Introduction
Cervical cancer remains a leading health concern for women in sub-Saharan Africa. In Kenya, screening through maternal and child health (MCH) clinics presents a vital touchpoint for early detection and prevention of cervical cancer. Understanding the factors that influence whether women participate in cervical cancer screening at MCH clinics can help policymakers, healthcare workers, and community organizations design interventions that increase uptake and save lives.
Key individual factors
Various personal characteristics shape a woman’s likelihood of getting screened. Age often plays a role, with different age groups displaying varying levels of awareness and perceived risk. Education level and health literacy influence understanding of screening benefits and procedures. Women with higher knowledge about cervical cancer and screening methods are more likely to participate. Perceived susceptibility is another driver; when women recognize their risk, they are more inclined to seek screening. Conversely, fears about pain, privacy concerns, or stigma can deter participation.
Socio-economic and demographic factors
Socio-economic status, including income and employment, can affect access to services and transportation. Women in rural areas may face longer travel times, higher costs, and limited clinic availability compared with urban residents. Household responsibilities, time constraints, and lack of childcare can also impede attendance at screening visits scheduled through MCH services.
Health system and service delivery factors
The structure and delivery of cervical cancer screening within MCH clinics significantly impact uptake. Key enablers include routine provider recommendations, which have been shown to strongly influence women’s decisions to screen. Integrated services—where screening is offered alongside other maternal and child health services—reduce missed opportunities and make screening more convenient for busy mothers.
Clinic accessibility, including operating hours, friendly staff, and availability of female healthcare workers, can affect comfort and willingness to undergo screening. The availability of affordable or free screening, clear referral pathways for abnormal results, and prompt follow-up care are crucial for sustained engagement. Stockouts of screening supplies or lengthy wait times can erode trust and deter future participation.
Community and social factors
Community norms, partner support, and family influence play a notable role. Encouragement or requests from spouses, mothers, and peers can increase screening uptake. Community health education campaigns that address myths and provide information in local languages help improve knowledge and reduce stigma. Positive experiences shared by other women at MCH clinics can create ripple effects, normalizing cervical cancer screening as part of routine care.
Barriers and facilitators
Barriers often cited include lack of knowledge about screening benefits, fear of discovering a health problem, transportation challenges, and costs. Facilitators include targeted education, male partner engagement where appropriate, mobile outreach clinics, and community-based screening programs linked to MCH services. Ensuring privacy and culturally sensitive communication also enhances trust and participation.
Implications for policy and practice
Policymakers and health managers should prioritize:
- Training for MCH clinic staff to deliver nonjudgmental, clear cervical cancer screening information and to reinforce the importance of screening during routine visits.
- Integrated service models that offer screening during well-baby visits, immunization days, or postnatal checkups to maximize reach.
- Community-based education campaigns using local languages and trusted community figures to dispel myths and promote early detection.
- Strengthened follow-up systems for abnormal results, including patient navigation and transport support where needed.
Conclusion
Screening for cervical cancer at maternal and child health clinics in Kenya is influenced by a mix of individual, socio-economic, health system, and community factors. By addressing knowledge gaps, reducing practical barriers, and embedding screening within routine MCH care, Kenya can improve screening rates, enable early treatment, and reduce the burden of cervical cancer among women.
