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“We Shall Tell them with Love, Inform them what we have Learnt and then Allow them to go” - Men’s Perspectives of Self-Collected Cervical Cancer Screening in Rural Uganda: A Qualitative Inquiry

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Abstract

Uganda has high incidence rates of cervical cancer (47.5/100,000/year) due to limited screening access. In settings where men hold most of the decision-making power, they play an important role in women’s uptake of cervical cancer screening. We aimed to capture men’s knowledge, beliefs and perspectives about cervical cancer, community-based screening and health system barriers. Focus group discussions were conducted with men in rural Uganda. Data were verbatim translated and transcribed into English. Transcripts were analysed in ATLAS.ti using a deductive approach of thematic content analysis and applied to an implementation research framework. Twenty-three men participated in focus groups. Men held poor knowledge of cervical cancer, its causes and treatment. Men felt screening would be acceptable by women if men and women were educated. Men highlighted health system barriers to accessing screening including: 1) poor-quality health services, 2) large distances to facilities/lack of affordable transportation and 3) lack of health workers/mistreatment by health workers. Men described supporting women through assisting with transportation, psychosocial support and sharing information. They requested services for men to be decentralized alongside community outreaches for cervical cancer screening. Engaging men in the implementation, education and planning of community-based cervical cancer screening programs is critical. Not engaging men is a missed opportunity to provide them with services and education. Concerted efforts must be made in educating men and reducing health system barriers to ensure rural women receive cervical cancer screening and follow-up care in low-income settings. Clinicaltrials.gov, NCT04000503; Registered 27 June 2019.

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Acknowledgements

We would like to thank the men who participated in our study for sharing their insights and time, as well as the community health workers who helped organize this research.

Funding

This study was funded by the Canadian Institutes of Health Research (CIHR). CIHR played no role in or had authority over the study design; collection, management, analysis and interpretation of data; writing of the report; or the decision to submit for publication.

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Authors and Affiliations

  1. Faculty of Medicine, School of Population and Public Health, University of British Columbia, 2206 East Mall Drive, Vancouver, BC, V6T 1Z3, Canada

    Angeli Rawat, Nadia Mithani, Beth Payne & Gina Ogilvie

  2. Women’s Health Research Institute, H203-4500 Oak St, Vancouver, BC, V6H 3N1, Canada

    Angeli Rawat, Nadia Mithani, Catherine Sanders, Beth Payne & Gina Ogilvie

  3. Uganda Cancer Institute, Upper Mulago Hill Road, P.O. Box 3935, Kampala, Uganda

    Ruth Namugosa, Jackson Orem & Carolyn Nakisige

  4. Department of Obstetrics & Gynaecology, Faculty of Medicine, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada

    Sheona Mitchell-Foster

Authors
  1. Angeli Rawat
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  2. Nadia Mithani
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  3. Catherine Sanders
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  4. Ruth Namugosa
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  5. Beth Payne
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  6. Sheona Mitchell-Foster
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  7. Jackson Orem
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  8. Gina Ogilvie
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  9. Carolyn Nakisige
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Contributions

Dr. Carolyn Nakisige was the local PI and oversaw the intervention and together with Dr. Angeli Rawat conceptualized, designed and implemented the study. Material preparation, data collection and analysis were performed by Dr. Angeli Rawat, Dr. Carolyn Nakisige and Ms. Ruth Namugosa. The first draft of the manuscript was written by Dr. Angeli Rawat, Ms. Nadia Mithani and Ms. Catherine Sanders and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Angeli Rawat.

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Ethics Approval

All aspects of the study were approved by the University of British Columbia Children and Women’s Research Ethics Board (H17-01593) and the Uganda Cancer Institute Ethics Review Board (UCIREC REF-02–2017). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Rawat, A., Mithani, N., Sanders, C. et al. “We Shall Tell them with Love, Inform them what we have Learnt and then Allow them to go” - Men’s Perspectives of Self-Collected Cervical Cancer Screening in Rural Uganda: A Qualitative Inquiry. J Canc Educ 38, 618–624 (2023). https://doi.org/10.1007/s13187-022-02163-x

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  • DOI: https://doi.org/10.1007/s13187-022-02163-x

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