Knowledge and health facility–related determinants of men’s support for spousal cervical cancer screening: a mixed-methods study in a rural county of Southeastern Kenya
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20260280Keywords:
Uterine cervical neoplasms, Papilloma infections, Kenya, Health knowledge, Men, Partner participationAbstract
Background: Globally, cervical cancer is the fourth leading cause of cancer deaths. In Kenya, it is ranked as the second cause of cancer-related deaths among females. Men’s knowledge of cervical cancer is essential in reducing cervical cancer burden. This study was conducted in Makueni County, Kenya, to establish knowledge and health facility-related determinants of men’s support for spousal cervical cancer screening in Kenya.
Methods: Quantitative and qualitative data were collected using structured questionnaires from married men aged 18–64 years attending three rural Health facilities in Makueni County, Kenya. Participants were recruited via simple random sampling from purposively selected hospitals. Quantitative data were analysed using descriptive and inferential methods, while qualitative data employed thematic coding. Key informant interviews with nurses heading Maternal and Child Health services provided qualitative insights. Ethical approval was obtained and participants consented.
Results: Male support for spousal cervical cancer screening was low, with 82% showing minimal involvement. Knowledge factors such as knowledge of cervical cancer signs or symptoms, causative agent, risk factors, prevention, screening frequency, and screening duration was strongly associated with male involvement (p<0.001). Awareness that men can transmit the causative agent to women also showed a significant relationship with involvement (p=0.019). The level of male support was significantly associated with service availability, presence of signage, and cost (p<0.005).
Conclusions: Male support for their spouses cervical cancer screening was low, calling for increased health education and awareness among men to boost support for cervical cancer screening initiatives. Health facilities should ensure continuous access to free services and promote their awareness.
Metrics
References
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-49. DOI: https://doi.org/10.3322/caac.21660
WHO. Kenya Cancer Statistics. The Global Cancer Observatory. 2021. Available at: https://gco.iarc.fr/. Accessed on 23 November 2025.
Simelela PN. WHO global strategy to eliminate cervical cancer as a public health problem: An opportunity to make it a disease of the past. Int J Gynecol Obstet.2021;152(1):1-3. DOI: https://doi.org/10.1002/ijgo.13484
Ministry of Health. Kenya-Cancer-Policy. Nairobi, Kenya: Ministry of Health, Nairobi: Kenya. 2020. Available at: https://guidelines.health.go.ke/. Accessed on 23 November 2025.
Adegboyega A, Aleshire M, Dignan M, Hatcher J. Spousal support and knowledge related to cervical cancer screening: Are Sub-Saharan African immigrant men interested?. Health Care Women Int. 2019;40(6):665-81. DOI: https://doi.org/10.1080/07399332.2019.1615914
Sharma S, Bhuvan KC, Khatri A. Factors influencing male participation in reproductive health: a qualitative study. J Multidiscip Healthc. 2018;11:601-8. DOI: https://doi.org/10.2147/JMDH.S176267
Adewumi K, Oketch SY, Choi Y, Huchko MJ. Female perspectives on male involvement in a human-papillomavirus-based cervical cancer-screening program in western Kenya. BMC Womens Health. 2019;19:107. DOI: https://doi.org/10.1186/s12905-019-0804-4
Kusumaningrum T. Men’s Participation to Support Early Detection of Cervical Cancer in Indonesia: A Literature Review in Proc. 8th International Nursing Conference on Education, Practice and Research Development in Nursing (INC 2017), Advances in Health Sciences Research, Atlantis Press, Apr. 2017, pp. 171–173, doi: 10.2991/inc-17.2017.45. DOI: https://doi.org/10.2991/inc-17.2017.45
Ngwenya D, Huang SL. Knowledge, attitude and practice on cervical cancer and screening: a survey of men and women in Swaziland. J Public Health (Oxf). 2018;40(3):e343-50. DOI: https://doi.org/10.1093/pubmed/fdx174
Binka C, Doku DT, Nyarko SH, Asare KA. Male support for cervical cancer screening and treatment in rural Ghana. PLoS One. 2019;14(11):e0224692. DOI: https://doi.org/10.1371/journal.pone.0224692
Rosser JI, Zakaras JM, Hamisi S, Huchko MJ. Men’s knowledge and attitudes about cervical cancer screening in Kenya. BMC Womens Health. 2014;14:138. DOI: https://doi.org/10.1186/s12905-014-0138-1
Darj E, Chalise P, Shakya S. Barriers and facilitators to cervical cancer screening in Nepal: A qualitative study. Sex Reprod Healthc. 2019;20:20-6. DOI: https://doi.org/10.1016/j.srhc.2019.02.001
Marlow L, McBride E, Varnes L, Waller J. Barriers to cervical screening among older women from hard-to-reach groups: A qualitative study in England. BMC Womens Health. 2019;19(1):38. DOI: https://doi.org/10.1186/s12905-019-0736-z
Liebermann EJ, VanDevanter N, Shirazian T, Frías Gúzman N, Niles M, Healton C, et al. Barriers to Cervical Cancer Screening and Treatment in the Dominican Republic: Perspectives of Focus Group Participants in the Santo Domingo Area. J Transcult Nurs. 2020;31(2):121-7. DOI: https://doi.org/10.1177/1043659619846247
Binka C, Nyarko SH, Awusabo-Asare K, Doku DT. Barriers to the Uptake of Cervical Cancer Screening and Treatment among Rural Women in Ghana. Bio Med Res Int. 2019;6320938. DOI: https://doi.org/10.1155/2019/6320938
Lunsford BN, Ragan K, Smith JL, Saraiya M, Aketch M. Environmental and Psychosocial Barriers to and Benefits of Cervical Cancer Screening in Kenya. Oncologist. 2017;22(2):173-81. DOI: https://doi.org/10.1634/theoncologist.2016-0213
Adewumi K, Nishimura H, Oketch SY, Adsul P, Huchko M. Barriers and Facilitators to Cervical Cancer Screening in Western Kenya: a Qualitative Study. J Cancer Educ. 2022;37(4):1122-8. DOI: https://doi.org/10.1007/s13187-020-01928-6
Moses E, Wagner EC, Sekikubo M, Pedersen HN, Money DM, Ogilvie GS, et al. Understanding Men’s Perceptions of Human Papillomavirus and Cervical Cancer Screening in Kampala, Uganda. J Glob Oncol. 2018;4:00106. DOI: https://doi.org/10.1200/JGO.17.00106
Okedo-Alex IN, Uneke CJ, Uro-Chukwu HC Akamike IC, Chukwu OE. “it is what i tell her that she will do”: A mixed methods study of married men’s knowledge and attitude towards supporting their wives’ cervical cancer screening in rural south-east nigeria. Pan Afr Med J. 2020;36:156. DOI: https://doi.org/10.11604/pamj.2020.36.156.21157
Nyaaba JA, Akurugu E. Knowledge, barriers and uptake towards Cervical Cancer screening among female health workers in Ghana: A perspective of the Health Belief Model. Int J Africa Nurs Sci. 2023;19:100587. DOI: https://doi.org/10.1016/j.ijans.2023.100587
Usman IM, Chama N, Aigbogun EO, Kabanyoro A, Kasozi KI, Usman CO, et al. Knowledge, Attitude, and Practice Toward Cervical Cancer Screening Among Female University Students in Ishaka Western Uganda. Int J Womens Health. 2023;15:611-20. DOI: https://doi.org/10.2147/IJWH.S404845
de Fouw M, Stroeken Y, Niwagaba B, Musheshe M, Tusiime J, Sadayo I, et al. Involving men in cervical cancer prevention; a qualitative enquiry into male perspectives on screening and HPV vaccination in Mid-Western Uganda. PLoS One. 2023;18(1): e0280052. DOI: https://doi.org/10.1371/journal.pone.0280052
Shahid R, Shoker M, Chu LM, Frehlick R, Ward H Pahwa P. Impact of low health literacy on patients’ health outcomes: a multicenter cohort study. BMC Health Serv Res. 2022;22:1148. DOI: https://doi.org/10.1186/s12913-022-08527-9
Petersen Z, Jaca A, Ginindza TG, Maseko G, Takatshana S, Ndlovu P, et al. Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review. BMC Womens Health. 2022;22:486. DOI: https://doi.org/10.1186/s12905-022-02043-y
Wangechi GA, Macharia D. Factors Influencing Utilization of Cervical Cancer Screening Services in Kenya: The Case of Nyeri County. Int J Public Heal Sci. 2018;7(4):236-47. DOI: https://doi.org/10.11591/ijphs.v7i4.15013
Onyenwenyi AOC, McHunu GG. Barriers to cervical cancer screening uptake among rural women in South West Nigeria: A qualitative study. S Afr J Obstet Gynaecol. 2018;24(1):22. DOI: https://doi.org/10.7196/sajog.1290