The survey, conducted by Mount Kenya University (MKU) across different private health facilities, also found that cultural factors, such as women staying away from facilities where men carry out tests, are also at play in reducing testing instances.
“Lack of knowledge on the availability of cervical cancer screening methods results in delays in care and treatment,” said the study, adding that at personal level, women also expressed fear that the testing procedure could be painful and uncomfortable as well as being intrusive.
“Multidimensional cultural barriers exist in some communities resulting in poor care outcomes in maternal health.”
The study also found that most facilities do not have adequate manpower when it comes to offering cervical cancer screening services.
It showed that only 43 per cent of the facilities that participated in the study had at least two staff providing screening, with the majority of the hospitals having only one provider.
Around 68 per cent of facilities provided cervical cancer screening services, primarily Visual Inspection with acetic acid.
Dr Jesse Gitaka, team leader of research at MKU and principal investigator explained that the study was aimed at providing evidence on routine HPV testing in cervical cancer screening among women attending private healthcare facilities.
“Before you do something, you need to understand what has been happening. In what context are you going to roll out interventions, which is what informed the need to do a survey,” he said.
“Treatment can only follow diagnosis. If you diagnose and do not offer treatment, it will discourage others not take up testing because they saw a neighbour or someone they know get tested but not treated. The two, diagnosis and treatment, go hand in hand.”
Dr Gitaka spoke during a forum to disseminate the findings of the study.
The symposium, which was held at Serena Hotel was attended by Dr. David Murage, program manager National Cancer Control Program in the Ministry of Health, who noted the importance of research while urging Kenyans to take testing seriously to be able to diagnose cancer cases early and successfully manage them.
HPV is the primary cause of 95 per cent of all cervical cancers and is sexually transmitted. Infection with one or more of the 15 high-risk oncogenic types usually results in invasive cervical cancer after 10-20 years, according to the Ministry of Health.
Failure to address cervical cancer prevention and control will continuously propagate gender inequalities and threaten women’s health.
Brian Lishenga, chairman Rural and urban Private Hospital Association (RUPHA), noted that working closely between public and private sectors could bridge the gap in cervical cancer testing.
“Kenya’s private sector contributes about 58 per cent (bed capacity) and 45 per cent (service provision), which is a critical part of the health jigsaw in Kenya,” he said.
“We think that we are in a unique place to help scale HPV screening because we have 451 member facilities across the country and represent about 20 per cent of all level four hospitals and 50 per cent of level five hospitals. In terms of scaling up and meeting the ambitious targets of this project.”
Prof Matilu Mwau of Kenya Medical Research Institute (Kemri) said there is a need to increase the number of testing areas as well as human resource capacity to cope with what he noted would be an increase in demand for testing services.
“Labs already exist that can serve the country now in terms of testing needs at this time but when you look a Kenya’s population, we are not talking about a small number of tests, so it is clear that in future, smaller labs need to come into play and even when you move a bit further into future, point of care tests will need to come into play including rapid diagnostic tests,” he said.
“There is also a need to continue to think about the human resource both in terms of number and skills mix… the people who test, those collecting samples, give information or those who treat."
Martha Mburu a nurse at Thika Level 5 in Kiambu County said in screening cervical cancer, the practice has been to offer services to patients who are already admitted to hospitals, for instance, women seeking maternal health services.
She noted that to address this gap, Thika Level 5 Hospital started a new unit that does screening for cancer as well as follows up with patients and has an outreach programme.
“We noted that there was a gap among women being screened and to address this, we started another clinic where we are screening all women, even the hard-to-reach women,” she said.
“We started screening pap smear and it is as cheap as Sh700 and turnaround is about three weeks. Since February this year, we have screened 700 women for cervical cancer and we can follow up with treatment.”
She added that women are more inclined to buy into testing when health practitioners go out and speak to them at their homes or areas of business.
“When we go to women in their familiar areas, they come for screening unlike in the hospital. We should also involve men in cervical cancer screening,” said Mburu.
