cancer screening, as endorsed by the WHO, stands as a crucial strategy towards the elimination of cervical cancer by 2030. Sociocultural barriers such as stigma, gender roles, and economic constraints continue to limit participation in preventive health programs. This study aimed to determine the sociocultural determinants influencing cervical pre-cancer screening uptake among women attending Mbagathi Level Four Hospital in Nairobi, Kenya, using the Health Belief Model as the guiding theoretical framework. An analytical cross-sectional design was employed, targeting women aged 25–49 years. A total of 240 participants were interviewed through systematic random sampling at the hospital’s Mother and Child Health Clinic. Data was collected using structured questionnaires administered via KoboCollect and supplemented by health worker interviews. Descriptive statistics, chi-square tests, and logistic regression analyses were conducted using SPSS version 26. The study revealed the cervical pre-cancer screening rate among respondents as 39.6%. Screening uptake was shaped by multiple sociocultural factors. Insurance coverage showed a notable disparity, with 65.8% of women enrolled in NHIF while 34.2% lacked coverage. Although 69.6% reported discussing cervical cancer screening, 30.4% avoided such conversations due to stigma and cultural restrictions. Social networks exerted a strong influence on behavior, as 55.4% of the participants had friends who had undergone screening. Regression analysis revealed that sociocultural factors moderately predicted screening uptake (R = 0.413), accounting for 17.1% of variance. Participation was mainly associated with age, education, occupation, and income, but not with marital status or religion. Results demonstrate that cultural stigmas together with financial difficulties and weak awareness levels prevent screening from taking place, although individuals show strong confidence in discussing the issue (mean = 4.79, SD = 0.579). The study results also demonstrate that sociocultural variables strongly influence preventive actions in healthcare, yet unidentified elements remain important. The solution to these hurdles demands expert-crafted education, which refutes superstitions while providing monetary support to reduce affordability problems, and peer-based healthcare promotion, which activates community networks. This research reveals universal importance beyond Nairobi through its demand for local healthcare initiatives that will break down barriers and achieve health equity across similar areas. Additional future research needs to study variables beyond the findings that include systemic roadblocks alongside mental barriers so that complete strategies for sustainable screening participation and cervical cancer prevention become possible.