The barriers to cervical cancer screening for urban and rural populations in Rwanda
Bibliographic record
Abstract
BACKGROUND: Cervical cancer is the leading cause of cancer mortality in Rwandan women. There is a limited understanding of the barriers that women face to obtain cervical cancer screening in Rwanda. It is important to understand the barriers in order to implement effective screening programs. The goal of this study is to describe the barriers to cervical cancer screening among women in Rwanda and how they differ among women in rural and urban areas. METHODS: This cross-sectional study recruited women from June 1 to 9, 2022, at Muhima and Nyamata District Hospitals in Rwanda. Women were eligible for the study if they were ≥ 18 years and spoke Kinyarwanda or English. Women completed a 15-min survey which included questions on the participants' demographics, knowledge of cervical cancer, cervical cancer screening history, and barriers to healthcare. Women were stratified by survey location (urban vs rural). Descriptive statistics were reported. RESULTS: A total of 374 women completed the survey with 169 participants from Muhima and 205 from Nyamata. Most women were in a relationship and had a primary school or less education. The most common barriers to accessing general healthcare services were long wait times at the facility (Muhima 26%; Nyamata 30%), low quality of care (Muhima 15%; Nyamata 12%), and transportation costs (Muhima 13%; Nyamata 9.3%). However, women from Nyamata were significantly more likely to report distance to the health center as a barrier (p-value < 0.001), and women from Muhima were significantly more likely to report transportation method as a barrier (p-value = 0.004). The primary reason reported for not obtaining cervical cancer screening was that women did not know how or where to get tested (Muhima 57%; Nyamata 51%). CONCLUSIONS: The most common barriers to cervical cancer screening in Rwanda were the quality of clinical care and issues with traveling to the clinic. Implementing a cervical cancer self-collection program could help eliminate many barriers that women face to obtain health services in Rwanda. More research is needed to better understand the acceptability of cervical cancer screening in Rwanda and how it could be integrated into the healthcare system.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".