Table 2.
Determinants of access and utilization of cervical cancer treatment and care from healthy women and patient surveys
| Participant type | aHealthy women with perceptions of access to treatment if diagnosed of cervical cancer (n = 70) | Cervical cancer patients treated (n = 92) [N = 134] | ||
|---|---|---|---|---|
| Variables | OR, (95% CI) | p value | OR, (95% CI) | p value |
| Individual factorsb | ||||
| Knowledge of prevention | 0.34 (0.06 to 1.88) | 0.218 | 2.50 (0.53 to 11.97) | 0.248 |
| Knowledge of causes | 6.18 (1.03 to 37.14) | 0.046 | 0.13 (0.02 to 0.68) | 0.016 |
| Perception of availability of treatment services | 1.08 (0.36 to 3.23) | 0.889 | 1.89 (0.65 to 5.54) | 0.244 |
| Affordability of treatment services | 0.50 (0.17 to 1.43) | 0.197 | 1.57 (0.45 to 5.59) | 0.480 |
| Locus of control regarding cervical cancer | 0.97 (0.39 to 2.42) | 0.949 | 2.90 (1.30 to 6.45) | 0.009 |
| Perception of threats from cervical cancer | 1.42 (0.61 to 3.28) | 0.412 | 0.49 (0.15 to 1.57) | 0.229 |
| Perception on medical tourism | 2.25 (0.95 to 5.34) | 0.064 | 0.91 (0.42 to 1.97) | 0.819 |
| Usage of health services in last 6 months | 1.74 (0.55 to 5.45) | 0.344 | – | – |
| Societal factorsb | ||||
| Perception of availability of prevention technologies (HPV vaccination and screening) | 0.82 (0.45 to 1.50) | 0.521 | 0.91 (0.42 to 1.97) | 0.777 |
| Perceptions of availability of equipment | 0.97 (0.36 to 2.58) | 0.946 | 0.51 (0.21 to 1.22) | 0.129 |
| Social support | 0.54 (0.18 to 1.68) | 0.291 | 0.28 (0.07 to 1.15) | 0.078 |
| Beliefs | 0.19 (0.02 to 1.77) | 0.145 | 0.70 (0.07 to 6.76) | 0.758 |
| Attitudes | 1.53 (0.37 to 6.25) | 0.555 | 0.24 (0.03 to 1.83) | 0.168 |
| Health system factorsb | ||||
| Perception of training of Health Professionals | 2.19 (0.73 to 6.60) | 0.162 | 0.88 (0.08 to 9.32) | 0.912 |
| Perceptions of adequacy of specialists | 10.77 (3.10 to 37.32) | < 0.001 | 7.32 (1.53 to 35.06) | 0.013 |
| Quality of care | – | – | 0.19 (0.03 to 1.45) | 0.110 |
| Satisfaction | – | – | 27.15 (1.61 to 458.85) | 0.022 |
| Accessibility of health facilitiesc | ||||
| Distance from nearest health facility | ||||
| Less than 10 km | 1.46 (0.13 to 16.64) | 1.24 (0.29 to 5.26) | 0.775 | |
| 21 to 40 km | Ref | Ref | – | |
| Mode of transport to nearest health facility | ||||
| Walking | 0.08 (0.03 to 0.24) | 0.759 | 0.21 (0.03 to 1.80) | 0.155 |
| Public transport | 0.75 (0.13 to 4.51) | – | 0.21 (0.02 to 1.93) | 0.169 |
| Private car | Ref | Ref | – | |
| Time to travel to nearest health facility | < 0.001 | |||
| 30 or less minutes | 0.87 (0.31 to 2.43) | 0.015 | 1.50 (0.29 to 7.70) | 0.624 |
| 31 to 60 min | – | – | 0.83 (0.12 to 5.63) | 0.848 |
| 90 or more minutes | Ref | 0.794 | Ref | – |
| - | ||||
aFor healthy women, proxy indicator of access to treatment was used based on their perceptions of whether they would access treatment services for cervical cancer if diagnosed. bModel 1 controlled for disease stage for patients and religion and ethnicity for healthy women, c Model 2 controlled for financial barriers for patients and religion and ethnicity for healthy women. Bold shows factors that are significant (p < 0.05)